Jiang Shan, Luan Chunyu, Liu Tongtong, Xu Tengfei, Zhang Jing, Zhang Peng
Department of Cardiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, China.
Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, China.
Int Urol Nephrol. 2025 Jan;57(1):197-203. doi: 10.1007/s11255-024-04152-z. Epub 2024 Jul 19.
Resolvin D1 (RvD1) inhibits inflammation, reduces oxidative stress, and forecasts the risk of cardiovascular events, but relevant evidence in hemodialysis patients is lacking. This study intended to investigate the predictive value of RvD1 for major adverse cardiovascular events (MACE) risk in hemodialysis patients.
Totally, 252 patients who underwent hemodialysis were included. Serum RvD1 was measured by enzyme-linked immunosorbent assay. Patients were followed up with a median of 12.1 months. MACE was recorded during the follow-up period.
RvD1 was inversely correlated with diabetes history (P = 0.002), cardiac troponin T (TnT) (P = 0.029), and high sensitivity C-reactive protein (hsCRP) (P < 0.001) in hemodialysis patients. 25 hemodialysis patients experienced MACE. RvD1 was reduced in hemodialysis patients with MACE versus those without MACE (P = 0.004). RvD1 exhibited a certain value in forecasting MACE risk, with an area under curve (AUC) of 0.675 [95% confidence interval CI: 0.565-0.786]. Increased RvD1 cut by median (P = 0.043) and cut by quartile (P = 0.042) were related to decreased accumulating MACE in hemodialysis patients. Moreover, RvD1 independently predicted declined MACE risk [odds ratio (OR) = 0.644, P = 0.045], but age (OR = 1.048, P = 0.039) and TnT (OR = 1.006, P = 0.005) independently predicted ascended MACE risk in hemodialysis patients. The combination of these independent factors displayed a good value for estimating MACE risk in hemodialysis patients with an AUC of 0.744 (95% CI: 0.640-0.849).
Serum RvD1 is inversely correlated with diabetes history, TnT, and hsCRP in hemodialysis patients. More importantly, it could serve as a potential marker to predict MACE risk in these patients.
消退素D1(RvD1)可抑制炎症、减轻氧化应激并预测心血管事件风险,但血液透析患者的相关证据尚缺。本研究旨在探究RvD1对血液透析患者主要不良心血管事件(MACE)风险的预测价值。
共纳入252例接受血液透析的患者。采用酶联免疫吸附测定法检测血清RvD1。对患者进行了为期12.1个月的中位随访。随访期间记录MACE。
血液透析患者中,RvD1与糖尿病史(P = 0.002)、心肌肌钙蛋白T(TnT)(P = 0.029)及高敏C反应蛋白(hsCRP)(P < 0.001)呈负相关。25例血液透析患者发生了MACE。发生MACE的血液透析患者的RvD1低于未发生MACE的患者(P = 0.004)。RvD1在预测MACE风险方面具有一定价值,曲线下面积(AUC)为0.675[95%置信区间CI:0.565 - 0.786]。血液透析患者中,RvD1以中位数截断(P = 0.043)和以四分位数截断(P = 0.042)的升高与累积MACE的减少相关。此外,RvD1独立预测MACE风险降低[比值比(OR)= 0.644,P = 0.045],但年龄(OR = 1.048,P = 0.039)和TnT(OR = 1.006,P = 0.005)独立预测血液透析患者MACE风险升高。这些独立因素的组合在评估血液透析患者MACE风险方面具有良好价值,AUC为0.744(95%CI:0.640 - 0.849)。
血液透析患者血清RvD1与糖尿病史、TnT及hsCRP呈负相关。更重要的是,它可作为预测这些患者MACE风险的潜在标志物。