Jian Sun1, Huatang Zhang2, Zhiwei Song3, Lei Jin4, Jian Yang1, Jun Gu4, Dan Ye5, Xueping Yu6, Jianghua Yang7. 1. Department of Infectious Diseases, the First Affiliated Hospital of Wannan Medical College, Wuhu 241000, China. 2. Department of Infectious Diseases, the First Hospital of Quanzhou, Fujian Medical University, Quanzhou 362000, China. 3. Department of Laboratory Medicine, Taizhou Municipal Hospital, Taizhou 318000, China. 4. Department of Gastroenterology, the Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China. 5. Department of Infectious Diseases, Taizhou Municipal Hospital, Taizhou 318000, China. 6. Department of Infectious Diseases, the First Hospital of Quanzhou, Fujian Medical University, Quanzhou 362000, China. Electronic address: xuepingyu163@163.com. 7. Department of Infectious Diseases, the First Affiliated Hospital of Wannan Medical College, Wuhu 241000, China. Electronic address: yjhpathway@163.com.
Abstract
BACKGROUND: Our study aimed to evaluate the correlation between the sensitivity of adenosine deaminase (ADA) testing for the diagnosis of tuberculous peritonitis (TBP) and patient age or cirrhosis status. METHODS: Clinical data for patients clinically diagnosed with TPB (n = 132) or not (n = 147) were assessed. ADA activity was compared among three age groups (< 45 yr, 45-60 yr, and ≥ 60 yr) and among cirrhosis-related subgroups. Cut-off values for the ADA test were analyzed among three patient populations (young non-cirrhotic, n = 97; older non-cirrhotic, n = 115; cirrhotic, n = 67), and validated in a cohort of 259 participants. RESULTS: According to the multivariate regression analyses, age < 45 yr is highly predictive of TBP risk. The young non-cirrhotic TBP patients had higher ADA activity than the middle-aged or old controls (p < 0.01). Significantly decreased activity and efficacy of ADA were observed in the cirrhotic subgroup/population, regardless of age or cohort. For the above-mentioned two non-cirrhotic populations in the validation cohort, the ADA test showed excellent performance using thresholds of 30.5 IU/L and 20.5 IU/L, with respective sensitivities of 91.1% and 92.6%. CONCLUSIONS: ADA activity is negatively associated with increasing age and underlying cirrhosis. Optimizing cut-off values for the ADA test can increase its sensitivity in non-cirrhotic individuals older than 45 years.
BACKGROUND: Our study aimed to evaluate the correlation between the sensitivity of adenosine deaminase (ADA) testing for the diagnosis of tuberculous peritonitis (TBP) and patient age or cirrhosis status. METHODS: Clinical data for patients clinically diagnosed with TPB (n = 132) or not (n = 147) were assessed. ADA activity was compared among three age groups (< 45 yr, 45-60 yr, and ≥ 60 yr) and among cirrhosis-related subgroups. Cut-off values for the ADA test were analyzed among three patient populations (young non-cirrhotic, n = 97; older non-cirrhotic, n = 115; cirrhotic, n = 67), and validated in a cohort of 259 participants. RESULTS: According to the multivariate regression analyses, age < 45 yr is highly predictive of TBP risk. The young non-cirrhotic TBP patients had higher ADA activity than the middle-aged or old controls (p < 0.01). Significantly decreased activity and efficacy of ADA were observed in the cirrhotic subgroup/population, regardless of age or cohort. For the above-mentioned two non-cirrhotic populations in the validation cohort, the ADA test showed excellent performance using thresholds of 30.5 IU/L and 20.5 IU/L, with respective sensitivities of 91.1% and 92.6%. CONCLUSIONS: ADA activity is negatively associated with increasing age and underlying cirrhosis. Optimizing cut-off values for the ADA test can increase its sensitivity in non-cirrhotic individuals older than 45 years.
Authors: Ruixi Zhou; Xia Qiu; Junjie Ying; Yan Yue; Tiechao Ruan; Luting Yu; Qian Liu; Xuemei Sun; Shaopu Wang; Yi Qu; Xihong Li; Dezhi Mu Journal: Front Public Health Date: 2022-09-21