Uric acid to albumin ratio

  • 文章类型: Journal Article
    背景:血浆尿酸与白蛋白之比(UAR)被认为是炎症的新型指标。然而,UAR与冠状动脉慢血流现象(CSFP)之间的关联尚不清楚.
    方法:本研究共纳入1328例慢性冠脉综合征(CCS)患者行冠状动脉造影(CAG),未发现明显的阻塞性狭窄(<40%)。79例发生CSFP,分为CSFP组。将1:2年龄匹配的冠状动脉血流量正常的患者分配到对照组(n=158)。临床特点,实验室参数,包括尿酸,白蛋白比,比较两组的UAR和血管造影特征。
    结果:CSFP患者的尿酸水平较高(392.3±85.3vs.273.8±71.5,P<0.001),UAR(10.7±2.2vs.7.2±1.9,P<0.001),但血浆白蛋白水平较低(36.9±4.2vs.38.5±3.6,P=0.003)。此外,UAR随着CSFP涉及的船只数量的增加而增加。Logistic回归分析显示UAR是CSFP的独立预测因子。受试者工作特征(ROC)曲线分析表明,当UAR大于7.9时,AUC为0.883(95%CI:0.840-0.927,p<0.001),敏感性和特异性分别为78.2%和88.2%。
    结论:尿酸与血浆白蛋白联用,UAR可以作为CSFP的独立预测因子。
    BACKGROUND: The plasma uric acid to albumin ratio (UAR) is considered as a novel indicator for Inflammation. However, the association between UAR and coronary slow flow phenomenon (CSFP) remains unclear.
    METHODS: A total of 1328 individuals with chronic coronary syndrome (CCS) receiving coronary angiography (CAG) and found no obvious obstructive stenosis (< 40%) were included in this study. 79 individuals developed CSFP and were divided into CSFP group. The 1:2 age-matched patients with normal coronary blood flow were allocated to the control group (n = 158). The clinical characteristics, laboratory parameters including uric acid, albumin ratio, UAR and the angiographic characteristics were compared between the two groups.
    RESULTS: Patients with CSFP had a higher level of uric acid (392.3 ± 85.3 vs. 273.8 ± 71.5, P < 0.001), UAR (10.7 ± 2.2 vs. 7.2 ± 1.9, P < 0.001), but a lower level of plasma albumin (36.9 ± 4.2 vs. 38.5 ± 3.6, P = 0.003). Moreover, UAR increased as the numbers of vessels involved in CSFP increased. The logistic regression analysis demonstrated that UAR was independent predictors for CSFP. The Receiver operating characteristic (ROC) curve analysis showed that when UAR was more than 7.9, the AUC was 0.883 (95% CI: 0.840-0.927, p < 0.001), with the sensitivity and specificity were 78.2% and 88.2% respectively.
    CONCLUSIONS: Combined uric acid with plasma albumin, UAR could serve as an independent predictor for CSFP.
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  • 文章类型: Journal Article
    背景:尿酸/白蛋白比值(UAR)是一种新型的复合生物标志物,对心血管疾病具有优异的预测价值。
    目的:探讨非ST段抬高型心肌梗死(NSTEMI)患者UAR与冠状动脉侧支循环(CCC)的关系。
    方法:总共205例NSTEMI患者接受了冠状动脉造影,至少有一个主要的冠状动脉狭窄,95%都包括在内。根据CCC的发展将患者分为两组:发育不良的CCC组(Rentrop0-1)和发育良好的CCC组(Rentrop2-3)。采用单因素分析和logistic回归分析探讨NSTEMI患者不良CCC形成的影响因素。绘制受试者工作特征(ROC)曲线以评估UAR的预测值,C反应蛋白(CRP),尿酸,和白蛋白的患者有不发达的CCC,并比较曲线下面积(AUC)。
    结果:NSTEMI患者的UAR值在发展不良的CCC组中明显高于发展良好的CCC组(10.19[8.80-11.74]vs.7.79[6.28-9.55],p<.001)。在多元逻辑回归检验中,UAR(优势比[OR]:1.365,95%置信区间[CI]:1.195-1.560,p<.001),CRP(OR:1.149,95%CI:1.072-1.231,p<.001),和糖尿病(OR:2.924,95%CI:1.444-5.920,p=.003)是发展不良的CCC的独立预测因子。ROC曲线分析表明,UAR预测低发展CCC的最佳临界值为8.78,灵敏度为76.8%,特异性为62.4%。AUC为0.737(95%Cl:0.668-0.805,p<.001)。
    结论:UAR升高可能是预测NSTEMI患者发展不良的独立且有效的生物标志物。
    BACKGROUND: Uric acid/albumin ratio (UAR) is a novel composite biomarker with superior predictive value for cardiovascular disease.
