Skip to main content
Erschienen in: Clinical Rheumatology 2/2019

15.09.2018 | Original Article

Clinical role of albumin to globulin ratio in microscopic polyangiitis: a retrospective monocentric study

verfasst von: Sung Soo Ahn, Juyoung Yoo, Seung Min Jung, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee

Erschienen in: Clinical Rheumatology | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

We investigated whether albumin to globulin ratio (AGR) at diagnosis may be associated with all-cause mortality in immunosuppressive drug-naïve patients with microscopic polyangiitis (MPA). We retrospectively reviewed the medical records of 88 MPA patients, who were first classified and in whom medications was first initiated in our tertiary Hospital. We collected clinical and laboratory data as well as the rate of all-cause mortality. AGR at diagnosis was calculated as a ratio of serum albumin over globulin fraction (protein–albumin). We compared variables between survived and deceased patients. The multivariable Cox hazard model was conducted to appropriately obtain the hazard ratios (HRs). The mean age at diagnosis was 56.3 years and 24 patients (27.3%) were men. Seven patients died for the mean follow-up period of 49.7 months. Deceased patients were elder than survived patients (P = 0.048). Five factor score (FFS) (2009) (P = 0.001), creatinine (P = 0.026) and AGR (P = 0.007) at diagnosis in deceased patients were higher than those in the survived. In the multivariable Cox hazard model analysis, only AGR at diagnosis (HR 0.004) was inversely associated with all-cause mortality during the follow-up. Furthermore, when the cutoff of AGR for death was set as 0.88, patients with AGR ≤ 0.88 exhibited the lower cumulative patients survival rate than those with AGR > 0.88 (P = 0.006). Among the conventional and MPA-related risk factors for mortality, AGR at diagnosis is inversely associated with all-cause mortality during follow-up in MPA patients.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, Flores-Suarez LF, Gross WL, Guillevin L, Hagen EC, Hoffman GS, Jayne DR, Kallenberg CGM, Lamprecht P, Langford CA, Luqmani RA, Mahr AD, Matteson EL, Merkel PA, Ozen S, Pusey CD, Rasmussen N, Rees AJ, Scott DGI, Specks U, Stone JH, Takahashi K, Watts RA (2013) 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 65(1):1–11CrossRefPubMed Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, Flores-Suarez LF, Gross WL, Guillevin L, Hagen EC, Hoffman GS, Jayne DR, Kallenberg CGM, Lamprecht P, Langford CA, Luqmani RA, Mahr AD, Matteson EL, Merkel PA, Ozen S, Pusey CD, Rasmussen N, Rees AJ, Scott DGI, Specks U, Stone JH, Takahashi K, Watts RA (2013) 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 65(1):1–11CrossRefPubMed
2.
Zurück zum Zitat Watts R, Lane S, Hanslik T, Hauser T, Hellmich B, Koldingsnes W, Mahr A, Segelmark M, Cohen-Tervaert JW, Scott D (2007) Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 66(2):222–227CrossRefPubMed Watts R, Lane S, Hanslik T, Hauser T, Hellmich B, Koldingsnes W, Mahr A, Segelmark M, Cohen-Tervaert JW, Scott D (2007) Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 66(2):222–227CrossRefPubMed
3.
