Adenosine Deaminase is a Potential Molecular Marker for Diagnosis and Prognosis of Haemorrhagic Fever with Renal Syndrome

Figures & data

Table 1 Biochemical Characteristics of Study Subjects

Parameters	HFRS (Information on Admission)	Control Group	P value
N	124	131
Males N (%)	89 (71.8%)	89 (67.9%)	0.585
Age (Year)	49±14	51±14	0.096
ALT (U/L)	54 (31, 105)	20 (14, 36)	<0.001
AST (U/L)	82 (51, 105)	24 (34, 18)	<0.001
ALP (U/L)	74 (61, 95)	88 (68, 107)	<0.001
GGT (U/L)	41 (23, 75)	30 (16, 52)	0.004
TB (μmol/L)	9.7 (7.3, 13.0)	11.4 (8.1, 16.2)	0.024
DB (μmol/L)	4.0 (2.9, 6.1)	3.9 (2.9, 5.6)	0.650
IB (μmol/L)	5.5 (4.0, 7.0)	7.1 (4.9, 10.0)	<0.001
TP (g/L)	56 ± 6	67 ± 9	<0.001
ALB (g/L)	31 ± 4	40 ± 6	<0.001
TBA (μmol/L)	4.5 (2.9, 8.6)	3.5 (2.0, 6.3)	<0.001
CHE (KU/L)	5.6 ± 1.6	7.7 ± 2.5	<0.001
ADA (U/L)	25 (20, 30)	9 (7, 11)	<0.001
PA (mg/dL)	12.2 (9.4, 15.4)	24.0 (16.6, 29.2)	<0.001
Scr (μmol/L)	143 (94, 306)	75 (60, 90)	<0.001
BUN (mmol/L)	10.8 (5.4, 18.0)	5.1 (4.1, 6.5)	<0.001
UA (μmol/L)	389 (291, 566)	302 (223, 372)	<0.001
GLU (mmol/L)	5.8 (5.1, 6.7)	5.5 (4.8, 6.4)	0.073
TG (mmol/L)	2.51 (1.86, 3.32)	1.34 (0.91, 2.00)	<0.001
TC (mmol/L)	2.92 (2.59, 3.61)	4.25 (3.50, 5.09)	<0.001
HDL-C (mmol/L)	0.80 (0.67, 1.00)	1.20 (0.94, 1.46)	<0.001
LDL-C (mmol/L)	1.38 (1.13, 1.64)	2.13 (1.66, 2.76)	<0.001
APOA1 (g/L)	0.83 (0.74, 1.00)	1.36 (1.11, 1.66)	<0.001
APOB (g/L)	0.76 ± 0.22	0.93 ± 0.30	<0.001
LPa (mg/L)	114 (71, 169)	115 (62, 192)	0.982
CK (U/L)	86 (48, 174)	82 (53, 111)	0.494
LDH (U/L)	423 (332, 541)	178 (153, 211)	<0.001
WBC (10^9/L)	10.9 (7.6, 15.4)	6.9 (5.5, 9.7)	<0.001
RBC (10^12/L)	4.8 (4.4, 5.3)	4.5 (4.0, 5.0)	<0.001
HB (g/L)	144 (132, 157)	135 (117, 148)	<0.001
PLT (10^9/L)	56 (31, 89)	229 (178, 284)	<0.001

Abbreviations: ALT, Alanine aminotransferase; AST, Aspartate aminotransferase; ALP, Alkaline phosphatase; GGT, γ-glutamyl transpeptadase; TB, Total bilirubin; DB, Direct bilirubin; IB, Indirect bilirubin; TP, Total protein; ALB, Albumin; TBA, Total biliary acid; CHE, Cholinesterase; ADA, Adenosine deaminase; PA, Prealbumin; Scr, Serum creatinine; BUN, Blood urea nitrogen; UA, Uric acid; GLU, Glucose; TG, Triglyceride; TC, Total cholesterol; HDL-C, High density lipoprotein cholesterol; LDL-C, Low density lipoprotein cholesterol; APOA1, Apolipoprotein A1; APOB, Apolipoprotein B; LPa, Lipoprotein a; CK, Creatine kinase; LDH, Lactate dehydrogenase; WBC, White blood cell count; RBC, Red blood cell count; HB, Hemoglobin; PLT, Platelet.

Table 2 Correlation of Laboratory Parameters with HFRS

Parameters	r value	P value
Age (Year)	−0.104	0.096
ALT (U/L)	0.506	<0.001
AST (U/L)	0.685	<0.001
ALP (U/L)	−0.204	0.001
GGT (U/L)	0.180	0.004
TB (μmol/L)	−0.141	0.024
DB (μmol/L)	0.028	0.650
IB (μmol/L)	−0.257	<0.001
TP (g/L)	−0.602	<0.001
ALB (g/L)	−0.644	<0.001
TBA (μmol/L)	0.162	0.010
CHE (KU/L)	−0.447	<0.001
ADA (U/L)	0.785	<0.001
PA (mg/dL)	−0.576	<0.001
Scr (μmol/L)	0.608	<0.001
BUN (mmol/L)	0.477	<0.001
UA (μmol/L)	0.339	<0.001
GLU (mmol/L)	0.120	0.073
TG (mmol/L)	0.504	<0.001
TC (mmol/L)	−0.533	<0.001
HDL-C (mmol/L)	−0.535	<0.001
LDL-C (mmol/L)	−0.549	<0.001
APOA1 (g/L)	−0.626	<0.001
APOB (g/L)	−0.291	<0.001
LPa (mg/L)	0.001	0.983
CK (U/L)	0.043	0.495
LDH (U/L)	0.743	<0.001
WBC (10^9/L)	0.390	<0.001
RBC (10^12/L)	0.267	<0.001
HB (g/L)	0.249	<0.001
PLT (10^9/L)	−0.730	<0.001

