Dual Validation Analysis of Serum CYP3A4 in Predicting NEC in Preterm Infants.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE

SHOCK Pub Date : 2025-04-04 DOI:10.1097/SHK.0000000000002590

Xue Liu, Wenqiang Sun, Xiayun Sheng, Jingtao Bian, Yihui Li, Xueping Zhu

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引用次数: 0

Abstract

Objective: Necrotizing enterocolitis (NEC) is a life-threatening condition in premature infants, where timely diagnosis and intervention are crucial. This study investigated the potential of serum CYP3A4 as an early predictive biomarker for NEC and developed a predictive model incorporating CYP3A4.

Methods: Bioinformatics analyses were performed to assess the association between CYP3A4 and NEC. Serum samples were collected from preterm infants with a gestational age of less than 32 weeks, born between January 2023 and December 2024. The cohort included 34 infants with NEC and 34 without NEC. Serum CYP3A4 levels were measured using ELISA, and clinical characteristics of NEC infants were analyzed using machine learning to identify predictive factors. A multivariate logistic regression model was constructed and evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).

Results: Serum CYP3A4 levels were significantly higher in NEC infants and were positively associated with disease severity (P < 0.05). CYP3A4 demonstrated positive correlations with inflammatory markers, including C-reactive protein (CRP) and the neutrophil-to-lymphocyte ratio (NLR), indicating its potential role in the inflammatory cascade and intestinal barrier disruption. In the predictive model, CYP3A4 emerged as a key variable, achieving an area under the ROC curve (AUC) of 0.877, reflecting strong predictive accuracy. Calibration plots and DCA confirmed the model's reliability and clinical utility.

Conclusion: Serum CYP3A4 is a promising biomarker for the early diagnosis of NEC, and the prediction model demonstrates robust performance. Future multicenter studies are warranted to validate its consistency and elucidate the underlying mechanisms.

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血清CYP3A4预测早产儿NEC的双重验证分析。

目的：坏死性小肠结肠炎（NEC）是危及早产儿生命的疾病，及时诊断和干预至关重要。本研究探讨了血清CYP3A4作为NEC早期预测生物标志物的潜力，并建立了一个包含CYP3A4的预测模型。方法：采用生物信息学方法分析CYP3A4与NEC的相关性。血清样本采集于2023年1月至2024年12月期间出生的胎龄小于32周的早产儿。该队列包括34名NEC患儿和34名非NEC患儿。采用ELISA检测血清CYP3A4水平，并利用机器学习分析NEC患儿的临床特征，以确定预测因素。建立多元logistic回归模型，并采用受试者工作特征（ROC）曲线、校正图和决策曲线分析（DCA）对模型进行评价。结果：NEC患儿血清CYP3A4水平显著升高，且与疾病严重程度呈正相关（P < 0.05）。CYP3A4与炎症标志物，包括c反应蛋白（CRP）和中性粒细胞与淋巴细胞比率（NLR）呈正相关，表明其在炎症级联和肠屏障破坏中的潜在作用。在预测模型中，CYP3A4作为关键变量出现，其ROC曲线下面积（area under ROC curve， AUC）为0.877，具有较强的预测准确性。校正图和DCA验证了模型的可靠性和临床实用性。结论：血清CYP3A4是一种有前景的NEC早期诊断生物标志物，该预测模型具有良好的性能。未来的多中心研究有必要验证其一致性并阐明其潜在机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

SHOCK 医学-外科

CiteScore

6.20

自引率

3.20%

发文量

199

审稿时长

1 months

期刊介绍： SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.