代谢综合征各组分对心房颤动患者不良肾脏结局风险的影响：一项全国性队列研究
Impact of components of metabolic syndrome on the risk of adverse renal outcomes in patients with atrial fibrillation: a nationwide cohort study.
作者信息
Kwon Soonil, Lee So-Ryoung, Choi Eue-Keun, Lee Seung-Woo, Jung Jin-Hyung, Han Kyung-Do, Ahn Hyo-Jeong, Oh Seil, Lip Gregory Y H
机构信息
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
出版信息
Front Cardiovasc Med. 2023 Oct 17;10:1208979. doi: 10.3389/fcvm.2023.1208979. eCollection 2023.
BACKGROUND
The renal effect of metabolic syndrome components is unclear in patients with atrial fibrillation. This study aimed to investigate the association between metabolic syndrome components and incident end-stage renal disease among patients with atrial fibrillation.
METHODS
A total of 202,434 atrial fibrillation patients without prevalent end-stage renal disease were identified from the National Health Insurance Service database between 2009 and 2016. We defined the metabolic score range from 0 to 5 points such that a patient received every 1 point if the patient met each component listed in the diagnostic criteria of metabolic syndrome. The population was divided into 6 groups: MS-MS for a metabolic score of 0-5, respectively. Multivariate Cox regression analysis was used to estimate the risks of end-stage renal disease.
RESULTS
There were 12,747, 31,059, 40,361, 48,068, 46,630, and 23,569 patients for MS-MS, respectively. Compared with MS, MS had a higher CHADS-VASc score (3.8 vs. 1.0) ( < .001). During a median follow-up of 3.5 years, compared with MS, MS-MS were associated with a gradually increasing incidence of end-stage renal disease, in relation to an increase in the metabolic score, (log-rank < .001). After multivariate adjustment, a higher metabolic score was associated with a greater risk of incident end-stage renal disease: adjusted hazard ratio [95% confidence interval] = 1.60 [0.78-3.48], 2.08 [1.01-4.31], 2.94 [1.43-6.06], 3.71 [1.80-7.66], and 4.82 [2.29-10.15], for MS-MS, respectively.
CONCLUSIONS
Metabolic syndrome components additively impacts the risk of incident end-stage renal disease among patients with atrial fibrillation.
背景
代谢综合征各组分对房颤患者肾脏的影响尚不清楚。本研究旨在探讨房颤患者中代谢综合征各组分与终末期肾病发生之间的关联。
方法
从2009年至2016年的国民健康保险服务数据库中识别出总共202434例无终末期肾病病史的房颤患者。我们将代谢评分范围定义为0至5分，即如果患者符合代谢综合征诊断标准中列出的每个组分，则得1分。将人群分为6组：代谢评分分别为0至5分的MS - MS组。采用多因素Cox回归分析来估计终末期肾病的风险。
结果
MS - MS组的患者分别有12747例、31059例、40361例、48068例、46630例和23569例。与MS组相比，MS组的CHADS - VASc评分更高（3.8对1.0）（<0.001）。在中位随访3.5年期间，与MS组相比，MS - MS组中终末期肾病的发病率随着代谢评分的增加而逐渐升高（对数秩检验<0.001）。多因素调整后，较高的代谢评分与终末期肾病发生风险增加相关：MS - MS组调整后的风险比[95%置信区间]分别为1.60[0.78 - 3.48]、2.08[1.01 - 4.31]、2.94[1.43 - 6.06]、3.71[1.80 - 7.66]和4.82[2.29 - 10.15]。
结论
代谢综合征各组分对房颤患者发生终末期肾病的风险具有累加影响。
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