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Ae 指数是超重和肥胖患者肾结石复发的独立预测因子。

Ae index is an independent predictor of kidney stone recurrence in overweight and obese patients.

机构信息

Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.

Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China.

出版信息

BMC Urol. 2023 Sep 23;23(1):151. doi: 10.1186/s12894-023-01321-7.

Abstract

BACKGROUND

Finding some convenient and economical indicators to initially screen overweight and obese patients at high risk of kidney stone recurrence can help them prevent stone recurrence with lower medical cost. The purpose of this article is to determine the clinical value of Ae index (Apo B × 1000/eGFR) as an independent predictor for kidney stone recurrence in overweight and obese populations.

METHODS

We queried the electronic medical records of patients with kidney stone operated at our hospital from March 2016 to March 2022, and selected BMI ≥ 25 kg/m as the study population and divided the patients into stone recurrence group and non-recurrence group. Relevant parameters of routine blood and biochemical test, glycated serum protein (GSP), and history of hypertension and hyperglycemia were collected. Then the Chi-square test, independent samples t-test or Wilcoxon rank-sum test were used to calculate the differences between the two groups of data. Next, we performed univariate and multivariate logistic regression analysis to screen out the most significant variables Apo B and eGFR, and then we calculated the Ae index using the formula Apo B × 1000/eGFR, and analyzed the relationship between Ae index and kidney stone recurrence.

RESULTS

Univariate analysis found that Apo B (OR:8.376,95%CI:3.093-22.680), Creatinine (OR:1.012,95%CI:1.003-1.021), Cystatin C(OR:2.747,95%CI:1.369-5.508), LDL-C (OR:1.588,95%CI:1.182-2.134), TC (OR:1.543,95%CI:1.198-1.988) were positively associated, eGFR (OR:0.980,95%CI:0.970-0.991) was negatively associated with kidney stone recurrence. And multivariate logistic regression analysis suggested that Apo B (OR:11.028, 95%CI:3.917-31.047) and eGFR (OR:0.976, 95%CI:0.965-0.988) were the most significant factors. Then we calculated Ae index and analyzed it, the sensitivity was 74.26% and the specificity was 60.00%, higher than either individual variable. Its smoothed curve revealed a non-linear relationship between them with the inflection point of 9.16. And the OR on the left side of the inflection point was 1.574 (95% CI: 1.228-2.018), whereas the OR on the right side of the inflection point was 1.088 (95% CI: 1.007-1.177).

CONCLUSIONS

Ae index is an easily calculated and obtained index that has some predictive value for kidney stone recurrence in overweight and obese patients, which is of interest.

摘要

背景

寻找一些方便、经济的指标来初步筛选超重和肥胖且肾结石复发风险高的患者,有助于他们以较低的医疗成本预防结石复发。本文旨在确定 Ae 指数(Apo B×1000/eGFR)作为超重和肥胖人群肾结石复发的独立预测因子的临床价值。

方法

我们查询了 2016 年 3 月至 2022 年 3 月在我院行肾结石手术的患者的电子病历,选择 BMI≥25kg/m2作为研究人群,并将患者分为结石复发组和未复发组。收集常规血生化、糖化血清蛋白(GSP)和高血压、高血糖病史等相关参数。然后采用卡方检验、独立样本 t 检验或 Wilcoxon 秩和检验比较两组数据的差异。接下来,我们进行单因素和多因素 logistic 回归分析,筛选出最显著的变量 Apo B 和 eGFR,然后使用公式 Apo B×1000/eGFR 计算 Ae 指数,并分析 Ae 指数与肾结石复发的关系。

结果

单因素分析发现 Apo B(OR:8.376,95%CI:3.093-22.680)、肌酐(OR:1.012,95%CI:1.003-1.021)、胱抑素 C(OR:2.747,95%CI:1.369-5.508)、LDL-C(OR:1.588,95%CI:1.182-2.134)、TC(OR:1.543,95%CI:1.198-1.988)与肾结石复发呈正相关,eGFR(OR:0.980,95%CI:0.970-0.991)与肾结石复发呈负相关。多因素 logistic 回归分析表明 Apo B(OR:11.028,95%CI:3.917-31.047)和 eGFR(OR:0.976,95%CI:0.965-0.988)是最重要的因素。然后我们计算了 Ae 指数并进行了分析,其敏感性为 74.26%,特异性为 60.00%,高于单个变量。其平滑曲线显示出两者之间的非线性关系,拐点为 9.16。拐点左侧的 OR 为 1.574(95%CI:1.228-2.018),而拐点右侧的 OR 为 1.088(95%CI:1.007-1.177)。

结论

Ae 指数是一个易于计算和获得的指标,对超重和肥胖患者肾结石复发有一定的预测价值,值得关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e80/10518111/a1f477891472/12894_2023_1321_Fig1_HTML.jpg

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