Zurück zum Zitat Oh JS, Lee CK, Kim YG, Nah SS, Moon HB, Yoo B (2009) Clinical features and outcomes of microscopic polyangiitis in Korea. J Korean Med Sci 24(2):269–274CrossRefPubMedPubMedCentral Oh JS, Lee CK, Kim YG, Nah SS, Moon HB, Yoo B (2009) Clinical features and outcomes of microscopic polyangiitis in Korea. J Korean Med Sci 24(2):269–274CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Ahn JK, Hwang JW, Lee J, Jeon CH, Cha HS, Koh EM (2012) Clinical features and outcome of microscopic polyangiitis under a new consensus algorithm of ANCA-associated vasculitides in Korea. Rheumatol Int 32(10):2979–2986CrossRefPubMed Ahn JK, Hwang JW, Lee J, Jeon CH, Cha HS, Koh EM (2012) Clinical features and outcome of microscopic polyangiitis under a new consensus algorithm of ANCA-associated vasculitides in Korea. Rheumatol Int 32(10):2979–2986CrossRefPubMed
5.
Zurück zum Zitat Mun CH, Yoo J, Jung SM, Song JJ, Park YB, Lee SW (2018) The initial predictors of death in 153 patients with ANCA-associated vasculitis in a single Korean centre. Clin Exp Rheumatol Mun CH, Yoo J, Jung SM, Song JJ, Park YB, Lee SW (2018) The initial predictors of death in 153 patients with ANCA-associated vasculitis in a single Korean centre. Clin Exp Rheumatol
6.
Zurück zum Zitat Xu PC, Tong ZY, Chen T, Gao S, Hu SY, Yang XW, et al. (2018) Hypoalbuminaemia in antineutrophil cytoplasmic antibody-associated vasculitis: incidence and significance. Clin Exp Rheumatol Xu PC, Tong ZY, Chen T, Gao S, Hu SY, Yang XW, et al. (2018) Hypoalbuminaemia in antineutrophil cytoplasmic antibody-associated vasculitis: incidence and significance. Clin Exp Rheumatol
7.
Zurück zum Zitat O’Connell TX, Horita TJ, Kasravi B (2005) Understanding and interpreting serum protein electrophoresis. Am Fam Physician 71(1):105–112PubMed O’Connell TX, Horita TJ, Kasravi B (2005) Understanding and interpreting serum protein electrophoresis. Am Fam Physician 71(1):105–112PubMed
8.
Zurück zum Zitat Du XJ, Tang LL, Mao YP, Sun Y, Zeng MS, Kang TB et al (2014) The pretreatment albumin to globulin ratio has predictive value for long-term mortality in nasopharyngeal carcinoma. PLoS One 9(4):e94473CrossRefPubMedPubMedCentral Du XJ, Tang LL, Mao YP, Sun Y, Zeng MS, Kang TB et al (2014) The pretreatment albumin to globulin ratio has predictive value for long-term mortality in nasopharyngeal carcinoma. PLoS One 9(4):e94473CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Suh B, Park S, Shin DW, Yun JM, Keam B, Yang HK, Ahn E, Lee H, Park JH, Cho B (2014) Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults. Ann Oncol 25(11):2260–2266CrossRefPubMed Suh B, Park S, Shin DW, Yun JM, Keam B, Yang HK, Ahn E, Lee H, Park JH, Cho B (2014) Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults. Ann Oncol 25(11):2260–2266CrossRefPubMed
10.
Zurück zum Zitat Azab B, Bibawy J, Harris K, Khoueiry G, Akerman M, Selim J, Khalil S, Bloom S, McGinn JT Jr (2013) Value of albumin-globulin ratio as a predictor of all-cause mortality after non-ST elevation myocardial infarction. Angiology 64(2):137–145CrossRefPubMed Azab B, Bibawy J, Harris K, Khoueiry G, Akerman M, Selim J, Khalil S, Bloom S, McGinn JT Jr (2013) Value of albumin-globulin ratio as a predictor of all-cause mortality after non-ST elevation myocardial infarction. Angiology 64(2):137–145CrossRefPubMed
11.
Zurück zum Zitat Mukhtyar C, Lee R, Brown D, Carruthers D, Dasgupta B, Dubey S et al (2011) Modification and validation of the Birmingham Vasculitis Activity Score (version 3). Ann Rheum Dis 68(12):1827–1832CrossRef Mukhtyar C, Lee R, Brown D, Carruthers D, Dasgupta B, Dubey S et al (2011) Modification and validation of the Birmingham Vasculitis Activity Score (version 3). Ann Rheum Dis 68(12):1827–1832CrossRef
12.
