不对称二甲基精氨酸水平作为慢性肾脏病患者心血管或全因死亡率的生物标志物的meta 分析。
Asymmetric dimethylarginine level as biomarkers of cardiovascular or all-cause mortality in patients with chronic kidney disease: a meta-analysis.
机构信息
Department of General Surgery, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China.
Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China.
出版信息
Biomarkers. 2021 Nov;26(7):579-585. doi: 10.1080/1354750X.2021.1954694. Epub 2021 Jul 27.
BACKGROUND
Studies have yielded conflicting findings on the association of asymmetric dimethylarginine (ADMA) level with cardiovascular or all-cause mortality in patients with chronic kidney disease (CKD). This meta-analysis sought to evaluate the association of blood ADMA level with cardiovascular or all-cause mortality in CKD patients.
MATERIALS AND METHODS
PubMed and Embase databases were comprehensively searched until September 9, 2020 for studies investigating the association of ADMA level with cardiovascular or all-cause mortality in CKD patients.
RESULTS
Data were collected from nine prospective studies involving 6553 patients. The pooled adjusted risk ratio (RR) of all-cause mortality was 2.06 (95% confidence interval [CI] 1.43-2.96) for the highest versus the lowest ADMA level. Each 0.20 μmol/L ADMA increase was associated with 21% (95% CI 1.09-1.35) higher risk of all-cause mortality but not cardiovascular mortality (RR 1.07; 95% CI 0. 99-1.16). Subgroup analysis showed that each 0.20 μmol/L ADMA increase was significantly associated with all-cause mortality in end-stage renal disease (ESRD) patients (RR 1.22; 95% CI 1.05-1.41) but not in patients with stage 3 to 4 CKD (RR 1.16; 95% CI 0.86-1.56).
CONCLUSIONS
Elevated ADMA level is independently associated with higher risk of all-cause mortality in ESRD patients.
背景
关于不对称二甲基精氨酸（ADMA）水平与慢性肾脏病（CKD）患者心血管或全因死亡率的关系，已有研究得出相互矛盾的结果。本荟萃分析旨在评估血液 ADMA 水平与 CKD 患者心血管或全因死亡率的关系。
材料和方法
全面检索了 PubMed 和 Embase 数据库，截至 2020 年 9 月 9 日，以调查 ADMA 水平与 CKD 患者心血管或全因死亡率之间关系的研究。
结果
共纳入 9 项前瞻性研究，纳入 6553 例患者。与 ADMA 水平最低者相比，ADMA 水平最高者全因死亡率的汇总调整风险比（RR）为 2.06（95%置信区间[CI]为 1.43-2.96）。ADMA 每增加 0.20μmol/L，全因死亡率的风险增加 21%（95%CI 为 1.09-1.35），但与心血管死亡率无关（RR 为 1.07；95%CI 为 0.99-1.16）。亚组分析显示，ADMA 每增加 0.20μmol/L，与终末期肾病（ESRD）患者的全因死亡率显著相关（RR 为 1.22；95%CI 为 1.05-1.41），但与 3 至 4 期 CKD 患者无关（RR 为 1.16；95%CI 为 0.86-1.56）。
结论
ADMA 水平升高与 ESRD 患者全因死亡率风险增加独立相关。
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