Open AccessAssociations among Serum Beta 2 Microglobulin, Malnutrition, Inflammation, and Advanced Cardiovascular Event in Patients with Chronic Kidney Disease
Author(s) -
Wu HungChieh,
Lee LinChien,
Wang WeiJie
Publication year - 2017
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22056
Subject(s) - medicine , hazard ratio , kidney disease , dialysis , gastroenterology , renal function , receiver operating characteristic , beta 2 microglobulin , proportional hazards model , creatinine , confidence interval
Objectives : This study examines the associations among serum β2 microglobulin (B2M), malnutrition, inflammation, and atherosclerosis ( MIA ) in those with chronic kidney disease ( CKD ). Methods: CKD patients who were followed in Taoyuan General Hospital from 2009 to 2015 were enrolled. Demographic and biochemical data, including B2M and C‐reactive protein ( CRP ) were reviewed. The participants were stratified according to B2M tertiles. Adjusted hazard ratios ( AHR s) and cumulative survival curves for death and MIA syndrome were evaluated by Cox hazard model and Kaplan–Meier method. We also calculated the area under the curve for the receiver operating characteristic curve ( AUROC ). Results : From a total of 312 CKD patients, mean follow‐up time was 39.7 months. Compared to those with lowest tertile of B2M, the highest tertile group had lower serum albumin, hemoglobin, and estimated glomerular filtration rate. After multivariate adjustment, the associations among tertiles of B2M, death or dialysis, cardiovascular events ( CVE s), and MIA syndrome remained significant. The AHR s for the highest tertile group in death or dialysis, CVE s, and MIA syndrome were 25.91 and 65.84 and 152.50(all P s <0.05).The AUROC for B2M in death or dialysis, CVE s, and MIA syndrome were greater than that for creatinine. The best cut‐off value of B2M for predicting death or dialysis, CVE s, and MIA syndrome were 5.39 mg/ dL (sensitivity: 67.1%, specificity 62.5%), 4.21 mg/ dL (sensitivity: 85.1%, specificity 52.1%), and 5.40 mg/ dL (sensitivity: 79.7%, specificity 64.1%). Conclusions: In those with CKD , serum B2M was more sensitive than creatinine in predicting CVE s and MIA syndrome.