Zurück zum Zitat Guillevin L, Pagnoux C, Seror R, Mahr A, Mouthon L, Le Toumelin P, French Vasculitis Study Group (FVSG) (2011) The five-factor score revisited: assessment of prognoses of systemic necrotizing vasculitides based on the French Vasculitis Study Group (FVSG) cohort. Medicine (Baltimore) 90(1):19–27CrossRef Guillevin L, Pagnoux C, Seror R, Mahr A, Mouthon L, Le Toumelin P, French Vasculitis Study Group (FVSG) (2011) The five-factor score revisited: assessment of prognoses of systemic necrotizing vasculitides based on the French Vasculitis Study Group (FVSG) cohort. Medicine (Baltimore) 90(1):19–27CrossRef
13.
Zurück zum Zitat Csernok E, Moosig F (2014) Current and emerging techniques for ANCA detection in vasculitis. Nat Rev Rheumatol 10(8):494–501CrossRefPubMed Csernok E, Moosig F (2014) Current and emerging techniques for ANCA detection in vasculitis. Nat Rev Rheumatol 10(8):494–501CrossRefPubMed
14.
Zurück zum Zitat Murray CJ, Atkinson C, Bhalla K, Birbeck G, Burstein R, Chou D, Dellavalle R, Danaei G, Ezzati M, Fahimi A, Flaxman D, Foreman, Gabriel S, Gakidou E, Kassebaum N, Khatibzadeh S, Lim S, Lipshultz SE, London S, Lopez, MacIntyre M, Mokdad AH, Moran A, Moran AE, Mozaffarian D, Murphy T, Naghavi M, Pope C, Roberts T, Salomon J, Schwebel DC, Shahraz S, Sleet DA, Murray, Abraham J, Ali MK, Atkinson C, Bartels DH, Bhalla K, Birbeck G, Burstein R, Chen H, Criqui MH, Dahodwala, Jarlais, Ding EL, Dorsey ER, Ebel BE, Ezzati M, Fahami, Flaxman S, Flaxman AD, Gonzalez-Medina D, Grant B, Hagan H, Hoffman H, Kassebaum N, Khatibzadeh S, Leasher JL, Lin J, Lipshultz SE, Lozano R, Lu Y, Mallinger L, McDermott M, Micha R, Miller TR, Mokdad AA, Mokdad AH, Mozaffarian D, Naghavi M, Narayan KM, Omer SB, Pelizzari PM, Phillips D, Ranganathan D, Rivara FP, Roberts T, Sampson U, Sanman E, Sapkota A, Schwebel DC, Sharaz S, Shivakoti R, Singh GM, Singh D, Tavakkoli M, Towbin JA, Wilkinson JD, Zabetian A, Murray, Abraham J, Ali MK, Alvardo M, Atkinson C, Baddour LM, Benjamin EJ, Bhalla K, Birbeck G, Bolliger I, Burstein R, Carnahan E, Chou D, Chugh SS, Cohen A, Colson KE, Cooper LT, Couser W, Criqui MH, Dabhadkar KC, Dellavalle RP, Jarlais, Dicker D, Dorsey ER, Duber H, Ebel BE, Engell RE, Ezzati M, Felson DT, Finucane MM, Flaxman S, Flaxman AD, Fleming T, Foreman, Forouzanfar MH, Freedman G, Freeman MK, Gakidou E, Gillum RF, Gonzalez-Medina D, Gosselin R, Gutierrez HR, Hagan H, Havmoeller R, Hoffman H, Jacobsen KH, James SL, Jasrasaria R, Jayarman S, Johns N, Kassebaum N, Khatibzadeh S, Lan Q, Leasher JL, Lim S, Lipshultz SE, London S, Lopez, Lozano R, Lu Y, Mallinger L, Meltzer M, Mensah GA, Michaud C, Miller TR, Mock C, Moffitt TE, Mokdad AA, Mokdad AH, Moran A, Naghavi M, Narayan KM, Nelson RG, Olives C, Omer SB, Ortblad K, Ostro B, Pelizzari PM, Phillips D, Raju M, Razavi H, Ritz B, Roberts T, Sacco RL, Salomon J, Sampson U, Schwebel DC, Shahraz S, Shibuya K, Silberberg D, Singh JA, Steenland K, Taylor JA, Thurston GD, Vavilala MS, Vos T, Wagner GR, Weinstock MA, Weisskopf MG, Wulf S, Murray, U.S. Burden of Disease Collaborators (2013) The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA 310(6):591–608CrossRefPubMed Murray CJ, Atkinson C, Bhalla K, Birbeck G, Burstein R, Chou D, Dellavalle R, Danaei G, Ezzati M, Fahimi A, Flaxman D, Foreman, Gabriel S, Gakidou E, Kassebaum N, Khatibzadeh S, Lim S, Lipshultz SE, London S, Lopez, MacIntyre M, Mokdad AH, Moran A, Moran AE, Mozaffarian D, Murphy T, Naghavi M, Pope C, Roberts T, Salomon J, Schwebel DC, Shahraz S, Sleet