Serum Bilirubin Is Correlated With the Progression of IgA Vasculitis With Nephritis.
Serum Bilirubin Is Correlated With the Progression of IgA Vasculitis With Nephritis.
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DOI：
10.3389/fmed.2021.596151
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发表时间：
2021
影响因子：
3.9
通讯作者：
Qin W
中科院分区：
文献类型：
--
作者：
Tan J;Pei G;Xu Y;Hu T;Tan L;Zhong Z;Tarun P;Tang Y;Qin W
背景：胆红素已被确定为内源性抗氧化剂和细胞保护剂。本研究旨在阐明血清胆红素对伊加血管炎伴肾炎（IgAV-N）的潜在影响。方法：收集189例14岁以上IgAV-N患者。根据ROC曲线计算出的最佳截断值将患者分为两组。复合终点定义为估计肾小球滤过率（e-GFR）下降60%、终末期肾病（ESRD）和/或死亡。采用Kaplan-Meier（K-M）分析和多因素考克斯分析确定肾脏预后的预测因素。为了消除不同基线数据的影响，进行了1：2的倾向评分（PS）匹配，以使结果具有可比性和说服力。结果如下：基线数据显示，低血清胆红素组患者收缩压、蛋白尿、血肌酐和新月体形成率显著升高，血清白蛋白和血红蛋白水平显著降低。肾存活率分析表明，血清胆红素水平较低与预后不良显着相关。多因素考克斯分析显示，血清胆红素水平升高是肾存活率的独立保护因素（HR，0.172，95%CI，0.030-0.991，P = 0.049）。PS匹配后，两组基线特征无统计学差异。K-M曲线和多因素考克斯分析结果相似。结论：胆红素水平升高可能与良好的肾脏结局有关。
Background: Bilirubin has been identified as an endogenous antioxidant and cellular protectant. The present study was performed to clarify the potential influence of serum bilirubin on IgA vasculitis with nephritis (IgAV-N). Methods: One hundred and eighty-nine IgAV-N patients over 14 years old were enrolled. The patients were divided into two groups by the optimum cut-off value calculated by ROC curve. The composite endpoints were defined as a 60% decline in estimate glomerular filtration rate (e-GFR), end-stage renal disease (ESRD) and/or death. Kaplan-Meier (K-M) analysis and multivariate Cox analysis were carried out to determine the predictors for renal outcomes. In order to eliminate the influence of different baseline data, a 1:2 propensity score (PS) match was performed to make the results comparable and convictive. Results: The baseline data suggested that patients in low serum bilirubin group had significantly higher levels of systolic blood pressure, proteinuria, serum creatinine and crescent formation ratio and lower levels of serum albumin and hemoglobin. Renal survival analysis indicated that lower serum bilirubin levels were significantly correlated with a poorer prognosis. Multivariate Cox analysis demonstrated that the higher level of serum bilirubin was an independent protective factor for renal survival (HR, 0.172; 95% CI, 0.030–0.991; P = 0.049). After PS matching, the baseline characters of two groups had no statistical differences. Similar outcomes were demonstrated in K-M curve and the multivariate Cox analysis. Conclusion: Elevated bilirubin levels might be related to the favorable renal outcomes.
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作者：
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DOI：
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发表时间：
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