tumor necrosis factor alpha

肿瘤坏死因子 α
  • 文章类型: Journal Article
    非酒精性脂肪性肝病(NAFLD)与骨代谢异常相关,肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)等促炎细胞因子水平升高可能介导。本研究旨在探讨肝组织对体外培养的成骨细胞和破骨细胞功能的直接调节作用。关注NAFLD的肝-骨轴。12周龄的C57BL/6小鼠饲喂对照饮食或高脂肪饮食(HFD)12周。使用microCT评估骨结构参数。从对照和HFD喂养的C57BL/6小鼠建立原代肝细胞培养物,以及IL-6-/-和TNF-α-/-小鼠。来自这些肝细胞培养物的上清液用于在体外诱导骨髓细胞来源的成骨细胞和破骨细胞的分化。结果显示,HFD小鼠肝脏和骨髓组织中的脂质浸润增加,同时骨量减少。此外,来自HFD小鼠肝细胞培养物的上清液显示升高的TNF-α和IL-6水平。这些上清液,特别是那些来自HFD喂养和IL-6-/-小鼠,在体外显著增强破骨细胞分化。相比之下,TNF-α-/-小鼠的上清液在体外对成骨细胞和破骨细胞的分化没有显著影响。在结论中,本研究提示脂肪肝组织可能对骨代谢产生负面影响。此外,TNF-α和IL-6基因的敲除揭示了对成骨细胞和破骨细胞功能的不同影响,突出了活体病理学和骨骼健康之间复杂的相互作用。
    Non-alcoholic fatty liver disease (NAFLD) is associated with abnormal bone metabolism, potentially mediated by elevated levels of proinflammatory cytokines such as tumor necrosis factor alpha (TNF-ɑ) and interleukin 6 (IL-6). This study aims to investigate the direct regulatory effects of liver tissues on osteoblast and osteoclast functions in vitro, focusing on the liver-bone axis in NAFLD. Twelve-week-old C57BL/6 mice were fed either a control diet or a high-fat diet (HFD) for 12 weeks. Bone structural parameters were assessed using microCT. Primary hepatocyte cultures were established from control and HFD-fed C57BL/6 mice, as well as IL-6-/- and TNF-α-/- mice. The supernatants from these hepatocyte cultures were used to induce differentiation in bone marrow cell-derived osteoblasts and osteoclasts in vitro. Results showed that mice on a HFD exhibited increased lipid infiltration in liver and bone marrow tissues, alongside reduced bone mass. Moreover, the supernatants from hepatocyte cultures from mice on a HFD displayed elevated TNF-α and IL-6 levels. These supernatants, particularly those derived from HFD-fed and IL-6-/- mice, significantly enhanced osteoclast differentiation in vitro. In contrast, supernatants from TNF-α-/- mice did not significantly affect osteoblast or osteoclast differentiation in vitro. In conclusions, this current study suggested that fatty liver tissues may negatively impact bone metabolism. Additionally, knockout of TNF-α and IL-6 genes revealed distinct influence on osteoblast and osteoclast functions, highlighting the complex interplay between live pathology and bone health.
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  • 文章类型: Journal Article
    急性皮肤红斑狼疮(ACLE)与系统性红斑狼疮(SLE)的全身症状密切相关。这项研究旨在确定ACLE的潜在生物标志物,并探索它们与SLE的关联,以便能够早期预测ACLE并确定未来的潜在治疗目标。总的来说,纳入185例诊断为SLE的患者,分为两组:ACLE患者和无皮肤受累患者。在对差异因素进行Logistic回归分析后,我们得出结论,肿瘤坏死因子-α(TNF-α)是ACLE的独立危险因素。对接收器工作特性的分析显示,TNF-α的曲线下面积为0.716。此外,TNF-α和ACLE均与疾病活动度呈正相关。TNF-α有望作为ACLE的生物标志物,在SLE患者中,ACLE可以作为中度至重度疾病活动的明确指标。
    Acute cutaneous lupus erythematosus (ACLE) is closely associated with systemic symptoms in systemic lupus erythematosus (SLE). This study aimed to identify potential biomarkers for ACLE and explore their association with SLE to enable early prediction of ACLE and identify potential treatment targets for the future. In total, 185 SLE-diagnosed patients were enrolled and categorized into two groups: those with ACLE and those without cutaneous involvement. After conducting logistic regression analysis of the differentiating factors, we concluded that tumor necrosis factor-alpha (TNF-α) is an independent risk factor for ACLE. Analysis of the receiver operating characteristic revealed an area under the curve of 0.716 for TNF-α. Additionally, both TNF-α and ACLE are positively correlated with disease activity. TNF-α shows promise as a biomarker for ACLE, and in SLE patients, ACLE may serve as a clear indicator of moderate-to-severe disease activity.
