Department of Nephrology, Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Int Urol Nephrol. 2020 Jun;52(6):1103-1115. doi: 10.1007/s11255-020-02453-7. Epub 2020 May 13.
To examine whether albumin-to-globulin ratio (AGR) is correlated with long-term mortality in patients with chronic kidney disease (CKD), we performed this study using data from the National Health and Nutrition Examination Survey through 1999-2006.
3302 CKD patients were included. Patients' baseline characteristics were collected. Multivariate Cox proportional hazards models were used to investigate the association between AGR and the study outcomes, including long-term all-cause and cardiovascular mortality. Subgroup analysis using the Cox proportional hazards model was performed as a sensitivity test.
During a median follow-up duration of 122.00 months, 1627 (49.27%) deaths were recorded and 440 patients died from cardiovascular disease. In adjusted model 1, AGR ≥ 1.26 group was associated with a lower risk of long-term all-cause mortality HR 0.72, 95% CI 0.65-0.81) compared with AGR < 1.26 group. A similar result was obtained in adjusted model 2. In adjusted model 1, AGR ≥ 1.08 group was associated with a lower risk of long-term cardiovascular mortality (HR 0.59, 95% CI 0.45-0.78) compared with AGR < 1.08 group. In adjusted model 2, there was no significant association between AGR ≥ 1.08 group and a decreased risk of long-term cardiovascular mortality (HR 0.82, 95% CI 0.95-1.12) compared with AGR < 1.08 group. The association of AGR with long-term all-cause mortality differed by gender and age while the association of AGR with long-term cardiovascular mortality differed by age after multivariate adjustment.
AGR is a potential biomarker in risk predictions for long-term mortality in CKD patients, especially in males under age 65.
通过使用 1999-2006 年国家健康和营养调查的数据，我们进行了这项研究，以检验白蛋白-球蛋白比值（AGR）与慢性肾脏病（CKD）患者的长期死亡率是否相关。
纳入了 3302 名 CKD 患者。收集了患者的基线特征。使用多变量 Cox 比例风险模型来研究 AGR 与研究结果之间的关系，包括长期全因和心血管死亡率。使用 Cox 比例风险模型进行亚组分析作为敏感性测试。
在中位数为 122.00 个月的随访期间，记录了 1627 例（49.27%）死亡，其中 440 例死于心血管疾病。在调整后的模型 1 中，AGR≥1.26 组与长期全因死亡率降低相关（HR 0.72，95%CI 0.65-0.81），与 AGR<1.26 组相比。在调整后的模型 2 中也得到了类似的结果。在调整后的模型 1 中，AGR≥1.08 组与长期心血管死亡率降低相关（HR 0.59，95%CI 0.45-0.78），与 AGR<1.08 组相比。在调整后的模型 2 中，AGR≥1.08 组与长期心血管死亡率降低的风险无显著相关性（HR 0.82，95%CI 0.95-1.12），与 AGR<1.08 组相比。AGR 与长期全因死亡率的关系因性别和年龄而异，而 AGR 与长期心血管死亡率的关系因年龄而异，这在多变量调整后有所不同。
AGR 是 CKD 患者长期死亡率风险预测的潜在生物标志物，尤其是在年龄小于 65 岁的男性中。
