Predictive Value of Serum Albumin Levels for Coronary Artery Calcification in Patients with Early Chronic Kidney Disease

MAI Peibiao; HUANG Shengwen; ZHANG Kun; WU Wei; LUO Niansang

doi:10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240305.007

您当前的位置：

首页 >

文章列表页 >

Predictive Value of Serum Albumin Levels for Coronary Artery Calcification in Patients with Early Chronic Kidney Disease

Clinical Research | 更新时间：2024-04-15

- Predictive Value of Serum Albumin Levels for Coronary Artery Calcification in Patients with Early Chronic Kidney Disease
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 45, Issue 2, Pages: 268-275(2024)
- 作者机构：
  
  1.中山大学孙逸仙纪念医院心血管内科，广东广州 510000
  2.中山大学附属第八医院心血管内科，广东深圳 518000
  3.梅州市人民医院心血管内科，广东梅州 514031
- 作者简介：
  
  LUO Niansang； E-mail： luons3@163.com
- 基金信息：
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240305.007
  CLC： R543.3
- Published：20 March 2024，
  
  Received：13 November 2023，
  
  Accepted：18 February 2024
扫描看全文
麦培彪,黄晟文,张坤等.早期慢性肾脏病患者体内血清白蛋白水平对冠脉钙化的预测价值[J].中山大学学报（医学科学版）,2024,45(02):268-275.

MAI Peibiao,HUANG Shengwen,ZHANG Kun,et al.Predictive Value of Serum Albumin Levels for Coronary Artery Calcification in Patients with Early Chronic Kidney Disease[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(02):268-275.
麦培彪,黄晟文,张坤等.早期慢性肾脏病患者体内血清白蛋白水平对冠脉钙化的预测价值[J].中山大学学报（医学科学版）,2024,45(02):268-275. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240305.007.

MAI Peibiao,HUANG Shengwen,ZHANG Kun,et al.Predictive Value of Serum Albumin Levels for Coronary Artery Calcification in Patients with Early Chronic Kidney Disease[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(02):268-275. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240305.007.

摘要

目的

探讨早期慢性肾脏病（CKD）患者的血清白蛋白水平与冠脉钙化（CAC）的相关性，以及对CAC发生及严重程度的预测价值。

方法

筛选2019年1月至2022年12月于中山大学孙逸仙纪念医院住院行冠状动脉CTA检查的早期CKD患者391例，收集一般临床资料、血清学检查结果、冠脉CTA检查结果。根据冠脉钙化积分（CACS）将患者分为非冠脉钙化组（CACS=0分）184例，冠脉钙化组（CACS>0分）207例；根据血清白蛋白水平分为三组，即白蛋白<35 g/L组（30例）、35 g/L≤白蛋白<40 g/L组（198例）、白蛋白≥40 g/L组（163例）。首先利用单因素及多因素回归方法分析血清白蛋白对早期CKD患者CAC的影响，其次对不同CAC程度患者中进行组内差异性分析、组间多重比较、logistics回归模型分析。

结果

冠脉钙化组患者的血清白蛋白水平显著低于非冠脉钙化组（

0.05）。在早期CKD患者中血清白蛋白水平与CACS呈负相关（

0.01），即血清白蛋白水平越低，CAC程度越严重。

结论

在早期CKD患者中，血清白蛋白水平越低，CAC发生率越高。并且低血清白蛋白水平是CAC进展的独立危险因素。

Abstract

Objective

To explore the correlation between serum albumin levels and coronary artery calcification （CAC） in patients with early-stage chronic kidney disease （CKD）， as well as the value of serum albumin levels in predicting the incidence and severity of CAC.

Methods

The study included 391 early-stage CKD patients who underwent coronary computed tomography angiography （CTA） at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2019 and December 2022. Demographic and biochemistry data， as well as the coronary CTA results， were collected. Based on the coronary artery calcification score （CACS）， all patients were divided into non-CAC group （CACS=0，

=184） and CAC group （CACS

0，

=207）. All patients were further divided into 3 groups based on the serum albumin levels： group A （serum albumin levels

35 g/L，

=30）， group B （35 g/L≤ serum albumin levels

40 g/L，

=198） and group C （serum albumin levels≥ 40 g/L，

=163）. Univariate and multivariate binary logistic regression analyses were conducted to investigate the association between serum albumin levels and CAC in early-stage CKD patients. Differences in CAC among groups were analyzed by using post-hoc multiple comparisons and ordinal logistic regression model analysis.

