Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, MacKay Medical College, No. 92, Sec. 2, Zhongshan N. Rd.,, Taipei, 10449, Taiwan.
Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan.
Sci Rep. 2024 Oct 26;14(1):25477. doi: 10.1038/s41598-024-77228-6.
Although several studies have demonstrated the cardiovascular (CV) implication of hypoalbuminemia and arterial calcification among hemodialysis patients, little is known regarding their cardiac correlates and relevant CV outcomes in asymptomatic individuals. We assessed the potential CV interrelation between serum albumin (SA) and aortic calcification. Among 2,723 asymptomatic individuals underwent cardiovascular health check-up, we assessed serum albumin (SA) level, thoracic aortic calcification (TAC) and coronary artery calcification (CAC) by multi-detector computed tomography, and ultrasound-determined carotid plaque burden. We related these measures to cardiac structure/function and CV outcomes. Lower SA level was associated with higher TAC score and volume rather than carotid plaque or coronary calcification burden in fully adjusted models. By categorizing the study population into 4 groups by SA (>, ≤ 4.6 mg/dL) and presence of TAC, subjects classified into low SA/TAC(+) category were oldest with highest prevalent CV disease. Both lower SA and TAC(+) were independently associated with impaired myocardial systolic/diastolic mechanics and higher CV events during a median of 6.6 years (IQR: 5.1, 6.8 years) follow-up. Participants classified into low SA/TAC(+) category showed highest risk for CV events (adjusted HR: 3.78 [95% CI: 2.11, 6.77], high SA/TAC[-] as reference) in fully adjusted Cox model. Among symptom-free individuals, TAC was closely associated with low SA concentration in relation to unfavorable cardiac mechanics and may serve as a useful prognosticator for adverse CV events.
虽然几项研究表明，低白蛋白血症和血液透析患者的动脉钙化与心血管（CV）有关，但对于无症状个体中它们的心脏相关性及其相关 CV 结局知之甚少。我们评估了血清白蛋白（SA）和主动脉钙化之间潜在的 CV 相互关系。在 2723 名接受心血管健康检查的无症状个体中，我们通过多探测器 CT 评估了血清白蛋白（SA）水平、胸主动脉钙化（TAC）和冠状动脉钙化（CAC），并通过超声确定了颈动脉斑块负担。我们将这些措施与心脏结构/功能和 CV 结局相关联。在完全调整的模型中，较低的 SA 水平与较高的 TAC 评分和体积相关，而与颈动脉斑块或冠状动脉钙化负担无关。通过将研究人群按 SA（>，≤4.6mg/dL）和 TAC 存在情况分为 4 组，分类为低 SA/TAC（+）组的患者年龄最大，且患有最多的 CV 疾病。在中位数为 6.6 年（IQR：5.1，6.8 年）的随访中，较低的 SA 和 TAC（+）均与心肌收缩/舒张力学受损和更高的 CV 事件独立相关。在完全调整的 Cox 模型中，分类为低 SA/TAC（+）组的患者发生 CV 事件的风险最高（调整后的 HR：3.78[95%CI：2.11，6.77]，以高 SA/TAC[-]为参考）。在无症状个体中，TAC 与低 SA 浓度密切相关，与不良的心脏力学有关，可能是不良 CV 事件的有用预后指标。