    OBJECTIVE: To investigate the relationship between UAR and coronary collateral circulation (CCC) in patients with non-ST segment elevation myocardial infarction (NSTEMI).
    METHODS: A total of 205 NSTEMI patients who underwent coronary arteriography with at least one major coronary stenosis, 95% were included. Patients were divided into two groups according to CCC development: poorly-developed CCC group (Rentrop 0-1) and well-developed CCC (Rentrop 2-3). Univariate analysis and logistic regression analysis were utilized to investigate the factors influencing adverse CCC formation in NSTEMI patients. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of UAR, C-reactive protein (CRP), uric acid, and albumin for patients with poorly developed CCC, and the area under the curve (AUC) was compared.
    RESULTS: The UAR values of NSTEMI patients were significantly higher in the poorly developed CCC group than those in the well-developed CCC group (10.19 [8.80-11.74] vs. 7.79 [6.28-9.55], p < .001). In the multiple logistic regression tests, UAR (odds ratio [OR]: 1.365, 95% confidence interval [CI]: 1.195-1.560, p < .001), CRP (OR: 1.149, 95% CI: 1.072-1.231, p < .001), and diabetes (OR: 2.924, 95% CI: 1.444-5.920, p = .003) were independent predictors of poorly developed CCC. The ROC curve analysis showed that the optimal cut-off value of UAR was 8.78 in predicting poorly developed CCC with a sensitivity of 76.8% and specificity of 62.4%, with the AUC of 0.737 (95% Cl: 0.668-0.805, p < .001).
    CONCLUSIONS: Elevated UAR may be an independent and effective biomarker for predicting poorly-developed CCC development in NSTEMI patients.
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  • 文章类型: Journal Article
    目的:尿酸/白蛋白比值(UAR),一本小说,简单,和综合实验室生物标志物,预测疾病预测和疾病预后最近引起了人们的关注。然而,尿酸相关生物标志物(尤其是UAR)是否可作为IgAN的预后指标尚不清楚.方法:在这项回顾性队列研究中,对华西医院2009年至2017年活检确诊的IgAN患者进行评估.使用Youden指数通过受试者工作特征曲线下面积(AUC)定义UAR对肾脏结局的最佳截止值。然后将患者分为高UAR组和低UAR组。肾脏终点定义为进展为ESRD,eGFR下降≥基线水平的50%,或开始肾脏替代治疗。Kaplan-Meier生存分析和Cox回归分析用于确定影响IgAN结局的因素。结果:共有1143例患者纳入研究,中位年龄为33.0(26.0-42.0)(男性占44.2%)。确定与肾脏存活率有关的最佳截止UAR为9.94,特异性为77.5%,灵敏度为61.5%(J,0.390;AUC,0.750)。然后,将患者分为标记为低和高UAR比率(分别为≥9.94和<9.94)的两组.在高UAR组中观察到更严重的临床表现和病理病变。校正重要临床病理参数后的多变量Cox回归分析表明,高UAR是IgAN的独立预后生物标志物。(p=0.036,HR=2.56,95%CI:1.07-6.16)。结论:UAR可能是肾脏进展的新预测因子,有助于有针对性的治疗。
    Objective: The uric acid/albumin ratio (UAR), a novel, simple, and compositive laboratory biomarker, has recently attracted attention for predicting disease prediction and disease prognosis. However, whether uric acid-related biomarkers (especially UAR) could serve as prognostic indicator for IgAN is unclear. Methods: In this retrospective cohort study, biopsy-confirmed IgAN patients from 2009 to 2017 from West China Hospital were evaluated. The optimal cutoff value of UAR for renal outcome was defined using the Youden index by the area under receiver operating characteristic curve (AUC). The patients were then categorized into the high UAR group and the low UAR group. Renal endpoints were defined as progression to ESRD, eGFR decreased ≥50% of the baseline level, or initiation of renal replacement treatment. Kaplan‒Meier survival analysis and Cox regression analysis were used to identify factors influencing IgAN outcomes. Results: A total of 1143 patients with a median age of 33.0 (26.0-42.0) (44.2% men) were included in the study. The best cut-off UAR concerned with renal survival was determined to be 9.94 with a specificity of 77.5% and a sensitivity of 61.5% (J, 0.390; AUC, 0.750). Then, the patients were divided into two groups labelled as low and high UAR ratios (≥ 9.94 and <9.94, respectively). More severe clinical manifestations and pathological lesions were observed in the high UAR group. Multivariate Cox regression analysis after adjusted for important clinicopathological parameters manifested that a high UAR was an independent prognostic biomarker for IgAN. (p = 0.036, HR =2.56, 95% CI: 1.07-6.16). Conclusion: UAR might be a novel predictor for renal progression and contribute to targeted management.