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  • 文章类型: Journal Article
    强有力的证据表明,趋化因子(CC基序)配体2(CCL2)表达的上调和炎性肿瘤微环境的存在显着促进了口腔鳞状细胞癌的迁移和侵袭性。特别是口腔舌鳞状细胞癌(OTSCC)。然而,在OTSCC中,导致炎症介质肿瘤坏死因子α(TNF-α)导致CCL2表达增强的确切表观遗传机制仍未得到充分阐明.我们已经证明,CCL2的产生可以由TNF-α诱导,这种诱导是由染色质重塑蛋白BRG1介导的。通过使用染色质免疫沉淀(ChIP)测定,我们发现BRG1参与CCL2启动子处乙酰化组蛋白H3和H4的募集,从而激活TNF-α诱导的CCL2转录。此外,我们观察到,在OTSCC细胞中,在BRG1过表达后,NF-κBp65向CCL2启动子的募集增加,在BRG1敲低后减少。我们的Re-ChIP分析表明,BRG1敲低完全抑制了乙酰化组蛋白H3或H4和NF-κB向CCL2启动子的募集。总之,我们的研究结果表明,BRG1在介导OTSCC细胞响应TNF-α刺激产生CCL2中起重要作用。该过程涉及乙酰化组蛋白和NF-κB募集到CCL2启动子位点的协同作用。我们的数据表明,BRG1是调节OTSCC细胞中TNF-α诱导的CCL2转录的关键表观遗传介质。
    Strong evidence has indicated that upregulation of chemokine (CC motif) ligand-2 (CCL2) expression and the presence of an inflammatory tumor microenvironment significantly contribute to the migratory and invasive properties of oral squamous cell carcinoma, specifically oral tongue squamous cell carcinoma (OTSCC). However, the precise epigenetic mechanism responsible for enhanced CCL2 expression in response to the inflammatory mediator tumor necrosis factor alpha (TNF-α) in OTSCC remains inadequately elucidated. We have demonstrated that the production of CCL2 can be induced by TNF-α, and this induction is mediated by the chromatin remodel protein BRG1. Through the use of a chromatin immunoprecipitation (ChIP) assay, we have found that BRG1 was involved in the recruitment of acetylated histones H3 and H4 at the CCL2 promoter, thereby activating TNF-α-induced CCL2 transcription. Furthermore, we have observed that recruitment of NF-κB p65 to the CCL2 promoter was increased following BRG1 overexpression and decreased after BRG1 knockdown in OTSCC cells. Our Re-ChIP assay has shown that BRG1 knockdown completely inhibits the recruitment of both acetylated histone H3 or H4 and NF-κB to the CCL2 promoter. In summary, the findings of our study demonstrate that BRG1 plays a significant role in mediating the production of CCL2 in OTSCC cells in response to TNF-α stimulation. This process involves the cooperative action of acetylated histone and NF-κB recruitment to the CCL2 promoter site. Our data suggest that BRG1 serves as a critical epigenetic mediator in the regulation of TNF-α-induced CCL2 transcription in OTSCC cells.
