慢性脏疾病的成年人血清同型半素和左室缩:一个病例对照研究
Yanping Lei1, Rui Liu2, Yue Zhao2
1Key Laboratory for Arteriosclerology of Hunan Province, Institute of Cardiovascular Disease, Hunan International Scientific and Technological Cooperation Base of Arteriosclerotic Disease, Hengyang Medical College, University of South China, Hengyang, Hunan, China.
Medicine
|January 14, 2025
概括
高水平的homocysteine与慢性病患者的左心室缩有关. 这一发现表明,同类半氨酸可能是CKD心脏缩的独立危险因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 临床生物化学 临床生物化学
背景情况:
- 过高homocysteinemia 在慢性病 (CKD) 中很普遍.
- 左心室缩 (LVH) 是CKD患者常见的并发症.
- 这两种情况都与CKD有着共同的关联,促使对它们之间的关系进行调查.
研究的目的:
- 为了研究血同型半氨酸 (Hcy) 水平与患有慢性病的成年人左心室缩 (LVH) 的患病率之间的联系.
- 确定高血糖蛋白质血症是否是该人群中LVH的独立风险因素.
- 开发一种预测模型,用于结合Hcy水平的CKD心脏缩.
主要方法:
- 一项涉及1068名患有慢性脏病的住院患者的病例控制研究.
- 收集心声回声图数据和血Hcy度.
- 线性和逻辑回归分析,调整为血红蛋白,费里丁,细胞质素C和β-上腺素抑制剂治疗;通过eGFR进行分层分析.
主要成果:
- 统变逻辑回归显示高血清Hcy和LVH之间存在显著的关联 (OR,1.16;95% CI,1.11-1.20).
- 多变量逻辑回归证实高血糖蛋白血是LVH的独立预测因子 (OR,1.14;95% CI,1.10-1.19).
- 包括Hcy在内的预测模型表现出强的性能 (AUC0.86) 和优越的临床实用性,与没有Hcy的模型相比.
结论:
- 血清homocysteine的升高与患有CKD的成年人左心室缩密切相关.
- 超homocysteinemia是一个独立的风险因素,为LVH在CKD患者.
- 将Hcy水平纳入预测模型可能会改善在CKD中心脏缩的识别.
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