Results

Patients with CAC had significantly lower serum albumin levels than those without CAC （

0.05）. There was a negative correlation between serum albumin levels and CACS in early-stage CKD patients （

0.01）， as serum albumin decreased in levels， CAC increased in severity.

Conclusions

Our study shows that early-stage CKD patients with lower serum albumin levels have a higher incidence of CAC. Low serum albumin level is an independent risk factor for CAC progression.

关键词

慢性肾脏病动脉粥样硬化冠状动脉钙化血清白蛋白肾小球滤过率危险因素

Keywords

chronic kidney disease （CKD）atherosclerosiscoronary artery calcification （CAC）serum albuminglomerular filtration raterisk factors

references

Pazianas M， Miller PD. Current understanding of mineral and bone disorders of chronic kidney disease and the scientific grounds on the use of exogenous parathyroid hormone in its management［J］. J Bone Metab，2020，27（1）： 1-13.

Zangeneh F， Clarke BL， Hurley DL， et al. Chronic kidney disease-mineral and bone disorders （CKD-MBDs）： what the endocrinologist needs to know［J］. Endocr Pract， 2014， 20（5）： 500-516.

Verma H， Sunder S， Sharma BB， et al. Prevalence of vascular calcification in chronic kidney disease stage 4 and 5 patients and its correlation with inflammatory markers of atherosclerosis［J］. Saudi J Kidney Dis Transpl， 2021， 32（1）： 30-41.

Seltzer MH， Bastidas JA， Cooper DM， et al. Instant nutritional assessment［J］. JPEN J Parenter Enteral Nutr， 1979， 3（3）： 157-159.

Yamada S， Tokumoto M， Taniguchi M， et al. Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis： The Q-Cohort Study［J］. Sci Rep， 2018， 8（1）： 11387.

Fowler WE， Fretto LJ， Hamilton KK， et al. Substructure of human von Willebrand factor［J］. J Clin Invest， 1985， 76（4）： 1491-1500.

Chen S， Chen L， Jiang H. Prognosis and risk factors of chronic kidney disease progression in patients with diabetic kidney disease and non-diabetic kidney disease： a prospective cohort CKD-ROUTE study［J］. Renal failure， 2022， 44（1）： 1309-1318.

Joki N， Hase H， Tanaka Y， et al. Relationship between serum albumin level before initiating haemodialysis and angiographic severity of coronary atherosclerosis in end-stage renal disease patients［J］. Nephrol Dial Transplant， 2006， 21（6）： 1633-1639.

KDIGOKCW Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease［J］. Kidney Int Suppl， 2013， 3（1）：1-150.

Thongprayoon C， Cheungpasitporn W， Chewcharat A， et al. Impacts of admission serum albumin levels on short-term and long-term mortality in hospitalized patients［J］. QJM， 2020， 113（6）： 393-398.

Abdelrahman KM， Chen MY， Dey AK， et al. Coronary computed tomography angiography from clinical uses to emerging technologies： JACC state-of-the-art review［J］. J Am Coll Cardiol， 2020， 76（10）： 1226-1243.

Serruys PW， Hara H， Garg S， et al. Coronary computed tomographic angiography for complete assessment of coronary artery disease： JACC state-of-the-art review［J］. J Am Coll Cardiol， 2021， 78（7）： 713-736.

Greenland P， Blaha MJ， Budoff MJ， et al. Coronary calcium score and cardiovascular risk［J］. J Am Coll Cardiol， 2018， 72（4）： 434-447.

Suzuki Y， Matsumoto N， Yoda S， et al. Coronary artery calcium score： current status of clinical application and how to handle the results［J］. J Cardiol， 2022， 79（5）： 567-571.

Xu C， Cunqing Y， Chun G， et al. The relationship between serum vitamin K concentration and coronary artery calcification in middle-aged and elderly people［J］. Clin Chim Acta， 2022， 531： 325-330.

Rabbani G， Ahn SN. Structure， enzymatic activities， glycation and therapeutic potential of human serum albumin： A natural cargo［J］. Int J Biol Macromol， 2019， 123： 979-990.

Mikhailidis DP， Ganotakis ES. Plasma albumin and platelet function： relevance to atherogenesis and thrombosis［J］. Platelets， 1996， 7（3）： 125-137.

Oduncu V， Erkol A， Karabay CY， et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention［J］. Coron Artery Dis， 2013， 24（2）： 88-94.

Kurtul A， Murat SN， Yarlioglues M， et al. Usefulness of serum albumin concentration to predict high coronary SYNTAX score and in-hospital mortality in patients with acute coronary syndrome［J］. Angiology， 2016， 67（1）： 34-40.

