Abstract：
OBJECTIVE: To investigate the relationship between the aspartate aminotransferase to alanine aminotransferase ratio (AAR) and the prognosis of IgA nephropathy (IgAN).
METHODS: Clinical, pathological and follow-up data of 271 patients with IgAN from January 1, 2013, to July 31, 2023, were collected. A 50% decrease in estimated glomerular filtration rate (eGFR) or end-stage renal disease (ESRD) was used as renal composite end point events. A receiver operating characteristic (ROC) curve was plotted to predict the composite end point events by AAR. The optimal cutoff value of 1.24 was determined, and patients were allocated to high AAR and low AAR groups. Kaplan‒Meier (K‒M) curves and Cox proportional hazard models were used to evaluate the predictive effect of AAR on renal composite end point events.
RESULTS: After a mean follow-up of 29 months, 39 patients achieved renal composite end point events. Among them, 9 and 30 patients in the low and high AAR groups achieved renal composite end point events, respectively, with a significant difference (P < 0.001). After adjustment for confounding factors, AAR was found to be an independent prognostic factor for renal composite end point events (HR = 3.283, 95% CI: 1.489-7.238, P = 0.003). Kaplan‒Meier analysis showed that high AAR was associated with achieving renal composite end point events in patients with IgAN. Moreover, the clinical features in the high AAR group were more severe. Further subgroup analysis showed that high AAR had a better predictive effect in patients with more severe clinicopathological manifestations.
CONCLUSIONS: AAR is an independent prognostic factor in patients with IgAN.
METHODS: Clinical, pathological and follow-up data of 271 patients with IgAN from January 1, 2013, to July 31, 2023, were collected. A 50% decrease in estimated glomerular filtration rate (eGFR) or end-stage renal disease (ESRD) was used as renal composite end point events. A receiver operating characteristic (ROC) curve was plotted to predict the composite end point events by AAR. The optimal cutoff value of 1.24 was determined, and patients were allocated to high AAR and low AAR groups. Kaplan‒Meier (K‒M) curves and Cox proportional hazard models were used to evaluate the predictive effect of AAR on renal composite end point events.
RESULTS: After a mean follow-up of 29 months, 39 patients achieved renal composite end point events. Among them, 9 and 30 patients in the low and high AAR groups achieved renal composite end point events, respectively, with a significant difference (P < 0.001). After adjustment for confounding factors, AAR was found to be an independent prognostic factor for renal composite end point events (HR = 3.283, 95% CI: 1.489-7.238, P = 0.003). Kaplan‒Meier analysis showed that high AAR was associated with achieving renal composite end point events in patients with IgAN. Moreover, the clinical features in the high AAR group were more severe. Further subgroup analysis showed that high AAR had a better predictive effect in patients with more severe clinicopathological manifestations.
CONCLUSIONS: AAR is an independent prognostic factor in patients with IgAN.
摘要：
目的：探讨谷草转氨酶与谷丙转氨酶比值(AAR)与IgA肾病(IgAN)预后的关系。
方法：临床，收集2013年1月1日至2023年7月31日的271例IgAN患者的病理和随访资料。估计肾小球滤过率（eGFR）或终末期肾病（ESRD）降低50％作为肾脏复合终点事件。绘制受试者工作特征（ROC）曲线以通过AAR预测复合终点事件。确定了1.24的最佳截止值，将患者分为高AAR组和低AAR组。使用Kaplan-Meier（K-M）曲线和Cox比例风险模型评估AAR对肾脏复合终点事件的预测作用。
结果：经过29个月的平均随访，39例患者实现肾脏复合终点事件。其中,低AAR组和高AAR组的9例和30例患者实现了肾脏复合终点事件，分别,有显著性差异(P<0.001)。在对混杂因素进行调整后，AAR是肾脏综合终点事件的独立预后因素(HR=3.283,95%CI:1.489-7.238,P=0.003)。Kaplan-Meier分析显示，在IgAN患者中，高AAR与实现肾脏复合终点事件相关。此外，高AAR组的临床特征更为严重.进一步亚组分析显示,高AAR对临床病理表现较严重的患者有较好的预测效果。
结论：AAR是IgAN患者的独立预后因素。
方法：临床，收集2013年1月1日至2023年7月31日的271例IgAN患者的病理和随访资料。估计肾小球滤过率（eGFR）或终末期肾病（ESRD）降低50％作为肾脏复合终点事件。绘制受试者工作特征（ROC）曲线以通过AAR预测复合终点事件。确定了1.24的最佳截止值，将患者分为高AAR组和低AAR组。使用Kaplan-Meier（K-M）曲线和Cox比例风险模型评估AAR对肾脏复合终点事件的预测作用。
结果：经过29个月的平均随访，39例患者实现肾脏复合终点事件。其中,低AAR组和高AAR组的9例和30例患者实现了肾脏复合终点事件，分别,有显著性差异(P<0.001)。在对混杂因素进行调整后，AAR是肾脏综合终点事件的独立预后因素(HR=3.283,95%CI:1.489-7.238,P=0.003)。Kaplan-Meier分析显示，在IgAN患者中，高AAR与实现肾脏复合终点事件相关。此外，高AAR组的临床特征更为严重.进一步亚组分析显示,高AAR对临床病理表现较严重的患者有较好的预测效果。
结论：AAR是IgAN患者的独立预后因素。
