血清晚期氧化蛋白产物与维持性血液透析患者死亡风险的关系。
Association between serum advanced oxidation protein products and mortality risk in maintenance hemodialysis patients.
机构信息
Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China.
Kidney Disease Center, College of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
出版信息
J Transl Med. 2021 Jun 30;19(1):284. doi: 10.1186/s12967-021-02960-w.
BACKGROUND
The association between serum advanced oxidation protein products (AOPP) and mortality risk remains equivocal. We aimed to assess the correlation of serum AOPP levels with the risk of all-cause mortality in hemodialysis (HD) patients.
METHODS
A total of 1394 maintenance HD patients with complete data on AOPP and related parameters were included from China Collaborative Study on Dialysis (CCSD), a multi-center, prospective cohort study. The primary outcome was all-cause mortality, the secondary outcome was cardiovascular disease (CVD) mortality.
RESULTS
During a median follow-up duration of 5.2 years (IQR, 2.1-5.4), all-cause mortality occurred in 492 (31.4%) participants. Overall, there was a reversed L-shaped association between serum AOPP and all-cause mortality in HD patients (P for nonlinearity = 0.04), with an inflection point at 87 µmol/L. Accordingly, there was no significant association between serum AOPP and all-cause mortality (per SD increment; HR, 0.94; 95%CI, 0.84, 1.05) in participants with AOPP < 87 µmol/L. However, there was a positive relationship of serum AOPP and all-cause mortality (per SD increment; HR, 1.24; 95%CI, 1.08, 1.42) in those with AOPP ≥ 87 µmol/L. Moreover, a similar trend was found for CVD mortality.
CONCLUSIONS
Elevated serum AOPP levels were associated with higher risk of all-cause mortality in Chinese maintenance HD patients.
背景
血清晚期氧化蛋白产物（AOPP）与死亡风险之间的关联仍存在争议。我们旨在评估血清 AOPP 水平与血液透析（HD）患者全因死亡率风险之间的相关性。
方法
共纳入来自中国血液净化研究协作组（CCSD）的 1394 例维持性 HD 患者，这些患者具有完整的 AOPP 和相关参数数据。该研究为一项多中心、前瞻性队列研究。主要结局是全因死亡率，次要结局是心血管疾病（CVD）死亡率。
结果
在中位随访时间为 5.2 年（IQR，2.1-5.4）期间，共有 492 名（31.4%）参与者发生全因死亡。总体而言，在 HD 患者中，血清 AOPP 与全因死亡率之间呈反向 L 形关联（P 非线性=0.04），拐点为 87µmol/L。因此，在 AOPP<87µmol/L 的参与者中，血清 AOPP 与全因死亡率之间没有显著关联（每 SD 增加；HR，0.94；95%CI，0.84，1.05）。然而，在 AOPP≥87µmol/L 的参与者中，血清 AOPP 与全因死亡率呈正相关（每 SD 增加；HR，1.24；95%CI，1.08，1.42）。此外，CVD 死亡率也呈现出类似的趋势。
结论
在中国维持性 HD 患者中，血清 AOPP 水平升高与全因死亡率风险增加相关。
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