ABSTRACT
Objective:To investigate the difference of metabolomics between acute heart failure (AHF) patients and control. To find and validate new metabolic biomarkers.Methods:This was a single-center case-control study which included 89 acute heart failure patients admitted to the emergency department of Henan Provincial People's Hospital from January 2018 to June 2019. Eighty people without heart failure and diastolic dysfunction were enrolled as control group whose age and sex were matched to the study group. The fasting blood samples were collected from femoral arterial. Qualitative and quantitative analyses of plasma metabolites were performed in 2 groups by high performance liquid chromatography tandem mass spectrometry (UHPLC-MS), Orthogonal partial least squares-discriminant analysis (OPLS-DA) model and ROC curve method were applied.Results:Compared with the control group, we found that AHF group had higher likelihood to groups with coronary heart disease (37% vs. 7%, P<0.001), hypertension (58% vs. 28%, P<0.001), diabetes (33% vs. 18%, P=0.033), atrial fibrillation (24% vs. 4%, P<0.001), smoking history (42% vs. 18%, P=0.001), and that AHF group had higher creatinine level [(121.6 ± 78.4) vs. (69.0 ± 21.0), P<0.001], higher urea level [(11.5 ± 7.6) vs. (6.2 ± 2.0), P<0.001], higher heart rate [(92 ± 23) vs. (78 ± 14), P<0.001], hypoproteinemia [(32.4 ± 5 .2) vs. (40.4 ± 2.2), P<0.001], and significantly increased BNP level [(4 200 ± 5 229) vs. (100 ± 68), P<0.001], lower left ventricular ejection fraction[(45 ± 8) vs. (57 ± 6), P<0.001], low serum sodium level ( P<0.001). The metabolites of AHF group were significantly different from those of the control group. The metabolites involved amino acids, fatty acids, lipids, nucleosides and their derivatives. Adenine, N-acetyl-L-glutamic, pseudouridine and Gamma-Glutamylcysteine had certain diagnostic value for AHF comparing to control. The AUC were 0.995, 0.932, 0.920 and 0.900. And the AUC value for BNP diagnosis of AHF is 0.978. Conclusions:There were significant differences in metabolism between AHF group and control group including multiple substances. Adenine, N-acetyl-L-glutamic, pseudouridine and Gamma-Glutamylcysteine has similar diagnostic value compared with BNP for diagnosing AHF.
ABSTRACT
Objective To assess the economic efficiency of glycated haemoglobin(HbA1C)determination in screening the undiagnosed diabetes among hospitalised patients. Methods Exclusive criteria were made based on the information of the electronic patient history,including age<18 years,hospitalization for diabetes treatment, and having received a transfusion within half a year. Pathology samples from participants were collected for blood routine analysis and HbA1C screening test. Screening the undiagnosed diabetes was based on the level of HbA1C. Results In this study ,1012 patients were enrolled ,78 patients with diabetes ,and 934 patients haven′t been diagnosed before. Among the 934 patients ,HbA1C level of 51 patients was over 6.5%(48 mmol/mol). These 51 patients (5.46%) were determined to have previously unknown diabetes. The prevalence of undiagnosed diabetes was 5.46% during the study period. The cost of HbA1C test was ￥1098 per new diagnosis of diabetes. Conclusions HbA1C is a simple ,inexpensive screening test for diabetes ,which can significantly improve the diagnostic efficiency,and the early detection of diabetes can slow the progression of complication and reduce the medical care expenditures.