The predictive value of uric acid, adiponectin and edema index for major adverse cardiovascular events in peritoneal dialysis patients

doi:10.11958/20252525

Abstract

Abstract:

Objective To explore the predictive value of uric acid (UA), adiponectin (APN) and edema index for major adverse cardiovascular events (MACE) in peritoneal dialysis (PD) patients. Methods Eighty patients who underwent PD treatment were selected as the study group, and another 30 healthy individuals who underwent physical examination during the same period were selected as the control group. The serum levels of UA, APN and the edema index were compared between the two groups. Patients were divided into the MACE group (n=22) and the non-MACE group (n=58) based on whether MACE occurred, and the relationship between serum UA, APN and edema index and the occurrence of MACE in PD patients was analyzed. ROC curve was established to evaluate the predictive value of serum UA, APN and edema index for the occurrence of MACE in PD patients. Results The serum levels of UA, APN and the edema index were all higher in the study group than those in the control group (all P<0.01). The serum levels of UA and APN were both positively correlated with the edema index of PD patients (r=0.456, 0.341, P<0.01). The serum UA level and edema index were significantly higher in the MACE group than those in the non-MACE group, and the serum APN level was significantly lower than that in the non-MACE group (all P<0.01). The serum UA level and edema index were positively correlated with the occurrence of MACE in PD patients (r_s=0.438, 0.465, P<0.001). The serum level of APN was negatively correlated with the occurrence of MACE in PD patients (r_s=-0.447, P<0.001). The area under the curve (AUC) of serum UA, APN and edema index in predicting MACE in PD patients were 0.709 (95%CI: 0.586-0.833), 0.771 (95%CI: 0.649-0.892) and 0.722 (95%CI: 0.596-0.848), respectively. The AUC of the combined prediction of the three was 0.944 (95%CI: 0.890-0.998). Conclusion The serum levels of UA, APN and edema index are increased in PD patients. All the three are related to the occurrence of MACE. The combined detection has a higher predictive efficacy for MACE.

Key words: peritoneal dialysis, continuous ambulatory, uric acid, adiponectin, edema index, major adverse cardiovascular events

CLC Number:

R692.5

Figures/Tables 5

References 19

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组别	n	UA/（μmol/L）	APN/（mg/L）	水肿指数
对照组	30	235.48±53.47	4.66±1.11	0.18±0.04
研究组	80	576.69±98.45	6.25±1.58	0.43±0.08
t		17.980^＊＊	5.057^＊＊	16.334^＊＊

组别	n	UA/（μmol/L）	APN/（mg/L）	水肿指数
对照组	30	235.48±53.47	4.66±1.11	0.18±0.04
研究组	80	576.69±98.45	6.25±1.58	0.43±0.08
t		17.980^＊＊	5.057^＊＊	16.334^＊＊

组别				n	性别（男/女）					年龄/ 岁					BMI/ （kg/m²）
非MACE组				58	33/25					55.78±11.39					24.05±3.98
MACE组				22	15/7					57.42±10.45					23.36±4.15
χ²或t					0.846					0.588					0.687
组别	原发病
组别	慢性肾小球肾炎					IgA 肾病		糖尿病肾病			高血压肾病		狼疮性肾炎			多囊肾		紫癜性肾炎
非MACE组	20					10		7			7		6			4		4
MACE组	5					5		5			3		2			1		1
χ²	0.135
组别		收缩压/（mmHg）							舒张压/（mmHg）					血肌酐/（μmol/L）
非MACE组		147.63±25.69							91.17±8.64					975.54±243.18
MACE组		152.36±32.45							95.52±10.36					1 001.48±256.64
t		0.683							1.902					0.420
组别			血尿素氮/ （mmol/L）				血糖/ （mmol/L）					总胆固醇/ （mmol/L）					三酰甘油/ （mmol/L）
非MACE组			20.48±4.29				6.19±1.72					4.16±1.20					1.24±0.33
MACE组			21.41±5.36				6.68±1.79					4.51±1.15					1.27±0.36
t			0.807				1.125					1.178					0.354

组别				n	性别（男/女）					年龄/ 岁					BMI/ （kg/m²）
非MACE组				58	33/25					55.78±11.39					24.05±3.98
MACE组				22	15/7					57.42±10.45					23.36±4.15
χ²或t					0.846					0.588					0.687
组别	原发病
组别	慢性肾小球肾炎					IgA 肾病		糖尿病肾病			高血压肾病		狼疮性肾炎			多囊肾		紫癜性肾炎
非MACE组	20					10		7			7		6			4		4
MACE组	5					5		5			3		2			1		1
χ²	0.135
组别		收缩压/（mmHg）							舒张压/（mmHg）					血肌酐/（μmol/L）
非MACE组		147.63±25.69							91.17±8.64					975.54±243.18
MACE组		152.36±32.45							95.52±10.36					1 001.48±256.64
t		0.683							1.902					0.420
组别			血尿素氮/ （mmol/L）				血糖/ （mmol/L）					总胆固醇/ （mmol/L）					三酰甘油/ （mmol/L）
非MACE组			20.48±4.29				6.19±1.72					4.16±1.20					1.24±0.33
MACE组			21.41±5.36				6.68±1.79					4.51±1.15					1.27±0.36
t			0.807				1.125					1.178					0.354

组别	n	UA/（μmol/L）	APN/（mg/L）	水肿指数
非MACE组	58	551.17±85.67	6.61±1.48	0.40±0.06
MACE组	22	624.09±102.34	5.59±1.26	0.48±0.09
t		3.219^＊＊	2.860^＊	4.606^＊＊