Abbreviations: ALT, Alanine aminotransferase; AST, Aspartate aminotransferase; ALP, Alkaline phosphatase; GGT, γ-glutamyl transpeptadase; TB, Total bilirubin; DB, Direct bilirubin; IB, Indirect bilirubin; TP, Total protein; ALB, Albumin; TBA, Total biliary acid; CHE, Cholinesterase; ADA, Adenosine deaminase; PA, Prealbumin; Scr, Serum creatinine; BUN, Blood urea nitrogen; UA, Uric acid; GLU, Glucose; TG, Triglyceride; TC, Total cholesterol; HDL-C, High density lipoprotein cholesterol; LDL-C, Low density lipoprotein cholesterol; APOA1, Apolipoprotein A1; APOB, Apolipoprotein B; LPa, Lipoprotein a; CK, Creatine kinase; LDH, Lactate dehydrogenase; WBC, White blood cell count; RBC, Red blood cell count; HB, Hemoglobin; PLT, Platelet.

Table 3 The Diagnostic Value of ADA for HFRS

Cut-Off Value	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	Youden Index (%)	AUC	95% CI for AUC
18 (U/L)	84.8	93.1	92.2	86.5	77.9	0.953	0.925, 0.981

Abbreviations: PPV, Positive predictive value; NPV, Negative predictive value; AUC, Area under the curve; CI, confidence interval.

Figure 1 ROC curve of ADA in diagnosing HFRS.

Table 4 Comparison of Each Parameter of 122 Patients with HFRS on Admission and Discharge

Parameters	Mean Difference (Admission - Discharge)	Std. Error	P value
ALT (U/L)	18.9	77	0.008
AST (U/L)	82	151	<0.001
ALP (U/L)	−13.5	43	0.001
GGT (U/L)	−2.7	63.2	0.635
TB (μmol/L)	0.07	7.7	0.917
DB (μmol/L)	0.5	5.3	0.294
IB (μmol/L)	−0.595	3.6	0.069
TP (g/L)	−11.1	7.5	<0.001
ALB (g/L)	−5.87	4.99	<0.001
TBA (μmol/L)	2.07	9.3	0.016
CHE (KU/L)	−1.3	1.5	<0.001
ADA (U/L)	9.9	6.9	<0.001
PA (mg/dL)	−18.7	12.4	<0.001
Scr (μmol/L)	116.7	159.3	<0.001
BUN (mmol/L)	7.69	8.9	<0.001
UA (μmol/L)	136.65	159.3	<0.001
GLU (mmol/L)	0.74	1.8	<0.001
TG (mmol/L)	−0.004	1.6	0.978
TC (mmol/L)	−1.01	1.2	<0.001
HDL-C (mmol/L)	−0.219	0.68	<0.001
LDL-C (mmol/L)	−0.69	0.67	<0.001
APOA1 (g/L)	−0.286	0.279	<0.001
APOB (g/L)	−0.17	0.25	<0.001
LPa (mg/L)	−68.2	144	<0.001
CK (U/L)	93	145	<0.001
LDH (U/L)	196.7	322.9	<0.001
WBC (10^9/L)	5.05	6.36	<0.001
RBC (10^12/L)	0.659	0.676	<0.001
HB (g/L)	20.3	20.9	<0.001
PLT (10^9/L)	−181.4	101.7	<0.001

Abbreviations: ALT, Alanine aminotransferase; AST, Aspartate aminotransferase; ALP, Alkaline phosphatase; GGT, γ-glutamyl transpeptadase; TB, Total bilirubin; DB, Direct bilirubin; IB, Indirect bilirubin; TP, Total protein; ALB, Albumin; TBA, Total biliary acid; CHE, Cholinesterase; ADA, Adenosine deaminase; PA, Prealbumin; Scr, Serum creatinine; BUN, Blood urea nitrogen; UA, Uric acid; GLU, Glucose; TG, Triglyceride; TC, Total cholesterol; HDL-C, High density lipoprotein cholesterol; LDL-C, Low density lipoprotein cholesterol; APOA1, Apolipoprotein A1; APOB, Apolipoprotein B; LPa, Lipoprotein a; CK, Creatine kinase; LDH, Lactate dehydrogenase; WBC, White blood cell count; RBC, Red blood cell count; HB, Hemoglobin; PLT, Platelet.

Figure 2 Tendency chart of ADA between admission and discharge.