Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Serum Assays
2.3. Treatments
2.4. Data Collection
2.5. Statistical Analysis
3. Results
3.1. Characteristics According to Disease Severity
3.2. IL-6 and CRP as Biomarkers for Disease Severity
3.3. Factors Associated with Time to Resolution
3.4. Factors Associated with Recurrence
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | All Patients (n = 41) | Mild (n = 5) | Moderate (n = 15) | Severe (n = 21) | p-Value | Adjusted p-Value | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Mild vs. Moderate | Mild vs. Severe | Moderate vs. Severe | ||||||||||
Age, mean (SD), years | 35.9 | (5.8) | 34.8 | (4.6) | 35.1 | (4.8) | 36.8 | (6.8) | 0.635 | |||
Body mass index, median (IQR), kg/m2 | 23.6 | (20.6−26.1) | 22.4 | (20.2−27.0) | 23.9 | (21.1−26.2) | 23.5 | (20.1−27.1) | 0.821 | |||
Age of menarche, median (IQR), years | 12.0 | (12.0−13.0) | 12.0 | (11.0−14.0) | 13.0 | (12.0−13.0) | 12.0 | (12.0−13.0) | 0.786 | |||
Pregnancy | 38 | (92.7) | 5 | (100) | 14 | (93.3) | 19 | (90.5) | >0.900 | |||
Gestation, median (IQR) | 1.0 | (1.0−2.0) | 2.0 | (1.5−2.5) | 1.0 | (1.0−2.0) | 1.0 | (1.0−2.0) | 0.426 | |||
Age of first pregnancy, mean (SD), years | 31.1 | (6.4) | 31.0 | (5.2) | 30.9 | (5.9) | 31.2 | (7.2) | >0.900 | |||
Breastfeeding | 37 | (90.2) | 5 | (100) | 14 | (93.3) | 18 | (85.7) | 0.782 | |||
Smoking | 2 | (4.9) | 1 | (20.0) | 0 | (0.0) | 1 | (4.8) | 0.360 | |||
Diabetes mellitus | 1 | (2.4) | 1 | (20.0) | 0 | (0.0) | 0 | (0.0) | 0.122 | |||
Lesion size, median (IQR), cm | 4.0 | (2.1−5.1) | 1.0 | (0.6−1.6) | 3.0 | (2.1−4.8) | 5.0 | (3.8−6.0) | <0.001 | 0.031 | <0.001 | 0.018 |
Abscess formation | 20 | (48.8) | 0 | (0.0) | 8 | (53.3) | 12 | (57.1) | 0.087 | |||
Multiple lesions | 29 | (70.7) | 0 | (0.0) | 15 | (100) | 14 | (66.7) | <0.001 | <0.001 | 0.036 | 0.082 |
Skin ulcer or fistula | 21 | (51.2) | 0 | (0.0) | 6 | (40.0) | 15 | (71.4) | 0.008 | 0.780 | 0.021 | 0.269 |
Symptom duration, median (IQR), weeks | 8.0 | (3.4−14.5) | 1.3 | (0.5−8.0) | 7.6 | (3.2−13.4) | 10.0 | (5.0−16.4) | 0.111 | |||
Bilateral lesions | 9 | (22.0) | 0 | (0.0) | 2 | (13.3) | 7 | (33.3) | 0.221 | |||
Extramammary manifestation | 11 | (26.8) | 2 | (40.0) | 2 | (13.3) | 7 | (33.3) | 0.330 | |||
Corynebacterium infection | 10 | (24.4) | 0 | (0.0) | 3 | (20.0) | 7 | (33.3) | 0.305 | |||
C-reactive protein, median (IQR), mg/dL | 0.56 | (0.14−2.89) | 0.08 | (0.05−0.23) | 0.26 | (0.13−0.83) | 1.80 | (0.75−5.14) | <0.001 | 0.571 | 0.002 | 0.007 |
Methotrexate use | 16 | (39.0) | 1 | (20.0) | 4 | (26.7) | 11 | (52.4) | 0.251 | |||
