Multivariate logistic regression analysis of poor prognosis of dermatomyositis and clinical value of ferritin/Kl-6 in predicting prognosis

Skin Res Technol. 2024 May;30(5):e13701. doi: 10.1111/srt.13701.

Abstract

Background: Dermatomyositis (DM) is a rare inflammatory disease. Our research focuses on predicting poor prognosis in DM patients and evaluating the prognostic significance of ferritin and Salivary Sugar Chain Antigen-6 (KL-6) through multivariate logistic regression analysis.

Methods: Between February 2018 and April 2020, 80 DM patients at our hospital were categorized into MDA5 positive (n = 20) and negative (n = 60) groups. We conducted multivariate logistic regression to determine DM's poor prognosis risk factors and evaluate ferritin/KL-6's predictive value for prognosis.

Results: Analysis showed no gender, age, body mass index (BMI), or lifestyle (smoking, drinking) differences, nor in dyspnea, muscle weakness, skin ulcers, and acetylcysteine treatment effects (p > 0.05). Significant differences emerged in arrhythmias, interstitial pneumonia, C-reactive protein, albumin, and lactate dehydrogenase levels (p < 0.05). Before treatment, differences were negligible (p > 0.05), but post-treatment, serum KL-6 and ferritin levels dropped. MDA5 positive patients had elevated serum KL-6 and ferritin levels than survivors (p < 0.05), with a strong correlation to DM. Combined diagnosis using serum KL-6 and ferritin for DM prognosis showed area under curves of 0.716 and 0.634, significantly outperforming single-index diagnoses with an area under curve (AUC) of 0.926 (p < 0.05).

Conclusion: Serum KL-6 and ferritin show marked abnormalities in DM, useful as indicators for evaluating polymyositis and DM conditions. However, the study's small sample size is a drawback. Expanding the sample size is essential to monitor serum KL-6 and ferritin changes in DM patients under treatment more closely, aiming to improve clinical assessment and facilitate detailed research.

Keywords: Kl‐6; dermatomyositis; ferritin; multivariate logistic regression analysis.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Dermatomyositis* / blood
  • Dermatomyositis* / diagnosis
  • Female
  • Ferritins* / blood
  • Humans
  • Interferon-Induced Helicase, IFIH1
  • Logistic Models
  • Male
  • Middle Aged
  • Mucin-1* / blood
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors

Substances

  • Biomarkers
  • Ferritins
  • IFIH1 protein, human
  • Interferon-Induced Helicase, IFIH1
  • MUC1 protein, human
  • Mucin-1