肥胖或不肥胖的个体中心力衰竭分类的尿酸切割点
Mandana Chitsazan1,2,3, Juhi K Parekh2,3, Leah B Kosyakovsky1,2,3
1Harvard Medical School, Boston, MA (M.C., L.B.K., J.L.J., J.E.H.).
Circulation. Heart failure
|August 20, 2025
概括
一个单一的尿酸 (NP) 切割点可能会错误地分类肥胖的心力衰竭 (HF) 风险. 调整肥胖的NP水平可以改善心力衰竭前期 (B期心力衰竭) 患者的风险评估.
科学领域:
- 心脏病学
- 生物标志物
- 肥胖药物
背景情况:
- 2022年AHA/ACC/HFSA指南使用高尿酸 (NP) 来定义B期心力衰竭 (HF),识别高危人群.
- 已知肥胖会影响NP水平,这可能会影响新的HF定义的准确性.
研究的目的:
- 调查单个NP切断点是否与正常体重的个体相比,不成比例地将肥胖个体升级为B期HF.
- 评估肥胖对NP水平的影响及其与未来HF风险的关联.
主要方法:
- 分析了来自5个社区群体的32,735名参与者,
- 使用2022年与2013年指导方针进行B期高血压再分类的比较,按肥胖类分层.
- 使用考克斯的比例危险模型来检查肥胖类别之间的NP-HF风险关联.
主要成果:
- 一个单一的NP切断点将较少的肥胖患者 (42-47%) 与正常体重患者 (62%) 相比升级为B阶段的肝炎.
- 较高的NP和体重指数独立地与HF风险增加有关 (P<0.0001).
- 在肥胖患者 (80 pg/ mL) 和正常体重 (109 pg/ mL) 中,预测HF风险的最佳NT-proBNP切割点较低.
结论:
- 均的NP切割点可能导致肥胖个体的HF风险低分类.
- 根据肥胖状况定制NP切割点可以提高B阶段HF识别和HF风险分层的精度.
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