Proteomic signatures to detect unilateral primary aldosteronism in hypertensive patients.

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Cheng-Hsuan Tsai, Po-Hsin Kong, Chen-Chan Hsieh, Yen-Chun Huang, Hao-Min Cheng, Chi-Sheng Hung, Chin-Chen Chang, Jeff S Chueh, Anand Vaidya, Vin-Cent Wu, Chen-Chung Liao, Yen-Hung Lin
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Abstract

Context: Primary aldosteronism (PA) is a major cause of hypertension and cardiovascular disease; however, diagnosing PA remains challenging.

Objective: We investigated whether deep proteomic analyses could be used to diagnose unilateral PA in hypertensive patients.

Methods: We enrolled 52 patients with unilateral PA and 46 with essential hypertension (EH) and divided them into training and validation cohorts. Plasma samples were collected at baseline from all patients and again from PA patients after adrenalectomy. Deep proteomic analysis was performed to identify peptide signatures used to develop a classification model distinguishing PA from EH in the training cohort. The classification model was subsequently tested in the validation cohort and post-adrenalectomy PA patients.

Results: After proteomic analysis, six peptide features including HBB, FIBA, Complement CO7, ALBU, C4BPA, and A2AP were selected to generate risk scores and develop a classification model for distinguishing unilateral PA from EH. Risk scores were significantly higher in PA patients compared to those with EH. The classification model had a sensitivity and specificity of 80.5% and 83.3%, respectively, for diagnosing unilateral PA in the training cohort, and 81.8% and 80.0% in the validation cohort. The model demonstrated strong performance with an area under the curve of .92 for distinguishing hypertensive patients with or without PA. Post-unilateral adrenalectomy, the risk scores showed a significant decrease.

Conclusions: Proteomic analysis can identify peptide signatures that effectively distinguish unilateral PA from EH. These findings underscore the potential utility of proteomics as an adjunct diagnostic and monitoring tool in the clinical management of PA.

检测高血压患者单侧原发性醛固酮增多症的蛋白质组学特征。
背景:原发性醛固酮增多症(PA)是高血压和心血管疾病的主要原因;然而,诊断PA仍然具有挑战性。目的:探讨深层蛋白质组学分析在高血压患者单侧PA诊断中的应用价值。方法:我们招募了52例单侧PA患者和46例原发性高血压(EH)患者,并将其分为训练组和验证组。在基线时收集所有患者的血浆样本,并在肾上腺切除术后再次收集PA患者的血浆样本。进行深度蛋白质组学分析以识别肽特征,用于开发区分训练队列中PA和EH的分类模型。该分类模型随后在验证队列和肾上腺切除术后的PA患者中进行了检验。结果:通过蛋白质组学分析,选取HBB、FIBA、补体CO7、ALBU、C4BPA、A2AP 6个肽特征进行风险评分,建立单侧PA与EH的分类模型。PA患者的风险评分明显高于EH患者。该分类模型在训练组诊断单侧PA的敏感性和特异性分别为80.5%和83.3%,在验证组诊断单侧PA的敏感性和特异性分别为81.8%和80.0%。该模型在区分高血压患者有无PA的曲线下面积为0.92,表现出较强的性能。单侧肾上腺切除术后,风险评分显著降低。结论:蛋白质组学分析可以识别肽特征,有效区分单侧PA和EH。这些发现强调了蛋白质组学作为PA临床管理辅助诊断和监测工具的潜在效用。
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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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