He Xiaojie, Wang Yaqing, Wang Yuqing, Li Xiaodong
Graduate School of Hebei Medical University, Shijiazhuang, Hebei, 050017, People's Republic of China.
Graduate School of Chengde Medical University, Chengde, Hebei, 06700, People's Republic of China.
J Inflamm Res. 2025 Jun 12;18:7735-7747. doi: 10.2147/JIR.S520602. eCollection 2025.
Intracerebral hemorrhage (ICH) is a life-threatening complication in patients undergoing maintenance hemodialysis (MHD), yet reliable biomarkers for early risk stratification remain scarce. The fibrinogen-to-albumin ratio (FAR), a composite inflammatory and nutritional marker, may offer predictive value for ICH in this high-risk population.
This retrospective study analyzed a total of 536 MHD patients (ICH group: n=207; non-ICH group: n=329) from June 2019 to June 2024. FAR was calculated based on laboratory parameters. Multivariate Logistic regression analysis was used to identify independent risk factors for ICH, and ROC curve analysis and restricted cubic spline (RCS) modeling were used to assess the predictive performance of FAR for cerebral hemorrhage in maintenance hemodialysis patients. Finally, the DeLong test was used to compare the differences in area under curve (AUC).
Logistic regression analysis revealed that FAR ([OR] 1.07, 95% [CI] 1.03-1.10, <0.001) was the independent predictor of ICH. Trend testing showed a dose-response correlation between FAR ( <0.001) and ICH risk. RCS showed a non-linear correlation between FAR and ICH risk (=0.029). ROC analysis demonstrated FAR's superior accuracy (AUC=0.75) compared to fibrinogen (AUC=0.67) and albumin (AUC=0.49), identifying 12.2 as the optimal cutoff (sensitivity=0.73, specificity=0.60). The DeLong's test confirm that FAR exhibits significantly superior discriminatory performance.
FAR may predict the occurrence of ICH in MHD patients. This study explores the application value of FAR in predicting ICH risk in MHD patients, providing a new biomarker for early identification of high-risk patients in clinical practice.
脑出血（ICH）是维持性血液透析（MHD）患者危及生命的并发症，但用于早期风险分层的可靠生物标志物仍然稀缺。纤维蛋白原与白蛋白比值（FAR）作为一种综合炎症和营养指标，可能为这一高危人群的脑出血提供预测价值。
本回顾性研究分析了2019年6月至2024年6月期间共536例MHD患者（脑出血组：n = 207；非脑出血组：n = 329）。根据实验室参数计算FAR。采用多因素Logistic回归分析确定脑出血的独立危险因素，并使用ROC曲线分析和限制性立方样条（RCS）模型评估FAR对维持性血液透析患者脑出血的预测性能。最后，使用DeLong检验比较曲线下面积（AUC）的差异。
Logistic回归分析显示FAR（[OR] 1.07，95% [CI] 1.03 - 1.10，< 0.001）是脑出血的独立预测因素。趋势检验显示FAR（< 0.001）与脑出血风险之间存在剂量反应相关性。RCS显示FAR与脑出血风险之间存在非线性相关性（= 0.029）。ROC分析表明，与纤维蛋白原（AUC = 0.67）和白蛋白（AUC = 0.49）相比，FAR具有更高的准确性（AUC = 0.75），确定12.2为最佳截断值（敏感性 = 0.73，特异性 = 0.60）。DeLong检验证实FAR具有显著优越的鉴别性能。
FAR可能预测MHD患者脑出血的发生。本研究探讨了FAR在预测MHD患者脑出血风险中的应用价值，为临床实践中早期识别高危患者提供了一种新的生物标志物。