Surgery | 14 | (34.1) | 0 | (0.0) | 7 | (46.7) | 7 | (33.3) | 0.162 | |||
Time to resolution, median (IQR), weeks | 26.3 | (12.4−56.0) | 8.0 | (4.4−15.1) | 20.3 | (13.3−32.6) | 54.7 | (26.1−77.0) | 0.002 | 0.328 | 0.004 | 0.061 |
Recurrence | 9 | (22.0) | 0 | (0.0) | 1 | (6.7) | 8 | (38.1) | 0.051 |
Cytokines | IGM (n = 11) | HC (n = 7) | p-Value | ||
---|---|---|---|---|---|
Median (IQR) | Median (IQR) | ||||
TNF-α, pg/mL | 11.66 | (8.70−24.11) | 7.21 | (4.97−7.21) | <0.001 |
IL-1β, pg/mL | 2.80 | (1.59−3.52) | 0.21 | (N.D.−1.42) | <0.001 |
IL-2, pg/mL | 13.77 | (3.97−22.08) | 2.63 | (N.D.−6.97) | 0.023 |
IL-4, pg/mL | N.D. | N.D. | N.A. | ||
IL-6, pg/mL | 3.89 | (N.D.−6.09) | N.D. | 0.023 | |
IL-10, pg/mL | 1.13 | (0.55−1.59) | 1.06 | (0.81−1.99) | 0.892 |
IL-12p70, pg/mL | 6.39 | (6.24−6.98) | 6.10 | (5.95−6.10) | 0.016 |
IL-17A, pg/mL | 1.13 | (0.41−1.98) | N.D. | 0.041 | |
IL-22, pg/mL | N.D. | (N.D.−14.29) | N.D. | (N.D.−48.66) | 0.885 |
IL-23, pg/mL | N.D. | N.D. | N.A. | ||
GM-CSF, pg/mL | N.D. | (N.D.−3.52) | N.D. | 0.118 |
Characteristics (n = 41) | Simple Linear Regression | |||||
---|---|---|---|---|---|---|
Unstandardized B (SE) | 95% CI | p-Value | ||||
Age, years | −0.009 | (0.029) | −0.069 | to | 0.050 | 0.756 |
Body mass index, kg/m2 | 0.064 | (0.887) | −1.731 | to | 1.858 | >0.900 |
Age of menarche, years | 0.501 | (1.542) | −2.618 | to | 3.621 | 0.747 |
Pregnancy | −1.012 | (0.630) | −2.285 | to | 0.262 | 0.116 |
Gestation | 0.037 | (0.332) | −0.636 | to | 0.710 | >0.900 |
Age of first pregnancy, years | 0.026 | (0.028) | −0.030 | to | 0.082 | 0.345 |
Breastfeeding | −1.188 | (0.538) | −2.276 | to | −0.100 | 0.033 |
Smoking | −1.650 | (0.740) | −3.147 | to | −0.153 | 0.032 |
Diabetes mellitus | −1.175 | (1.081) | −3.362 | to | 1.012 | 0.284 |
Lesion size, cm | 0.435 | (0.287) | −0.146 | to | 1.015 | 0.138 |
Abscess formation | 0.417 | (0.332) | −0.255 | to | 1.088 | 0.217 |
Multiple lesions | 0.674 | (0.356) | −0.047 | to | 1.394 | 0.066 |
Skin ulcer or fistula | 1.480 | (0.242) | 0.991 | to | 1.969 | <0.001 |
Symptom duration, weeks | 0.083 | (0.129) | −0.179 | to | 0.345 | 0.525 |
Bilateral lesions | 1.325 | (0.350) | 0.618 | to | 2.032 | <0.001 |
Extramammary manifestation | 0.466 | (0.375) | −0.292 | to | 1.224 | 0.221 |
Corynebacterium infection | 0.666 | (0.380) | −0.102 | to | 1.434 | 0.087 |
C-reactive protein, mg/dL | 0.404 | (0.071) | 0.260 | to | 0.548 | <0.001 |
Methotrexate use | 1.203 | (0.289) | 0.619 | to | 1.787 | <0.001 |
Surgery | −0.131 | (0.356) | −0.852 | to | 0.590 | 0.715 |
