Expression and significance of serum insulin-like growth factor binding protein-7 and silencing information regulator 4 in patients with acute heart failure

Objective To investigate the expression levels of serum insulin-like growth factor binding protein-7 (IGFBP-7) and silence-information regulatory factor 4 (SIRT4) in patients with acute heart failure (AHF) and their prognostic value.

Methods A total of 151 patients with AHF (AHF group) and 151 healthy subjects (control group) were enrolled. Serum IGFBP-7, SIRT4, N-terminal natriuretic peptide precursors (NT-proBNP) and reactive oxygen species (ROS) were detected in the two groups. The relationships of serum levels of IGFBP-7, SIRT4, NT-proBNP, ROS with clinical grade were analyzed. Pearson correlation coefficient was used to analyze the correlations of IGFBP-7 and SIRT4 with NT-proBNP and ROS. Multivariate Logistic regression analysis was used to analyze the prognostic factors of AHF patients, and the Receiver operating characteristic (ROC) curve was drawn to analyze the predictive efficacy of serum IGFBP-7 and SIRT4 on poor prognosis of AHF patients.

Results Compared with the control group, the expression levels of IGFBP-7, SIRT4, NT-proBNP and ROS in serum of the AHF group were significantly increased (P < 0.05). The expression levels of IGFBP-7, SIRT4, NT-proBNP and ROS in the serum of patients with clinical disease grade Ⅳ were higher than that in grade Ⅲ and grade Ⅱ, and those with grade Ⅲ was significantly higher than that of grade Ⅱ (P < 0.05). The expression levels of IGFBP-7, SIRT4, NT-proBNP and ROS and severity grading in patients with poor prognosis in the AHF group were significantly higher than those in patients with good prognosis (P < 0.05). The expression levels of IGFBP-7 and SIRT4 in serum were positively correlated with the levels of NT-proBNP and ROS (r=0.523, 0.498, 0.578, 0.557, P < 0.05). Multifactor Logistic regression analysis showed that clinical grade, serum expression levels of IGFBP-7, SIRT4, NT-proBNP and ROS were independent influencing factors for prognosis of AHF (P < 0.05). ROC curve analysis showed that serum IGFBP-7 and SIRT4 had a certain predictive value for prognosis in AHF patients, with AUC of 0.794 and 0.795, and the combined detection of IGFBP-7 and SIRT4 had a higher predictive value (AUC was 0.909, 95%CI, 0.858 to 0.959).

Conclusion Serum IGFBP-7 and SIRT4 are highly expressed in patients with AHF, and their expression levels are correlated with clinical grade and prognosis, and the combined detection of the two indicators is of high reference value for evaluating the prognosis of patients.