透析前慢性肾脏病患者体重变异性与冠状动脉钙化进展的关联
Association of Body Weight Variability With Progression of Coronary Artery Calcification in Patients With Predialysis Chronic Kidney Disease.
作者信息
Suh Sang Heon, Oh Tae Ryom, Choi Hong Sang, Kim Chang Seong, Bae Eun Hui, Oh Kook-Hwan, Lee Kyu-Beck, Han Seung Hyeok, Sung Suah, Ma Seong Kwon, Kim Soo Wan
机构信息
Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
出版信息
Front Cardiovasc Med. 2022 Jan 26;8:794957. doi: 10.3389/fcvm.2021.794957. eCollection 2021.
BACKGROUND
We investigated whether high body weight variability (BWV) is associated with a higher prevalence of coronary artery calcification (CAC) or more rapid progression of CAC in patients with predialysis chronic kidney disease (CKD).
METHODS
A total of 1,162 subjects from a nationwide prospective cohort of predialysis CKD were analyzed. The subjects were divided into the tertile (T1, T2, and T3) by BWV. CAC was assessed at the baseline and a 4-year follow-up by CT scan. Rapid progression of coronary artery calcification was defined as an increase in coronary artery calcium score (CACS) more than 200 Agatston units during a 4-year follow-up.
RESULTS
One-way ANOVA revealed that CACS change during the follow-up period is significantly higher in the subjects with high BWV, although CACS at the baseline and 4-year follow-up was not different among the tertile groups by BWV. Logistic regression analysis revealed that compared to low BWV (T1), both moderate (T2, adjusted odds ratio (OR) 2.118, 95% CI 1.075-4.175) and high (T3, adjusted OR 2.602, 95% CI 1.304-5.191) BWV was associated with significantly increased risk of rapid progression of CAC. Importantly, the association between BWV and progression of CAC remained robust even among the subjects without significant BW gain or loss during follow-up periods (T2, adjusted OR 2.007, 95% CI 1.011-3.984; T3, adjusted OR 2.054, 95% CI 1.003-4.207).
CONCLUSION
High BWV is independently associated with rapid progression of CAC in patients with predialysis CKD.
背景
我们研究了高体重变异性（BWV）是否与透析前慢性肾脏病（CKD）患者冠状动脉钙化（CAC）的较高患病率或CAC的更快进展相关。
方法
对来自全国性透析前CKD前瞻性队列的1162名受试者进行了分析。根据BWV将受试者分为三分位数（T1、T2和T3）。通过CT扫描在基线和4年随访时评估CAC。冠状动脉钙化的快速进展定义为在4年随访期间冠状动脉钙评分（CACS）增加超过200阿加斯顿单位。
结果
单因素方差分析显示，高BWV受试者在随访期间的CACS变化显著更高，尽管按BWV划分的三分位数组在基线和4年随访时的CACS并无差异。逻辑回归分析显示，与低BWV（T1）相比，中度（T2，调整优势比（OR）2.118，95%CI 1.075 - 4.175）和高度（T3，调整OR 2.602，95%CI 1.304 - 5.191）BWV均与CAC快速进展的风险显著增加相关。重要的是，即使在随访期间体重没有显著增加或减少的受试者中，BWV与CAC进展之间的关联仍然很强（T2，调整OR 2.007，95%CI 1.011 - 3.984；T3，调整OR 2.054，95%CI 1.003 - 4.207）。
结论
高BWV与透析前CKD患者CAC的快速进展独立相关。
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