DA, Murray, Abraham J, Ali MK, Atkinson C, Bartels DH, Bhalla K, Birbeck G, Burstein R, Chen H, Criqui MH, Dahodwala, Jarlais, Ding EL, Dorsey ER, Ebel BE, Ezzati M, Fahami, Flaxman S, Flaxman AD, Gonzalez-Medina D, Grant B, Hagan H, Hoffman H, Kassebaum N, Khatibzadeh S, Leasher JL, Lin J, Lipshultz SE, Lozano R, Lu Y, Mallinger L, McDermott M, Micha R, Miller TR, Mokdad AA, Mokdad AH, Mozaffarian D, Naghavi M, Narayan KM, Omer SB, Pelizzari PM, Phillips D, Ranganathan D, Rivara FP, Roberts T, Sampson U, Sanman E, Sapkota A, Schwebel DC, Sharaz S, Shivakoti R, Singh GM, Singh D, Tavakkoli M, Towbin JA, Wilkinson JD, Zabetian A, Murray, Abraham J, Ali MK, Alvardo M, Atkinson C, Baddour LM, Benjamin EJ, Bhalla K, Birbeck G, Bolliger I, Burstein R, Carnahan E, Chou D, Chugh SS, Cohen A, Colson KE, Cooper LT, Couser W, Criqui MH, Dabhadkar KC, Dellavalle RP, Jarlais, Dicker D, Dorsey ER, Duber H, Ebel BE, Engell RE, Ezzati M, Felson DT, Finucane MM, Flaxman S, Flaxman AD, Fleming T, Foreman, Forouzanfar MH, Freedman G, Freeman MK, Gakidou E, Gillum RF, Gonzalez-Medina D, Gosselin R, Gutierrez HR, Hagan H, Havmoeller R, Hoffman H, Jacobsen KH, James SL, Jasrasaria R, Jayarman S, Johns N, Kassebaum N, Khatibzadeh S, Lan Q, Leasher JL, Lim S, Lipshultz SE, London S, Lopez, Lozano R, Lu Y, Mallinger L, Meltzer M, Mensah GA, Michaud C, Miller TR, Mock C, Moffitt TE, Mokdad AA, Mokdad AH, Moran A, Naghavi M, Narayan KM, Nelson RG, Olives C, Omer SB, Ortblad K, Ostro B, Pelizzari PM, Phillips D, Raju M, Razavi H, Ritz B, Roberts T, Sacco RL, Salomon J, Sampson U, Schwebel DC, Shahraz S, Shibuya K, Silberberg D, Singh JA, Steenland K, Taylor JA, Thurston GD, Vavilala MS, Vos T, Wagner GR, Weinstock MA, Weisskopf MG, Wulf S, Murray, U.S. Burden of Disease Collaborators (2013) The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA 310(6):591–608CrossRefPubMed
15.
Zurück zum Zitat Koo BK, Lee CH, Yang BR, Hwang SS, Choi NK (2014) The incidence and prevalence of diabetes mellitus and related atherosclerotic complications in Korea: a National Health Insurance Database Study. PLoS One 9(10):e110650CrossRefPubMedPubMedCentral Koo BK, Lee CH, Yang BR, Hwang SS, Choi NK (2014) The incidence and prevalence of diabetes mellitus and related atherosclerotic complications in Korea: a National Health Insurance Database Study. PLoS One 9(10):e110650CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Kim NH, Lee J, Kim TJ, Kim NH, Choi KM, Baik SH, Choi DS, Pop-Busui R, Park Y, Kim SG (2015) Body mass index and mortality in the general population and in subjects with chronic disease in Korea: a nationwide cohort study (2002-2010). PLoS One 10(10):e0139924CrossRefPubMedPubMedCentral Kim NH, Lee J, Kim TJ, Kim NH, Choi KM, Baik SH, Choi DS, Pop-Busui R, Park Y, Kim SG (2015) Body mass index and mortality in the general population and in subjects with chronic disease in Korea: a nationwide cohort study (2002-2010). PLoS One 10(10):e0139924CrossRefPubMedPubMedCentral
Metadaten
Titel
Clinical role of albumin to globulin ratio in microscopic polyangiitis: a retrospective monocentric study
verfasst von
Sung Soo Ahn
Juyoung Yoo
Seung Min Jung
Jason Jungsik Song
Yong-Beom Park
Sang-Won Lee
Publikationsdatum
15.09.2018
Verlag
Springer London
Erschienen in
Clinical Rheumatology / Ausgabe 2/2019
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-018-4292-y

Weitere Artikel der Ausgabe 2/2019

Clinical Rheumatology 2/2019 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.