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  • 文章类型: Journal Article
    尿酸(UA)与白蛋白之比(UAR)是预测冠状动脉疾病(CAD)相关事件的新兴标志物。关于慢性CAD患者UAR与疾病严重程度之间关系的数据有限。我们旨在使用语法评分(SS)评估UAR作为CAD严重程度的指标。我们回顾性招募了558例稳定型心绞痛患者,并接受了冠状动脉造影(CAG)。患者分为两组,根据CAD严重程度:低SS(≤22)和中高SS(>22)组。中高SS评分组的UA水平较高,白蛋白水平较低(P<0.001)。中高SS组的UAR水平明显较高(P<.001)。此外,UAR水平与SS之间存在显着相关性(r=.55,95%置信区间(CI):.49-.60,P<.001)。在多变量分析中,UAR>1.34(赔率,3.8[2.3-6.2];P<.001)是中高SS的独立预测因子,而白蛋白和UA水平则不是。总之,UAR预测慢性CAD患者的疾病负担。它可能被证明是一种简单且容易获得的标记,可用于选择患者进行进一步评估。
    Uric acid (UA) to albumin ratio (UAR) is an emerging marker to predict coronary artery disease (CAD)-related events. There is limited data on the relationship between UAR and the severity of the disease in chronic CAD patients. We aimed to evaluate UAR as an indicator for CAD severity using the Syntax score (SS). We retrospectively enrolled 558 patients with stable angina pectoris and underwent coronary angiography (CAG). Patients were divided into 2 groups, according to CAD severity: low SS (≤22) and intermediate-high SS (>22) groups. UA levels were higher and albumin levels were lower in the intermediate-high SS score group (P < .001). UAR levels were significantly higher in the intermediate-high SS group (P < .001). Also, there was a significant correlation between UAR levels and SS (r = .55, 95% confidence interval (CI): .49-.60, P < .001). In multivariable analysis, UAR >1.34 (Odds ratio, 3.8 [2.3-6.2]; P < .001) was an independent predictor of intermediate-high SS while albumin and UA levels were not. In conclusion, UAR predicted disease burden in chronic CAD patients. It may prove useful as a simple and readily available marker to select patients for further evaluation.
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  • 文章类型: Journal Article
    造影剂肾病(CIN)是直接经皮冠状动脉介入治疗(pPCI)后ST段抬高型心肌梗死(STEMI)的常见并发症之一。血清尿酸与白蛋白比值(UAR)是一种新型的标志物,这与重症监护病房患者的急性肾损伤有关。我们调查了UAR对pPCI术后STEMI患者(n=1379)CIN发展的预测价值。CIN的诊断是基于pPCI术后72h内基础肌酐水平>.5mg/dL或25%的增加而做出的;CIN()组128例,CIN(-)组1251例。CIN(+)患者血清尿酸(SUA)较高,UAR,白蛋白水平低于CIN(-)患者。年龄,糖尿病,高血压,血红蛋白,入院时的葡萄糖,基础肌酐,肌钙蛋白I峰值,总胆红素,造影剂体积/肾小球滤过率,和UAR是CIN的独立预测因子。UAR检测CIN发展的截断值为1.62,灵敏度为54%,特异性为87.4%,UAR的辨别能力优于SUA或白蛋白。总之,UAR是CIN发展的独立预测因子。
    Contrast-induced nephropathy (CIN) is one of the common complication of ST-elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (pPCI). Serum uric acid to albumin ratio (UAR) is a novel marker, which is associated with acute kidney injury in intensive care unit patients. We investigated the predictive value of UAR for the development of CIN in STEMI patients (n = 1379) after pPCI. The diagnosis of CIN was made based on an increase of basal creatinine levels >.5 mg/dL or 25% within 72 h after pPCI; 128 patients were in the CIN (+) group and 1251 patients were in the CIN (-) group. CIN (+) patients had higher serum uric acid (SUA), UAR, and lower albumin levels than CIN (-) patients. Age, diabetes, hypertension, hemoglobin, glucose at admission, basal creatinine, peak troponin I, total bilirubin, contrast volume/glomerular filtration rate, and UAR were independent predictors of CIN. A cutoff value of 1.62 for UAR detected CIN development with a sensitivity of 54% and specificity of 87.4%, and the discrimination ability of UAR was better than that of SUA or albumin. In conclusion, UAR was an independent predictor of the development of CIN.
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