基于肌素和囊素C的功能测量与中风和大出血的相关性中的性别差异
Jennifer Susan Lees1, Nicole L De La Mata2, Michael K Sullivan1
1School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
European stroke journal
|August 29, 2023
概括
基于囊素C的功能估计 (eGFRCys) 比基于肌素的估计 (eGFRCr) 更好地预测中风和出血风险,特别是在女性中. 这可以改善临床决策和风险分层.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
- 流行病学 流行病学
背景情况:
- 功能估计对于心血管风险分层至关重要.
- 基于肌素的估计膜过率 (eGFRCr) 被广泛使用,但可能有局限性.
- 基于囊素C的 (eGFRCys) 和结合的 (eGFRCr-Cys) 测量为功能提供了替代评估.
研究的目的:
- 评估eGFRCr,eGFRCys或eGFRCr-Cys是否可以改善中风和严重出血的风险分层.
- 调查这些功能生物标志物的附加值的潜在性别差异.
主要方法:
- 利用了英国生物库的参与者,他们的基线是功能测量,没有先前的中风或重大出血.
- 采用特定原因的考克斯比例危险模型来评估与缺血性中风,出血性中风,严重出血和全因死亡率的关联.
- 在eGFRCr,eGFRCys和eGFRCr-Cys之间比较了风险关联.
主要成果:
- eGFRCys与缺血性中风风险的关联比eGFRCr更强,特别是在女性中.
- eGFRCys和eGFRCr-Cys在两种性别中都比eGFRCr更强烈地与严重出血和全因死亡率相关.
- 对eGFRCys和eGFRCr-Cys观察到性别特异的相互作用效应,但对于缺血性中风风险而言,没有eGFRCr.
结论:
- 与eGFRCr相比,eGFRCys和eGFRCr-Cys为缺血性中风和大出血提供了优越的风险分层.
- 在女性中,eGFRCr低估了风险,这凸显了囊蛋白C测量的重要性.
- 纳入囊素C测量可以提高临床决策对心血管风险评估,特别是在女性.
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