血清半乳糖凝集素-3 水平与维持性血液透析患者的全因和心血管死亡率：一项前瞻性队列研究。
Serum Galectin-3 levels and all-cause and cardiovascular mortality in maintenance hemodialysis patients: a prospective cohort study.
机构信息
Department of Nephrology, Dalian Municipal Central Hospital, No.826, Xinan Road, Dalian, Liaoning, 116033, People's Republic of China.
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
出版信息
BMC Nephrol. 2022 Jan 3;23(1):5. doi: 10.1186/s12882-021-02636-z.
BACKGROUND
Higher serum galectin-3 levels are related to adverse outcomes in different disease states. However, the association of galectin-3 with mortality in the maintenance hemodialysis (HD) population has not been fully described. Thus, we aimed to assess the predictive significance of galectin-3 for all-cause and cardiovascular (CV) mortality through a Chinese maintenance HD population.
METHODS
A prospective cohort study was conducted in five hundred and six patients with end-stage renal disease who underwent hemodialysis at Dalian Central Hospital before December 31, 2014. Serum galectin-3 levels were measured at baseline and classified as high (> 8.65 ng/ml) or low (≤ 8.65 ng/ml) according to the "X-tile" program. Primary and secondary outcomes were all-cause and CV mortality, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the Cox proportional hazards regression models.
RESULTS
During the median follow-up of 60 months, there were 188 all-cause deaths and 125 CV deaths. Compared with maintenance HD population with galectin-3 ≤ 8.65 ng/ml, the adjusted HR for all-cause mortality among those with galectin-3 > 8.65 ng/ml was 1.59 (CI: 0.96-2.65, p = 0.07). Furthermore, multivariable analysis showed that maintenance HD patients with galectin-3 > 8.65 ng/ml had a 2.13-fold higher risk of CV death than those with galectin-3 ≤ 8.65 ng/ml (HR = 2.13, 95% CI 1.07-4.26).
CONCLUSION
Galectin-3 is an independent predictor of CV mortality in maintenance HD patients.
背景
血清半乳糖凝集素-3 水平升高与不同疾病状态下的不良结局有关。然而，半乳糖凝集素-3 与维持性血液透析（HD）人群死亡率的关系尚未完全描述。因此，我们旨在通过中国维持性 HD 人群评估半乳糖凝集素-3 对全因和心血管（CV）死亡率的预测意义。
方法
对 2014 年 12 月 31 日前在大连市中心医院接受血液透析的 506 例终末期肾病患者进行前瞻性队列研究。在基线时测量血清半乳糖凝集素-3 水平，并根据“X-tile”程序将其分为高（>8.65ng/ml）或低（≤8.65ng/ml）。主要和次要结局分别为全因死亡率和 CV 死亡率。通过 Cox 比例风险回归模型计算危险比（HR）和 95%置信区间（CI）。
结果
在中位随访 60 个月期间，发生了 188 例全因死亡和 125 例 CV 死亡。与半乳糖凝集素-3≤8.65ng/ml 的维持性 HD 人群相比，半乳糖凝集素-3>8.65ng/ml 的患者全因死亡率的调整 HR 为 1.59（95%CI：0.96-2.65，p=0.07）。此外，多变量分析显示，半乳糖凝集素-3>8.65ng/ml 的维持性 HD 患者发生 CV 死亡的风险比半乳糖凝集素-3≤8.65ng/ml 的患者高 2.13 倍（HR=2.13，95%CI 1.07-4.26）。
结论
半乳糖凝集素-3 是维持性 HD 患者 CV 死亡率的独立预测因子。
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