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This study was designed to investigate the plasma level of soluble ST2 (sST2) and its related influencing factors, and establish its reference value in the community-based healthy population in Beijing area of China.
We measured plasma sST2 level by enzyme-linked immunosorbent assay between March 2012 and August 2012 from 1334 healthy subjects in communities, including 597 males and 737 females. The inclusion criteria of healthy subjects include no history of lung diseases, sepsis, serious trauma and heart disease; never taking any cardiovascular drugs; normal cardiac structure and function determined by echocardiography; normal ECG; sinus rhythm; no 3/6 and above systolic murmur or diastolic murmur; systolic pressure <140 mmHg and diastolic pressure <90 mmHg; fasting blood glucose <7.0 mmol/L; estimated glomerular filtration rate (eGFR) >60 ml·min-1·1.73m-2; BMI<30 kg/m2. Empiric and quantile regression methods were used to determine the reference range of plasma sST2. A multiple linear regression model was established to analyze the factors that may affect the level of plasma sST2.
Gender is the most important factor affecting the plasma level of sST2 in healthy people. Plasma level of sST2 is significantly higher in men than in women (P<0.001). Within each age strata, i.e. <45, 45-54, 55-64, ≥65 years old, the plasma levels of sST2 are still significantly higher in men (all P≤0.001). Age, body mass index (BMI), systolic blood pressure, diastolic blood pressure, and smoking does not affect plasma sST2 level. Reference range of sST2 is 5.7-53.5ug/L for men and 4.4-42.4ug/L for women (95% nonparametric reference interval). The one-side upper 95th percentile value of sST2 to discriminate the cardiovascular diseases from healthy state is 47.2ug/L for men and 37.2ug/L for women.
This study established the normal reference range of plasma sST2 in community-based healthy population. The major influencing factor of sST2 level in healthy population is gender.
Key words: Reference values; ST2, soluble; cardiovascular diseases