Tan Li1, Jing-Jing Jing2, Li-Ping Sun2, Yue-Hua Gong2, Nan-Nan Dong2, Jun Yang3, Yuan Yuan4. 1. Tumor Etiology and Screening Department of Cancer Institute and General Surgery, Liaoning Provincial Education Department, The First Hospital of China Medical University, Key Laboratory of Cancer Etiology and Prevention, China Medical University, Shenyang 110001, China; Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang 110001, China. 2. Tumor Etiology and Screening Department of Cancer Institute and General Surgery, Liaoning Provincial Education Department, The First Hospital of China Medical University, Key Laboratory of Cancer Etiology and Prevention, China Medical University, Shenyang 110001, China. 3. Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang 110001, China. 4. Tumor Etiology and Screening Department of Cancer Institute and General Surgery, Liaoning Provincial Education Department, The First Hospital of China Medical University, Key Laboratory of Cancer Etiology and Prevention, China Medical University, Shenyang 110001, China. Electronic address: yuanyuan@cmu.edu.cn.
Abstract
BACKGROUND: Immune inflammation appears to play a role in aortic aneurysm (AA) pathology. Toll-like receptor 4 (TLR4) has been proved to involve in immune inflammatory diseases. However, the relationship between serum TLR4 and AA is still unclear. METHODS: The study included 282 AA patients and 287 controls. The clinical test related information was collected in medical records. The levels of serum TLR4 were measured by enzyme-linked immunosorbent assay. RESULTS: Serum TLR4 levels were significantly higher in case groups and could be influenced by age, smoking, hypertension, diabetes and hyperlipidemia. Serum TLR4 was positively correlated with circulating CRP, Hcy, D-dimer, Fg and Cys-c in AA patients, even after adjusting the possible influencing factors. The optimal cut-off value of TLR4 was 13.64 ng/ml for discriminating AA, and the screening accuracy was higher for those who were males (sensitivity of 63.5% and specificity of 68.6%), smokers (sensitivity of 63.5% and specificity of 82.7%) and hyperlipidemia (sensitivity of 59.1% and specificity of 81.2%). Multiple logistic analyses showed that serum TLR4 was significantly correlated with AA risk (OR = 1.119, 95% CI = 1.077-1.162, p < 0.001) and subjects with high TLR4 levels (>13.64 ng/ml) were more likely to have AA (OR = 4.225, 95% CI = 2.477-7.206, p < 0.001). CONCLUSIONS: Serum TLR4 was closely related to AA and associated with some AA-related circulating markers. Serum TLR4 could be a novel and promising biomarker with important diagnostic and predictive value in the identification of aortic aneurysmal diseases.
BACKGROUND: Immune inflammation appears to play a role in aortic aneurysm (AA) pathology. Toll-like receptor 4 (TLR4) has been proved to involve in immune inflammatory diseases. However, the relationship between serum TLR4 and AA is still unclear. METHODS: The study included 282 AA patients and 287 controls. The clinical test related information was collected in medical records. The levels of serum TLR4 were measured by enzyme-linked immunosorbent assay. RESULTS: Serum TLR4 levels were significantly higher in case groups and could be influenced by age, smoking, hypertension, diabetes and hyperlipidemia. Serum TLR4 was positively correlated with circulating CRP, Hcy, D-dimer, Fg and Cys-c in AA patients, even after adjusting the possible influencing factors. The optimal cut-off value of TLR4 was 13.64 ng/ml for discriminating AA, and the screening accuracy was higher for those who were males (sensitivity of 63.5% and specificity of 68.6%), smokers (sensitivity of 63.5% and specificity of 82.7%) and hyperlipidemia (sensitivity of 59.1% and specificity of 81.2%). Multiple logistic analyses showed that serum TLR4 was significantly correlated with AA risk (OR = 1.119, 95% CI = 1.077-1.162, p < 0.001) and subjects with high TLR4 levels (>13.64 ng/ml) were more likely to have AA (OR = 4.225, 95% CI = 2.477-7.206, p < 0.001). CONCLUSIONS: Serum TLR4 was closely related to AA and associated with some AA-related circulating markers. Serum TLR4 could be a novel and promising biomarker with important diagnostic and predictive value in the identification of aortic aneurysmal diseases.