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  • 文章类型: Journal Article
    肿瘤坏死因子α(TNFα),炎性细胞因子,诱导脂解并增加游离脂肪酸的循环浓度。此外,TNFα是肥胖中由脂肪组织产生的第一个脂肪因子,导致肥胖相关的代谢疾病。鉴于异硫氰酸苄酯(BITC)是一种众所周知的抗炎剂,我们假设BITC可以改善TNFα诱导的脂解,并研究了相关的工作机制。我们首先用TNFα攻击3T3-L1脂肪细胞诱导脂解,甘油释放增加证实了这一点,过氧化物酶体增殖物激活受体γ(PPARγ)和perilipin1(PLIN1)的蛋白表达降低,ERK的磷酸化增加,蛋白激酶A(PKA),激素敏感性脂肪酶(HSL)。然而,ERK或PKA的抑制显着减弱了TNFα的脂解活性。同时,用BITC预处理显着改善了TNFα的脂解活性;TNFα诱导的ERK磷酸化,PKA,和HSL;TNFα诱导的PPARγ泛素化;TNFα诱导的PPARγ核蛋白与PPAR反应元件结合的减少;以及TNFα诱导的PLIN1蛋白表达的减少。我们的结果表明,BITC通过抑制ERK/PKA/HSL信号通路改善TNFα诱导的脂解,防止PPARγ蛋白酶体降解,维持PLIN1蛋白表达。
    Tumor necrosis factor α (TNFα), an inflammatory cytokine, induces lipolysis and increases circulating concentrations of free fatty acids. In addition, TNFα is the first adipokine produced by adipose tissue in obesity, contributing to obesity-associated metabolic disease. Given that benzyl isothiocyanate (BITC) is a well-known anti-inflammatory agent, we hypothesized that BITC can ameliorate TNFα-induced lipolysis and investigated the working mechanisms involved. We first challenged 3T3-L1 adipocytes with TNFα to induce lipolysis, which was confirmed by increased glycerol release, decreased protein expression of peroxisome proliferator-activated receptor γ (PPARγ) and perilipin 1 (PLIN1), and increased phosphorylation of ERK, protein kinase A (PKA), and hormone-sensitive lipase (HSL). However, inhibition of ERK or PKA significantly attenuated the lipolytic activity of TNFα. Meanwhile, pretreatment with BITC significantly ameliorated the lipolytic activity of TNFα; the TNFα-induced phosphorylation of ERK, PKA, and HSL; the TNFα-induced ubiquitination of PPARγ; the TNFα-induced decrease in PPARγ nuclear protein binding to PPAR response element; and the TNFα-induced decrease in PLIN1 protein expression. Our results indicate that BITC ameliorates TNFα-induced lipolysis by inhibiting the ERK/PKA/HSL signaling pathway, preventing PPARγ proteasomal degradation, and maintaining PLIN1 protein expression.
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  • 文章类型: Review
    脑震荡性颅脑损伤(CHI)是军事人员晚年发展为帕金森病的主要危险因素之一,影响其终身功能和认知障碍。迄今为止,没有合适的疗法可用于减弱CHI或PD诱导的脑病理。因此,在提高美国退伍军人或服役人员的生活质量方面,非常有必要使用纳米医学进一步探索新型治疗药物.由于PD或CHI诱导氧化应激并扰乱与磷酸化tau(p-tau)沉积相关的神经营养因子调节,存在一种可能性,即纳米递送可增强神经营养因子平衡和减轻氧化应激的药物在本质上可能具有神经保护作用.在这次审查中,在模型实验中,在CHI后的PD中检查了脑活素的纳米递送-几种神经营养因子和活性肽片段的平衡组合物以及针对神经元一氧化氮合酶(nNOS)的单克隆抗体和p-tau抗体。我们的结果表明,nNOS和p-tau的纳米抗体与脑活素的联合施用可显着减弱CHI诱导的PD脑病理学恶化。这种联合治疗在CHI或PD单独治疗中也有有益效果。之前没有报道。
    Concussive head injury (CHI) is one of the major risk factors for developing Parkinson\'s disease in later life of military personnel affecting lifetime functional and cognitive disturbances. Till date no suitable therapies are available to attenuate CHI or PD induced brain pathology. Thus, further exploration of novel therapeutic agents are highly warranted using nanomedicine in enhancing the quality of life of veterans or service members of US military. Since PD or CHI induces oxidative stress and perturbs neurotrophic factors regulation associated with phosphorylated tau (p-tau) deposition, a possibility exists that nanodelivery of agents that could enhance neurotrophic factors balance and attenuate oxidative stress could be neuroprotective in nature. In this review, nanowired delivery of cerebrolysin-a balanced composition of several neurotrophic factors and active peptide fragments together with monoclonal antibodies to neuronal nitric oxide synthase (nNOS) with p-tau antibodies was examined in PD following CHI in model experiments. Our results suggest that combined administration of nanowired antibodies to nNOS and p-tau together with cerebrolysin significantly attenuated CHI induced exacerbation of PD brain pathology. This combined treatment also has beneficial effects in CHI or PD alone, not reported earlier.
