The influence of body composition on renal function in patients with coronary artery disease and its prognostic significance: a retrospective cohort study.
The influence of body composition on renal function in patients with coronary artery disease and its prognostic significance: a retrospective cohort study.
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身体成分对冠心病患者肾功能的影响及其预后意义：一项回顾性队列研究
DOI：
10.1186/s12933-016-0420-7
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发表时间：
2016-08-02
影响因子：
9.3
通讯作者：
Huang DJ
中科院分区：
文献类型：
--
作者：
Peng Y;Wang H;Chen F;Huang FY;Xia TL;Liao YB;Chai H;Wang PJ;Zuo ZL;Liu W;Zhang C;Li YJ;Gui YY;Chen M;Huang DJ
方法回顾性分析2989例经冠状动脉造影证实的冠心病患者，将其分为肾功能基本保留（eGFR ≥60 ml/min）和肾功能明显降低（eGFR <60 ml/min）两组，分析肾功能对不同体成分冠心病患者死亡的影响。从体重指数（BMI）、体脂（BF）、瘦体重指数（LMI）等身体成分的三分位数分析肾功能不全对冠心病死亡率的影响。结果平均随访时间为29.1 ± 12.5个月，死亡271例。RRF的发生率与BF呈正相关，与LMI呈负相关，与BMI无关。生存曲线显示，在使用BMI、BF或LMI分层的所有亚组中，RRF患者的死亡风险显著较高（对数秩检验，所有p < 0.001）。考克斯多因素回归分析显示，高BF（HR 1.95，CI 1.25-3.05）和低LMI（HR 1.82，CI 1.19-2.79）的RRF患者的死亡风险显著增加。同时，高BMI（HR 2.08，CI 1.22-3.55）或低BMI（HR 1.98，CI 1.28-3.08）的RRF患者的死亡风险显著较高，但中等BMI患者的死亡风险不显著（HR 1.12，0.65-1.94）。急性冠状动脉综合征（ACS）患者的亚组分析显示类似的results.ConclusionsFor CAD患者，肾功能不全呈正相关，BF，负相关，与LMI，和BMI无关。肾功能不全对冠心病死亡风险的影响与身体成分有关。
ObjectiveWe try to analyse the effect of renal functions on death in CAD patients with different body compositions.MethodsA retrospective analysis was conducted in 2989 consecutive patients with CAD confirmed by coronary angiography were enrolled and were grouped into two categories: basically preserved renal function (PRF) (eGFR ≥60 ml/min) and obviously reduced renal function (RRF) (eGFR <60 ml/min). The influence of renal insufficiency on mortality of CAD was detected in every tertile of body composition, including body mass index (BMI), body fat (BF) and lean mass index (LMI). The end points were all-cause mortality.ResultsThe mean follow-up time was 29.1 ± 12.5 months and death events occurred in 271 cases. The percentage of patients with RRF was positively correlated with BF and inversely correlated with the LMI, but no relationship to BMI. The survival curves showed that the risk of death was significantly higher in the RRF patients in all subgroups stratified using BMI, BF, or LMI (log rank test, all p < 0.001). The COX multivariate regression analysis showed that the risk of death was significantly higher in the RRF patients with high BF (HR 1.95, CI 1.25–3.05) and low LMI (HR 1.82, CI 1.19–2.79). Meanwhile, risk of death was significantly higher in RRF patients with a high BMI (HR 2.08, CI 1.22–3.55) or low BMI (HR 1.98, CI 1.28–3.08) but this risk was not significant in patients with a medium BMI (HR 1.12, 0.65–1.94). The subgroup analysis of patients with acute coronary syndrome (ACS) showed similar results.ConclusionsFor patients with CAD, renal insufficiency was positively correlated with BF, inversely correlated with LMI, and unrelated to BMI. The effect of renal insufficiency on the risk of death of CAD was related to body composition.