Prognostic utility of plasma S100A12 levels to establish a novel scoring system for predicting mortality in maintenance hemodialysis patients: a two-year prospective observational study in Japan.
Prognostic utility of plasma S100A12 levels to establish a novel scoring system for predicting mortality in maintenance hemodialysis patients: a two-year prospective observational study in Japan.
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DOI：
10.1186/1471-2369-14-16
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发表时间：
2013-01-16
期刊：
影响因子：
2.3
通讯作者：
Kosaki A
中科院分区：
文献类型：
--
作者：
Shiotsu Y;Mori Y;Nishimura M;Hatta T;Imada N;Maki N;Iida K;Iwamoto N;Matsuoka E;Tamagaki K;Kosaki A
S100A12蛋白是糖基化终末产物的内源性受体配体。在这项研究中，血浆S100A12水平被评估为死亡率的独立预测因子，并对其在临床环境中的实用性进行了检验。在先前的一项横断面研究中，对550名维持性血液透析患者的血浆S100A12水平进行了测定，以确定S100A12与心血管疾病(CVD)患病率的相关性。在这项前瞻性研究中，确定了两年内的死亡风险。建立了一个基于血浆S100A12水平预测死亡率的整数评分系统。较高的血浆S100A12水平(≥18.79 ng/mL)与较低的血浆S100A12水平(<；18.79 ng/mL；P = 0.001)相比，与较高的全因死亡率密切相关。多因素COX比例风险分析显示较高的血浆S100A12水平[危险比(HR)，2.267；95%可信区间(CI)，1.195-4.302；P = 0.012]、年龄≥65岁(HR，1.961；95%CI，1.017-3.781；P = 0.044)、血清白蛋白水平和3.5g/dL(HR，2.198；95%CI，1.218-3.968；P = 0.012)和心血管病史(HR，2.068；95%CI，1.146-3.732；P = 0.016)是两年全因死亡率的独立预测因素。通过给这些因素分配分数并确定总分，得出了整数分。评分系统显示了预测全因死亡率的评分增加的趋势[c-统计量 = 0.730(0.656-0.804)]。所建立的模型对303名血液透析患者的有效人群显示出很好的区分能力[c-统计量 = 0.721(0.627-0.815)]。结果表明，血浆S100A12水平是两年全因死亡率的独立预测因子。因此，建立了一个基于血浆S100A12水平预测死亡率的简单整数评分系统。
S100A12 protein is an endogenous receptor ligand for advanced glycation end products. In this study, the plasma S100A12 level was assessed as an independent predictor of mortality, and its utility in clinical settings was examined. In a previous cross-sectional study, plasma S100A12 levels were measured in 550 maintenance hemodialysis patients to determine the association between S100A12 and the prevalence of cardiovascular diseases (CVD). In this prospective study, the risk of mortality within a two-year period was determined. An integer scoring system was developed to predict mortality on the basis of the plasma S100A12 levels. Higher plasma S100A12 levels (≥18.79 ng/mL) were more closely associated with higher all-cause mortality than lower plasma S100A12 levels (<18.79 ng/mL; P = 0.001). Multivariate Cox proportional hazards analysis revealed higher plasma S100A12 levels [hazard ratio (HR), 2.267; 95% confidence interval (CI), 1.195–4.302; P = 0.012], age ≥65 years (HR, 1.961; 95%CI, 1.017–3.781; P = 0.044), serum albumin levels <3.5 g/dL (HR, 2.198; 95%CI, 1.218–3.968; P = 0.012), and history of CVD (HR, 2.068; 95%CI, 1.146–3.732; P = 0.016) to be independent predictors of two-year all-cause mortality. The integer score was derived by assigning points to these factors and determining total scores. The scoring system revealed trends across increasing scores for predicting the all-cause mortality [c-statistic = 0.730 (0.656–0.804)]. The resulting model demonstrated good discriminative power for distinguishing the validation population of 303 hemodialysis patients [c-statistic = 0.721 (0.627–0.815)]. The results indicate that plasma S100A12 level is an independent predictor for two-year all-cause mortality. A simple integer scoring system was therefore established for predicting mortality on the basis of plasma S100A12 levels.