Circulating Malondialdehyde Is a Potential Biomarker for Predicting All-Cause Mortality during Follow-Up by Reflecting Comprehensive Inflammation at Diagnosis in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Clinical Data
2.3. Measurement of cMDA
2.4. Statistical Analyses
3. Results
3.1. Patient Characteristics
3.2. Correlation Analysis
3.3. Cut-Off, RR, and Survival Rates of cMDA for Mortality
3.4. Cox Proportional Analyses for All-Cause Mortality during Follow-Up
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Values |
---|---|
At AAV diagnosis | |
Demographic data | |
Age (years) | 63.0 (51.8–73.3) |
Male sex (n, (%)) | 32 (41.0) |
Female sex (n, (%)) | 46 (59.0) |
Ex-smoker (n, (%)) | 3 (3.8) |
Body mass index (kg/m2) | 22.4 (20.8–24.7) |
AAV subtypes (n, (%)) | |
MPA | 38 (48.7) |
GPA | 23 (29.5) |
EGPA | 17 (21.8) |
ANCA positivity (n, (%)) | |
MPO-ANCA titre | 0 (0–20.5) |
PR3-ANCA titre | 0 (0–0) |
MPO-ANCA (or P-ANCA)-positive | 43 (55.1) |
PR3-ANCA (or C-ANCA)-positive | 12 (15.4) |
Both ANCA-positive | 3 (3.8) |
AAV-specific indices | |
BVAS | 5.0 (3.0–17.0) |
FFS | 0 (0–1.0) |
Comorbidities (n, (%)) | |
Type 2 diabetes mellitus | 17 (21.8) |
Hypertension | 25 (32.1) |
Acute-phase reactants | |
ESR (mm/h) | 24.5 (9.8–79.8) |
CRP (mg/L) | 3.4 (0.8–19.4) |
Laboratory results | |
White blood cell count (/mm3) | 7,710.0 (5952.5–10,525.0) |
Haemoglobin (g/dL) | 12.5 (10.3–13.6) |
Platelet count (x1000/mm3) | 241.0 (191.5–356.5) |
Fasting glucose (mg/dL) | 94.5 (87.8–109.3) |
Total cholesterol (mg/dL) | 175.5 (140.0–212.3) |
Blood urea nitrogen (mg/dL) | 19.3 (13.7–28.7) |
Serum creatinine (mg/dL) | 0.8 (0.6–1.6) |
Total serum protein (g/dL) | 6.8 (6.3–7.3) |
Serum albumin (g/dL) | 4.2 (3.6–4.4) |
cMDA (ng/mL) | 99.3 (4.0–196.8) |
During AAV follow-up | |
Mortality | |
All-cause mortality | 6 (7.7) |
Follow-up duration based on all-cause mortality | 26.7 (12.0–45.9) |
Medications | |
Glucocorticoids | 77 (98.7) |
Cyclophosphamide | 51 (65.4) |
Rituximab | 16 (20.5) |
Mycophenolate mofetil | 20 (25.6) |
Azathioprine | 48 (61.5) |
Tacrolimus | 7 (9.0) |
Methotrexate | 3 (3.8) |
Variables | cMDA | |
---|---|---|
Correlation Coefficient (r) | p Value | |
Age | 0.049 | 0.668 |
Body mass index | −0.187 | 0.101 |
MPO-ANCA titre | 0.078 | 0.498 |
PR3-ANCA titre | 0.006 | 0.959 |
BVAS | 0.117 | 0.310 |
FFS | 0.163 | 0.154 |
ESR | 0.251 | 0.027 |
CRP | 0.222 | 0.058 |
Variables | Univariable | Multivariable (with cMDA) | Multivariable (with cMDA ≥ 221.7 ng/mL) | ||||||
---|---|---|---|---|---|---|---|---|---|
HR | 95% CI | p Value | HR | 95% CI | p Value | HR | 95% CI | p Value | |
Age | 1.098 | 0.999, 1.207 | 0.052 | 1.169 | 1.024, 1.334 | 0.021 | 1.132 | 1.012, 1.266 | 0.030 |
Male sex | 2.861 | 0.524, 15.618 | 0.225 | ||||||
Ex-smoker | 0.046 | 0.000, 1,332,560.558 | 0.726 | ||||||
Body mass index | 1.099 | 0.862, 1.400 | 0.446 | ||||||
MPO-ANCA (or P-ANCA)-positive | 4.708 | 0.549, 40.404 | 0.158 | ||||||
PR3-ANCA (or C-ANCA)-positive | 0.038 | 0.000, 516.628 | 0.501 | ||||||
BVAS | 1.077 | 0.995, 1.165 | 0.065 | 1.028 | 0.915, 1.155 | 0.643 | 1.047 | 0.910, 1.206 | 0.520 |
FFS | 2.512 | 0.831, 5.574 | 0.115 | ||||||
Type 2 diabetes mellitus | 3.962 | 0.799, 19.640 | 0.092 | 1.650 | 0.202, 13.460 | 0.640 | 2.372 | 0.226, 24.923 | 0.472 |
Hypertension | 1.124 | 0.206, 6.141 | 0.892 | ||||||
ESR | 1.022 | 1.002, 1.042 | 0.029 | 1.012 | 0.984, 1.040 | 0.415 | 1.016 | 0.984, 1.050 | 0.324 |
CRP | 1.019 | 1.001, 1.036 | 0.034 | 1.006 | 0.976, 1.037 | 0.701 | 1.008 | 0.971, 1.046 | 0.680 |
cMDA | 1.006 | 1.001, 1.011 | 0.023 | 1.010 | 1.000, 1.019 | 0.055 | |||
cMDA ≥ 221.7 ng/mL | 11.098 | 2.027, 60.745 | 24.076 | 2.422, 239.368 | 0.007 |
Variables | Multivariable (with cMDA) | Multivariable (with cMDA ≥ 221.7 ng/mL) | ||||
---|---|---|---|---|---|---|
HR | 95% CI | p Value | HR | 95% CI | p Value | |
ESR (mm/h) | 1.015 | 0.990, 1.041 | 0.241 | 1.017 | 0.987, 1.048 | 0.268 |
CRP (mg/L) | 1.007 | 0.984, 1.031 | 0.553 | 1.011 | 0.981, 1.042 | 0.482 |
cMDA (ng/mL) | 1.005 | 1.000, 1.011 | 0.064 | |||
cMDA ≥ 221.7 ng/mL | 13.462 | 2.235, 81.067 | 0.005 |
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Chung, J.; Yoon, T.; Do, H.; Park, Y.-B.; Lee, S.-W. Circulating Malondialdehyde Is a Potential Biomarker for Predicting All-Cause Mortality during Follow-Up by Reflecting Comprehensive Inflammation at Diagnosis in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. Medicina 2024, 60, 1182. https://doi.org/10.3390/medicina60071182
Chung J, Yoon T, Do H, Park Y-B, Lee S-W. Circulating Malondialdehyde Is a Potential Biomarker for Predicting All-Cause Mortality during Follow-Up by Reflecting Comprehensive Inflammation at Diagnosis in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. Medicina. 2024; 60(7):1182. https://doi.org/10.3390/medicina60071182
Chicago/Turabian StyleChung, Jihye, Taejun Yoon, Hyunsue Do, Yong-Beom Park, and Sang-Won Lee. 2024. "Circulating Malondialdehyde Is a Potential Biomarker for Predicting All-Cause Mortality during Follow-Up by Reflecting Comprehensive Inflammation at Diagnosis in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis" Medicina 60, no. 7: 1182. https://doi.org/10.3390/medicina60071182