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  • 文章类型: Journal Article
    这项荟萃分析调查了长期运动训练(ET)的效果,包括有氧运动,阻力,在涉及健康受试者的随机对照试验(RCT)中,多组分ET对炎症生物标志物水平的影响。
    我们搜索了七个数据库中的文章,直到5月1日,2023年。随机效应荟萃分析,亚组分析,使用STATA16.0进行荟萃回归以及修剪和填充方法。
    38项研究纳入荟萃分析,涉及2,557名健康受试者(平均年龄从21岁到86岁不等)。长期内皮素诱导的白细胞介素-6(IL-6)水平显着降低(SMD-0.16,95%CI-0.30至-0.03,p=0.017),C反应蛋白(CRP)(SMD-0.18,95%CI-0.31至-0.06,p=0.005),以及肿瘤坏死因子α(TNFα)(SMD-0.43,95%CI-0.62至-0.24,p<0.001)。亚组分析显示,长期ET进行超过12周,中等强度的运动具有更大的抗炎作用。Meta回归分析显示,长期内皮素诱导的CRP水平降低随着运动强度的增加而减弱。
    长期ET在健康受试者中诱导显著的抗炎作用。长期内皮素诱导的抗炎作用与中等强度运动和超过12周的训练有关。系统审查注册:https://www。crd.约克。AC.uk/PROSPERO/#myprospro,PROSPERO,标识符CRD42022346693。
    UNASSIGNED: This meta-analysis investigated the effect of long-term exercise training (ET) including aerobic, resistance, and multicomponent ET on the levels of inflammatory biomarkers in randomized controlled trials (RCTs) involving healthy subjects.
    UNASSIGNED: We searched seven databases for articles until May 1st, 2023. A random-effect meta-analysis, subgroup analysis, meta-regressions as well as trim and fill method were conducted using STATA 16.0.
    UNASSIGNED: Thirty-eight studies were included in the meta-analysis, involving 2,557 healthy subjects (mean age varies from 21 to 86 years). Long-term ET induced significantly decreased in the levels of interleukin-6 (IL-6) (SMD -0.16, 95% CI -0.30 to -0.03, p = 0.017), C-reactive protein (CRP) (SMD -0.18, 95% CI -0.31 to -0.06, p = 0.005), as well as tumor necrosis factor alpha (TNFα) (SMD -0.43, 95% CI -0.62 to -0.24, p < 0.001). Subgroup analysis revealed that Long-term ET conducted for more than 12 weeks and exercise of moderate intensity had greater anti-inflammatory effects. Meta-regression analysis showed that the reduction in CRP level induced by long-term ET was weakened by increasing exercise intensity.
    UNASSIGNED: Long-term ET induced significant anti-inflammatory effects in healthy subjects. Long-term ET-induced anti-inflammatory effects were associated with exercise of moderate intensity and training conducted for more than 12 weeks.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/# myprospero, PROSPERO, identifier CRD42022346693.
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  • 文章类型: Review
    在全球的作战行动中,军事人员经常暴露在二氧化硅粉尘中。在美国军事或服务人员中暴露于二氧化硅粉尘可能导致沙漠斯特罗姆肺炎,也称为AlEskan病,导致多个器官受损并导致自身免疫功能障碍。然而,尚未探讨吸入沙粒引起的脑损伤对创伤性脑或脊髓损伤的病理生理学的影响。先前的二氧化硅纳米颗粒(50-60nm大小)的中毒被证明会加剧脊髓损伤,从而导致血液脊髓屏障破坏。水肿形成和细胞变化。然而,二氧化硅纳米颗粒诱导脐带病理学的机制尚不清楚。众所周知,脊髓损伤会改变5-羟色胺(5-羟色胺)的代谢并诱导氧化应激,包括一氧化氮合酶和肿瘤坏死因子α的上调。这表明这些药物与脊髓损伤的病理生理学有关。在这次审查中,我们研究了联合纳米注射神经元型一氧化氮合酶(nNOS)单克隆抗体与肿瘤坏死因子α(TNF-α)抗体和强效抗氧化剂H-290/51在与二氧化硅纳米颗粒中毒相关的脊髓损伤中诱导神经保护的作用.我们的结果首次表明,nNOS和TNF-α的抗体与H-290/51共同施用可显着减弱二氧化硅纳米颗粒诱导的脊髓病理恶化,之前没有报道。
