Graduate School, Dalian Medical University, Dalian, China.
Dalian Key Laboratory of Intelligent Blood Purifcation, Dalian Municipal Central Hospital affiliated with Dalian University of Technology, Dalian, China.
BMC Nephrol. 2023 Jun 13;24(1):170. doi: 10.1186/s12882-023-03191-5.
The association between serum β-microglobulin (βM) levels and the risk of all-cause and cardiovascular disease (CVD) mortality and the incidence of cardiovascular events (CVEs) in patients undergoing maintenance hemodialysis (MHD) is inconclusive. Furthermore, no study has been performed in China on the significance of serum βM levels in MHD patients. Therefore, this study investigated the aforementioned association in MHD patients.
In this prospective cohort study, 521 MHD patients were followed at Dalian Municipal Central Hospital affiliated with Dalian University of Technology from December 2019 to December 2021. The serum βM levels were categorized into three tertiles, and the lowest tertile served as the reference group. Survival curves were calculated by the Kaplan-Meier method. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models. Sensitivity analysis was performed by excluding patients with CVD at baseline.
During the follow-up period of 21.4 ± 6.3 months, there were 106 all-cause deaths, of which 68 were caused by CVD. When excluding CVD patients at baseline, there were 66 incident CVEs. Kaplan-Meier analysis revealed that the risk of all-cause and CVD mortality in the highest tertile of serum βM levels was significantly higher than that in the lowest tertile (P < 0.05), but not for the CVEs (P > 0.05). After adjusting for potential confounders, serum βM levels were positively associated with the risk of all-cause (HR = 2.24, 95% CI = 1.21-4.17) and CVD (HR = 2.54, 95% CI = 1.19-5.43) mortality, and a linear trend was evident (P < 0.05). Besides, the results of sensitivity analysis were consistent with the main findings. However, we didn't observed the significant association between serum βM levels and CVEs (P > 0.05).
The serum βM level may be a significant predictor of the risk of all-cause and CVD mortality in MHD patients. Further studies are needed to confirm this finding.
血清β-微球蛋白（βM）水平与接受维持性血液透析（MHD）患者全因和心血管疾病（CVD）死亡率以及心血管事件（CVE）发生率之间的关系尚无定论。此外，中国尚未研究血清βM 水平在 MHD 患者中的意义。因此，本研究调查了 MHD 患者中上述关联。
在这项前瞻性队列研究中，大连大学附属大连市市中心医院于 2019 年 12 月至 2021 年 12 月对 521 名 MHD 患者进行了随访。将血清βM 水平分为三个三分位数，最低三分位数为参考组。通过 Kaplan-Meier 方法计算生存曲线。使用 Cox 比例风险模型计算危险比（HR）和 95%置信区间（CI）。通过排除基线时患有 CVD 的患者进行敏感性分析。
在 21.4±6.3 个月的随访期间，发生了 106 例全因死亡，其中 68 例由 CVD 引起。排除基线时患有 CVD 的患者后，发生了 66 例 CVE。Kaplan-Meier 分析表明，血清βM 水平最高三分位的全因和 CVD 死亡率风险明显高于最低三分位（P<0.05），但 CVE 则不然（P>0.05）。在校正潜在混杂因素后，血清βM 水平与全因（HR=2.24，95%CI=1.21-4.17）和 CVD（HR=2.54，95%CI=1.19-5.43）死亡率的风险呈正相关，且存在线性趋势（P<0.05）。此外，敏感性分析的结果与主要发现一致。然而，我们没有观察到血清βM 水平与 CVE 之间存在显著关联（P>0.05）。
血清βM 水平可能是 MHD 患者全因和 CVD 死亡率风险的重要预测指标。需要进一步的研究来证实这一发现。
