Metabolic Syndrome Severity Score, Comparable to Serum Creatinine, Could Predict the Occurrence of End-Stage Kidney Disease in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Journal of Clinical Medicine

Ji Hye Huh¹  Sung Soo Ahn²  Jason Jungsik Song²  Jung Yoon Pyo²  Sang-Won Lee²  Pil Gyu Park²  Yong-Beom Park² 

[1]Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Gyeonggi-do, Korea

[2]Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea

关键词: antineutrophil cytoplasmic antibody;    vasculitis;    metabolic syndrome;    severity score;    end-stage kidney disease;   

DOI  :  10.3390/jcm10245744

来源: DOAJ

【 摘 要 】

This study investigated whether the metabolic syndrome (MetS) severity (MSSS) at diagnosis could predict poor outcomes during follow-up in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients with MetS. The equation for the MSSS at diagnosis used in this study was developed and validated in Korean adults aged 20–59 years. The medical records of 261 patients with AAV were retrospectively reviewed, and finally, 36 AAV patients with MetS aged 20–59 years fulfilling the inclusion criteria were included in this study. All-cause mortality, relapse, end-stage kidney disease (ESKD), cerebrovascular accident, and cardiovascular disease were assessed as the poor outcomes of AAV. Their median age was 51.2 years and 36.1% were male. The MSSS was significantly correlated with age and serum albumin but not AAV-specific indices. Among the five poor outcomes, only ESKD showed a relatively significant area under the curve (area 0.696) in receiver operating characteristic curve analysis. In the multivariable Cox hazards model analysis, both serum creatinine (HR 3.033) and MSSS (HR = 2.221) were significantly associated with ESKD occurrence. When the cut-off of the MSSS for ESKD was set at 1.72, ESKD occurred more frequently in patients with MSSS ≥ 1.72 than in those with MSSS < 1.72 (75.0% versus 14.3%, p = 0.002). Furthermore, patients with MSSS ≥ 1.72 exhibited a significantly lower cumulative ESKD-free survival rate than those with MSSS < 1.72 (p = 0.001). MSSS at the time of AAV diagnosis independently predicted the occurrence of ESKD during follow-up in patients with AAV and MetS.

【 授权许可】

Unknown