    Military personnel are often exposed to silica dust during combat operations across the globe. Exposure to silica dust in US military or service personnel could cause Desert Strom Pneumonitis also referred to as Al Eskan disease causing several organs damage and precipitate autoimmune dysfunction. However, the effects of microfine particles of sand inhalation-induced brain damage on the pathophysiology of traumatic brain or spinal cord injury are not explored. Previously intoxication of silica nanoparticles (50-60 nm size) is shown to exacerbates spinal cord injury induces blood-spinal cord barrier breakdown, edema formation and cellular changes. However, the mechanism of silica nanoparticles-induced cord pathology is still not well known. Spinal cord injury is well known to alter serotonin (5-hydroxytryptamine) metabolism and induce oxidative stress including upregulation of nitric oxide synthase and tumor necrosis factor alpha. This suggests that these agents are involved in the pathophysiology of spinal cord injury. In this review, we examined the effects of combined nanowired delivery of monoclonal antibodies to neuronal nitric oxide synthase (nNOS) together with tumor necrosis factor alpha (TNF-α) antibodies and a potent antioxidant H-290/51 to induce neuroprotection in spinal cord injury associated with silica nanoparticles intoxication. Our results for the first time show that co-administration of nanowired delivery of antibodies to nNOS and TNF-α with H-290/51 significantly attenuated silica nanoparticles-induced exacerbation of spinal cord pathology, not reported earlier.
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  • 文章类型: Journal Article
    蜱传脑炎病毒(TBEV)属于虫媒病毒,是人畜共患病原体的主要成员。TBEV感染导致严重的人脑炎,没有特异性抗病毒药物。由于其使用的抗病毒药物对广泛的病毒,我们研究了利巴韦林在易感人类细胞系A549和SH-SY5Y中对TBEV的抗病毒作用。利巴韦林对多种细胞系表现出轻微的细胞毒性。利巴韦林明显损害TBEV复制并保护感染细胞免受细胞病变作用。重要的是,利巴韦林显着抑制TBEV繁殖,如TBEV产生和病毒RNA复制受损所证明的。用利巴韦林治疗(共同治疗和后处理)导致TBEV滴度以及病毒RNA水平的剂量依赖性降低。抗病毒蛋白粘液病毒抗性在利巴韦林处理后,在TBEV感染的A549细胞中,mRNA表达显着上调,信号转导子和转录激活因子3被激活。利巴韦林治疗后,TBEV诱导的炎性细胞因子肿瘤坏死因子α在A549细胞中降低,而白细胞介素1β释放似乎未受影响。这些结果表明,利巴韦林可能是一种有前途的安全有效的抗TBEV抗病毒药物。
    Tick-borne encephalitis virus (TBEV) belonging to arboviruses is a major member of zoonotic pathogens. TBEV infection causes severe human encephalitis without specific antiviral drugs. Due to its use of antiviral drug against a wide range of viruses, we investigated antiviral effect of ribavirin against TBEV in susceptible human cell lines A549 and SH-SY5Y. Ribavirin displayed minor cytotoxicity on multiple cell lines. Ribavirin obviously impaired TBEV replication and protected the infected cells from cytopathic effect. Importantly, ribavirin markedly inhibited TBEV propagation, as evidenced by impairment of TBEV production and viral RNA replication. Treatment with ribavirin (co-treatment and post-treatment) led to a dose-dependent reduction in TBEV titers as well as the viral RNA levels. Antiviral protein myxovirus resistance A mRNA expression was significantly up-regulated and signal transducer and activator of transcription 3 was activated in TBEV-infected A549 cells upon the ribavirin treatment. Induction of inflammatory cytokine tumor necrosis factor alpha by TBEV was decreased in A549 cells with the treatment of ribavirin, whereas interleukin 1 beta release appeared to be unaffected. These results suggest that ribavirin might represent a promising safe and effective antiviral drug against TBEV.
