Cai Meiling, Jiang Fei, Peng Yanchun, Li Sailan, Xie Yuling, Chen Liangwan, Lin Yanjuan
Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China.
Ren Fail. 2024 Dec;46(2):2433152. doi: 10.1080/0886022X.2024.2433152. Epub 2025 Jan 20.
Acute kidney injury (AKI) is a common surgical complication of acute type A aortic dissection (AAAD) and strongly associated with an unfavorable prognosis. Although elevated leptin levels have been identified as a potential risk factor for chronic kidney disease in middle-aged and elderly individuals, their association with AKI following AAAD surgery remains unknown. This study investigated the association between preoperative leptin levels and postoperative AKI in patients with AAAD.
This study included 159 patients with AAAD at Fujian Heart Medical Center. The Kidney Disease: Improving Global Outcomes standards were used to define and classify AKI. The receiver operating characteristic (ROC) curves were used to assess the ability of leptin levels to predict AKI. Binary logistic regression analysis was used to study the association between leptin level and AKI.
The incidence of AKI was 33.96%. Leptin levels in the AKI group and stage 1, 2, and 3 AKI groups were higher than those in the non-AKI group ( < 0.05). Multivariate analysis revealed that elevated leptin levels were an independent risk factor for AKI ( < 0.001). ROC analysis of leptin detection for AKI showed an area under the curve of 0.71. The risk of AKI in the high-level group (leptin levels ≥3.62 ng/mL) was 3.87 times to the low-level group (leptin levels < 3.62 ng/mL).
Elevated leptin levels are associated with AKI, and plasma leptin may serve as a potential early blood biomarker for AKI in patients with AAAD.
急性肾损伤（AKI）是急性A型主动脉夹层（AAAD）常见的手术并发症，且与不良预后密切相关。尽管瘦素水平升高已被确定为中老年个体慢性肾脏病的潜在危险因素，但其与AAAD手术后AKI的关联仍不清楚。本研究调查了AAAD患者术前瘦素水平与术后AKI之间的关联。
本研究纳入了福建心脏医疗中心的159例AAAD患者。采用改善全球肾脏病预后组织（KDIGO）标准对AKI进行定义和分类。采用受试者工作特征（ROC）曲线评估瘦素水平预测AKI的能力。采用二元逻辑回归分析研究瘦素水平与AKI之间的关联。
AKI的发生率为33.96%。AKI组及AKI 1、2、3期组的瘦素水平高于非AKI组（<0.05）。多因素分析显示，瘦素水平升高是AKI的独立危险因素（<0.001）。瘦素检测对AKI的ROC分析显示曲线下面积为0.71。高水平组（瘦素水平≥3.62 ng/mL）发生AKI的风险是低水平组（瘦素水平<3.62 ng/mL）的3.87倍。
瘦素水平升高与AKI相关，血浆瘦素可能是AAAD患者AKI潜在的早期血液生物标志物。
