Predictive value of uric acid/albumin ratio for coronary heart disease in patients with chronic kidney disease

doi:10.11958/20240522

Abstract

Abstract:

Objective To investigate the clinical significance and level changes of uric acid (UA)/albumin(ALB) ratio (UAR) in patients with chronic kidney disease (CKD) complicated with coronary heart disease (CHD). Methods A total of 175 patients with CKD were divided into the simple CKD group (control group, n=94) and the CKD complicated with CHD group (experimental group, n=81). The differences of blood routine, blood lipid, renal function and UAR were compared between the two groups. The influencing factors of CKD complicated with CHD were analyzed by binary Logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of each index for CKD complicated with CHD. Results There were no significant differences in white blood cell count (WBC), monocytes (Mon), total cholesterol (TC), total triglyceride (TG), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) between the two groups. The levels of neutrophils (Neu), red cell distribution width variation coefficient (RDW-CV), blood urea nitrogen (BUN), creatinine (Cr), UA and UAR levels were higher in the experimental group than those in the control group (Ρ<0.05). The levels of lymphocyte (Lym), red blood cell count (RBC), mean corpuscular hemoglobin concentration (MCHC), platelet (PLT), estimated glomerular filtration rate (eGFR) and albumin (Alb) were lower in the experimental group than those in the control group (Ρ<0.05). Logistic regression analysis showed that lower levels of RBC and MCHC, and higher levels of UAR were independent risk factors for CKD complicated with CHD. ROC curve showed that the area under the UAR curve was the largest in RBC, MCHC and UAR detection, which was 0.912 (95%CI: 0.870-0.953), the sensitivity was 90.10%, the specificity was 77.70%, the Yoden index was 0.678 and the cutoff value was 10.935. The AUC of combined detection of RBC, MCHC and UAR was 0.987 (95%CI: 0.974-0.999), the sensitivity was 93.80% and the specificity was 97.90%. Conclusion The increased serum UAR level in patients with CKD is a predictor of CHD. The combined detection of UAR, RBC and MCHC has higher prediction efficiency.

Key words: nephrosis, chronic disease, coronary disease, erythrocyte count, uric acid, serum albumin, ROC curve, uric acid/albumin ratio

CLC Number:

R692，R541.4

Figures/Tables 8

References 29

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组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²）	原发病因（a/b/c/d/e）
对照组	94	45/49	48.83±15.96	23.23±2.60	26/23/17/15/13
试验组	81	50/31	51.94±15.70	23.11±2.20	24/20/15/12/10
χ²或t		3.366	1.294	0.333	0.174

组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²）	原发病因（a/b/c/d/e）
对照组	94	45/49	48.83±15.96	23.23±2.60	26/23/17/15/13
试验组	81	50/31	51.94±15.70	23.11±2.20	24/20/15/12/10
χ²或t		3.366	1.294	0.333	0.174

组别	n			WBC/（×10⁹/L）		Neu/（×10⁹/L）		Lym/（×10⁹/L）
对照组	94			6.12（4.88，8.15）		3.62（2.82，5.15）		1.82（1.36，2.34）
试验组	81			6.21（5.02，8.61）		4.42（3.45，6.10）		1.10（0.71，1.51）
Z				0.600		2.758^＊＊		6.427^＊＊
组别		Mon/（×10⁹/L）			RBC/（×10¹²/L）				MCHC/（g/L）
对照组		0.43（0.32，0.58）			4.35±0.73				335.81±10.88
试验组		0.42（0.30，0.62）			3.08±0.77				329.58±12.93
Z或t		0.441			11.176^＊＊				3.459^＊＊
组别			RDW-CV/%				PLT/（×10⁹/L）
对照组			12.30（12.00，13.02）				221（188，268）
试验组			13.50（12.55，14.95）				179（150，230）
Z			5.957^＊＊				3.410^＊＊

组别	n			WBC/（×10⁹/L）		Neu/（×10⁹/L）		Lym/（×10⁹/L）
对照组	94			6.12（4.88，8.15）		3.62（2.82，5.15）		1.82（1.36，2.34）
试验组	81			6.21（5.02，8.61）		4.42（3.45，6.10）		1.10（0.71，1.51）
Z				0.600		2.758^＊＊		6.427^＊＊
组别		Mon/（×10⁹/L）			RBC/（×10¹²/L）				MCHC/（g/L）
对照组		0.43（0.32，0.58）			4.35±0.73				335.81±10.88
试验组		0.42（0.30，0.62）			3.08±0.77				329.58±12.93
Z或t		0.441			11.176^＊＊				3.459^＊＊
组别			RDW-CV/%				PLT/（×10⁹/L）
对照组			12.30（12.00，13.02）				221（188，268）
试验组			13.50（12.55，14.95）				179（150，230）
Z			5.957^＊＊				3.410^＊＊

组别	n	TC/ （mmol/L）	TG/ （mmol/L）	HDL-C/ （mmol/L）	LDL-C/ （mmol/L）
对照组	94	4.2（3.5，4.8）	1.5（1.1，2.0）	1.2±0.2	2.4（1.9，2.8）
试验组	81	4.3（3.8，5.2）	1.4（1.0，2.0）	1.2±0.4	2.5（2.1，3.0）
t或Z		1.689	0.952	0.122	1.795