Relationships of serum Sestrin2 and Fetuin-A levels with disease outcome in patients with severe pulmonary tuberculosis

Objective To explore the relationships of serum Sestrin2 and Fetuin-A with disease outcome in patients with severe pulmonary tuberculosis.

Methods A total of 108 patients with severe pulmonary tuberculosis admitted to our hospital from December 2020 to December 2022 were selected as study objects. Serum Sestrin2 and Fetuin-A levels were determined by enzyme-linked immunosorbent assay. According to 30 d disease outcomes, the patients in the study group were divided into death-disease group (22 cases) and survival group (86 cases). Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze the predictive value of serum Sestrin2 and Fetuin-A levels in patients with severe pulmonary tuberculosis. The influencing factors of prognosis in patients with severe pulmonary tuberculosis were explored by multivariate Logistic regression.

Results The serum Fetuin-A level in the survival group was higher than that in the death group, and the serum Sestrin2 level was lower than that in the death group (P < 0.05). The AUC (95%CI) of serum Sestrin2 and Fetuin-A were 0.752 (0.712 to 0.797) and 0.887 (0.842 to 0.937), respectively, with truncation values of 12.39 ng/mL and 350.67 μg/mL, the specificity of 55.64% and 65.57%, and the sensitivity of 92.73% and 92.73%. The AUC of the combined diagnosis was 0.920 (0.875 to 0.970), the specificity was 86.06%, and the sensitivity was 88.21%. The proportion of diabetes history in the death group was higher than that in the survival group, and peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF), forced expiratory volume in the first second (FEV₁) and left ventricular ejection fraction (LVEF) were lower than those in the survival group(P < 0.05). Multiple Logistic regression analysis showed that LVEF≤50.00% (OR=3.777, 95%CI, 1.393 to 10.243), Fetuin-A < 350.67 μg/mL (OR=3.031, 95%CI, 1.943 to 4.730), Sestrin2≥12.39 ng/L (OR=5.709, 95%CI, 1.933 to 16.355) were the risk factors of the outcome of severe pulmonary tuberculosis(P < 0.05).

Conclusion Serum Sestrin2 and Fetuin-A levels are closely related to the outcome of patients with severe pulmonary tuberculosis, and can be used as biological indicators to evaluate the outcome of severe pulmonary tuberculosis. The combined prediction has higher accuracy.