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  • 文章类型: Journal Article
    手术期间皮肤/肌肉切开和缩回(SMIR)可导致慢性术后疼痛(CPSP)。潜在的机制仍不清楚。在本研究中,我们表明,大腿的SMIR诱导细胞外信号调节激酶(ERK)的磷酸化,其次是血清和糖皮质激素诱导激酶-1(SGK1)在脊髓背角激活。鞘内注射PD98059,一种ERK抑制剂,或GSK650394,一种SGK1抑制剂,显著减弱SMIR大鼠的机械性疼痛超敏反应。PD98059或GSK650394可显著降低脊髓肿瘤坏死因子α和乳酸水平。此外,PD98059下降了脊髓背角SGK1的激活。这些结果表明,脊髓背角中的ERK-SGK1活化以及促炎介质释放是CPSP的基础。
    Skin/muscle incision and retraction (SMIR) during surgeries can lead to chronic postsurgical pain (CPSP). The underlying mechanisms are still unclear. In the present study, we showed that SMIR of the thigh induced phosphorylation of extracellular signal-regulated kinase (ERK), followed by serum- and glucocorticoid-inducible kinase-1 (SGK1) activation in the spinal dorsal horn. Intrathecal injection of PD98059, an ERK inhibitor, or GSK650394, a SGK1 inhibitor, significantly attenuated mechanical pain hypersensitivity in SMIR rats. The level of tumor necrosis factor α and lactate in spinal cord was significantly decreased by PD98059 or GSK650394 injection. Furthermore, PD98059 decreased the activation of SGK1 in the spinal dorsal horn. These results indicate that ERK-SGK1 activation followed by proinflammatory mediator release in the spinal dorsal horn underlies CPSP.
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  • 文章类型: Journal Article
    目的:据报道,维生素D(VD)缺乏有助于克罗恩病(CD)的进展,并影响CD患者的预后。这项研究调查了血清VD的作用,体重指数(BMI),肿瘤坏死因子α(TNF-α)在克罗恩病诊断中的应用.
    方法:纳入2019年5月至2020年12月的CD患者(n=76)和健康受试者(n=76)。血清25-羟维生素D[25(OH)D]水平,BMI,和TNF-α水平,连同其他生化参数,在治疗前进行评估。单一和联合检测血清25(OH)D的诊断效能,BMI,使用受试者工作特征(ROC)曲线确定TNF-α。
    结果:25(OH)D,BMI,和营养指标,包括血红蛋白,总蛋白质,白蛋白,高密度脂蛋白胆固醇,要低得多,CD患者的TNF-α水平明显高于健康受试者(均P<0.05)。单次检测25(OH)D的ROC曲线下面积,BMI,和TNF-α分别为0.887、0.896和0.838,最佳截止值为20.64ng/mL,19.77kg/m2,6.85fmol/mL,分别。联合检测25(OH)D的诊断效能,BMI,TNF-α最高,ROC曲线下面积为0.988(95CI:0.968-1.000)。
    结论:25(OH)D的联合检测,TNF-α,BMI表现出很高的敏感性,特异性,和CD诊断的准确性;因此,在临床实践中对CD的诊断是有效的。
    OBJECTIVE: Vitamin D (VD) deficiency was reported to contribute to the progression of Crohn\'s disease (CD) and affect the prognosis of CD patients. This study investigated the role of serum VD, body mass index (BMI), and tumor necrosis factor alpha (TNF-α) in the diagnosis of Crohn\'s disease.
    METHODS: CD patients (n=76) and healthy subjects (n=76) were enrolled between May 2019 and December 2020. The serum 25-hydroxyvitamin D [25(OH)D] levels, BMI, and TNF-α levels, together with other biochemical parameters, were assessed before treatment. The diagnostic efficacy of the single and joint detection of serum 25(OH)D, BMI, and TNF-α was determined using receiver operating characteristic (ROC) curves.
    RESULTS: The levels of 25(OH) D, BMI, and nutritional indicators, including hemoglobin, total protein, albumin, and high-density lipoprotein cholesterol, were much lower, and the TNF-α levels were much higher in the CD patients than in the healthy subjects (P<0.05 for all). The areas under the ROC curve for the single detection of 25(OH)D, BMI, and TNF-α were 0.887, 0.896, and 0.838, respectively, with the optimal cutoff values being 20.64 ng/mL, 19.77 kg/m2, and 6.85 fmol/mL, respectively. The diagnostic efficacy of the joint detection of 25(OH)D, BMI, and TNF-α was the highest, with an area under the ROC curve of 0.988 (95%CI: 0.968-1.000).
    CONCLUSIONS: The joint detection of 25(OH)D, TNF-α, and BMI showed high sensitivity, specificity, and accuracy in CD diagnosis; thus, it would be effective for the diagnosis of CD in clinical practice.
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