Recurrence | 0.784 | (0.389) | −0.003 | to | 1.572 | 0.051 |
Characteristics (n = 41) | Multiple Linear Regression (Backward) | |||||
---|---|---|---|---|---|---|
Unstandardized B (SE) | 95% CI | p-Value | ||||
Breastfeeding | −0.724 | (0.339) | −1.414 | to | −0.034 | 0.040 |
Smoking | −1.001 | (0.489) | −1.898 | to | 0.091 | 0.074 |
Bilateral lesions | 0.549 | (0.266) | 0.008 | to | 1.089 | 0.047 |
C-reactive protein, mg/dL | 0.322 | (0.086) | 0.148 | to | 0.497 | <0.001 |
Methotrexate use | 0.707 | (0.230) | 0.239 | to | 1.176 | 0.004 |
Recurrence | −0.612 | (0.322) | −1.266 | to | 0.042 | 0.066 |
Characteristics (n = 41) | Univariate Logistic Regression | ||||
---|---|---|---|---|---|
Odds Ratio | 95% CI | p-Value | |||
Age, years | 1.179 | 1.000 | to | 1.390 | 0.049 |
Body mass index, kg/m2 | 0.969 | 0.827 | to | 1.135 | 0.697 |
Age of menarche, years | 1.113 | 0.604 | to | 2.052 | 0.731 |
Pregnancy | 0.533 | 0.043 | to | 6.655 | 0.625 |
Gestation | 1.817 | 0.873 | to | 3.783 | 0.110 |
Age of first pregnancy, years | 1.027 | 0.904 | to | 1.166 | 0.687 |
Breastfeeding | 0.828 | 0.075 | to | 9.074 | 0.877 |
Smoking | N.A. | ||||
Diabetes mellitus | N.A. | ||||
Lesion size, cm | 1.165 | 0.737 | to | 1.843 | 0.514 |
Abscess formation | 2.571 | 0.545 | to | 12.139 | 0.233 |
Multiple lesions | 1.591 | 0.279 | to | 9.066 | 0.601 |
Skin ulcer or fistula | 11.692 | 1.302 | to | 105.028 | 0.028 |
Symptom duration, weeks | 1.016 | 0.975 | to | 1.059 | 0.456 |
Bilateral lesions | 4.320 | 0.851 | to | 21.929 | 0.078 |
Extramammary manifestation | 2.857 | 0.601 | to | 13.586 | 0.187 |
Corynebacterium infection | 0.857 | 0.147 | to | 4.999 | 0.864 |
C-reactive protein, mg/dL | 1.874 | 1.139 | to | 3.084 | 0.013 |
Methotrexate use | 4.400 | 0.911 | to | 21.248 | 0.065 |
Surgery | 0.955 | 0.199 | to | 4.571 | >0.900 |
Time to resolution, weeks | 1.015 | 0.993 | to | 1.038 | 0.171 |
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Huang, Y.-M.; Lo, C.; Cheng, C.-F.; Lu, C.-H.; Hsieh, S.-C.; Li, K.-J. Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis. J. Clin. Med. 2021, 10, 2077. https://doi.org/10.3390/jcm10102077
Huang Y-M, Lo C, Cheng C-F, Lu C-H, Hsieh S-C, Li K-J. Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis. Journal of Clinical Medicine. 2021; 10(10):2077. https://doi.org/10.3390/jcm10102077
Chicago/Turabian StyleHuang, Yi-Min, Chiao Lo, Chiao-Feng Cheng, Cheng-Hsun Lu, Song-Chou Hsieh, and Ko-Jen Li. 2021. "Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis" Journal of Clinical Medicine 10, no. 10: 2077. https://doi.org/10.3390/jcm10102077