Ritchie RF， Palomaki GE， Neveux LM， et al. Reference distributions for the negative acute-phase serum proteins， albumin， transferrin and transthyretin： a practical， simple and clinically relevant approach in a large cohort［J］. J Clin Lab Anal， 1999， 13（6）： 273-279.

李国华，李玲，何敏，等.多种炎症指标联合淋巴细胞亚群在COVID-19不同临床分型的临床诊断价值分析［J］. 重庆医科大学学报，2020，45（7）：971-975.

Li GH，Li L，He M，et al. Value of various inflammatory markers combined with lymphocyte subsets on clinical diagnosis of different clinical types of COVID-19［J］.J Chongqing Med Univ，2020，45（7）：971-975.

李希，林敏，马犇，等.治疗前炎症指标构建模型预测卵巢癌患者术后生存［J］.中山大学学报（医学科学版），2021，42（6）：937-943.

Li X，Lin M，Ma B，et al. Model based on preoperative inflammatory markers to predict the overall survival in patients with ovarian cancer［J］. J Sun Yat-Sen Univ（Med Sci）， 2021，42（6）：937-943.

Kaysen GA， Dubin JA， Müller HG， et al. Inflammation and reduced albumin synthesis associated with stable decline in serum albumin in hemodialysis patients［J］. Kidney Int， 2004， 65（4）： 1408-1415.

Akboga MK， Yayla C， Balci KG， et al. Relationship between serum albumin level and monocyte-to-high-density lipoprotein cholesterol ratio with saphenous vein graft disease in coronary bypass［J］. Thorac Cardiovasc Surg， 2017， 65（4）： 315-321.

Arques S. Human serum albumin in cardiovascular diseases［J］. Eur J Intern Med， 2018， 52： 8-12.

Kawai Y， Masutani K， Torisu K， et al. Association between serum albumin level and incidence of end-stage renal disease in patients with immunoglobulin a nephropathy： a possible role of albumin as an antioxidant agent［J］. PloS One， 2018， 13（5）： e0196655.

Mukai H， Villafuerte H， Qureshi AR， et al. Serum albumin， inflammation， and nutrition in end-stage renal disease： C-reactive protein is needed for optimal assessment［J］. Semin Dial， 2018， 31（5）： 435-439.

Donadio C， Tognotti D， Donadio E. Albumin modification and fragmentation in renal disease［J］. Clin Chim Acta， 2012， 413（3-4）： 391-395.

Yamada S， Tokumoto M， Tsuruya K， et al. Fetuin-A decrease induced by a low-protein diet enhances vascular calcification in uremic rats with hyperphosphatemia［J］. Am J Physiol Renal Physiol， 2015， 309（8）： F744-754.

Yamada S， Tokumoto M， Tatsumoto N， et al. Very low protein diet enhances inflammation， malnutrition， and vascular calcification in uremic rats［J］. Life Sci， 2016， 146： 117-123.

Dautova Y， Kozlova D， Skepper JN， et al. Fetuin-A and albumin alter cytotoxic effects of calcium phosphate nanoparticles on human vascular smooth muscle cells［J］. PloS One， 2014， 9（5）： e97565.

Defilippis AP， Kramer HJ， Katz R， et al. Association between coronary artery calcification progression and microalbuminuria： the MESA study［J］. JACC Cardiovasc Imaging， 2010， 3（6）： 595-604.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Risk Prediction Model for Pulmonary Fungal Infections in Patients with Lung Cancer

Risk Factors and Predictive Model for Severe Myelosuppression due to Chemotherapy in Triple-negative Breast Cancer

The Role of EO% and CRP in Risk Factors Analysis of Young Patients with Transfusion Related Adverse Reactions

Risk Factors for in-Hospital Mortality in Patients with Takotsubo Syndrome

Related Author

LIANG Jian-ping

LUO Tian

JI Wen-tao

DU Wei-wei

LV Yan-hua

LI Ding

TANG Na

WANG Lin

Related Institution

Graduate School of Zunyi Medical University Zhuhai Campus

Department of Respiratory and Critical Care Medicine， Zhongshan City People's Hospital

Department of General Surgery, The Second Affiliated Hospital of Jiujiang College

Department of Breast Surgery, The Second Affiliated Hospital of Nanchang University

Department of Blood Transfusion， Sun Yat-sen Memorial Hospital， Sun Yat-sen University

Postal code：510080
Tel：020-87331643，87330827 Email：xbmed@mail.sysu.edu.cn
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