Background
Methods
Study participants
Data collection and laboratory measurements
Scoring systems | Score |
---|---|
GPS | |
CRP ≤ 10 mg/L and ALB ≥ 35 g/L | 0 |
CRP > 10 mg/L or ALB < 35 g/L | 1 |
CRP > 10 mg/L and ALB < 35 g/L | 2 |
PNI | |
10 × serum albumin value (g/dl) + 0.005 × peripheral lymphocyte count (/ul) ≥ 45 | 0 |
10 × serum albumin value (g/dl) + 0.005 × peripheral lymphocyte count (/ul) < 45 | 1 |
PI | |
CRP ≤ 10 mg/L and WBC ≤ 11 × 109/L | 0 |
CRP ≤10 mg/L and WBC > 11 × 109/L | 1 |
CRP > 10 mg/L and WBC ≤ 11 × 109/L | 1 |
CRP > 10 mg/L and WBC > 11 × 109/L | 2 |
Outcomes
Statistical analysis
Results
Baseline demographic and clinical characteristics
Characteristics | Values |
---|---|
Age (years) | 46.4 ± 15.1 |
Gender (Male) | 887 (59.1%) |
Smoke | 253 (16.9%) |
Body mass index (kg/m2) | 21.5 ± 3.7 |
Systolic BP (mmHg) | 136.2 ± 20.6 |
Diastolic BP (mmHg) | 84.9 ± 14.4 |
Hypertension | 605 (40.3%) |
Diabetes mellitus | 326 (21.7%) |
Cardiovascular disease | 249 (16.6%) |
Serum albumin (g/L) | 36.4 ± 5.0 |
Calcium (mmol/L) | 2.2 ± 0.3 |
Phosphorus (mmol/L) | 1.7 ± 0.6 |
iPTH (pg/mL) | 289.0 (144.4–455.5) |
CRP (mg/L) | 1.6 (0.8–5.5) |
WBC (× 109/L) | 6.9 ± 2.4 |
Lymphocyte (× 109//L) | 1.4 ± 0.6 |
Hemoglobin (g/L) | 89.8 ± 22.8 |
Total cholesterol (mmol/L) | 5.1 ± 1.4 |
Total triglycerides (mmol/L) | 1.6 ± 1.1 |
HDL-C (mmol/L) | 1.2 ± 0.4 |
LDL-C (mmol/L) | 3.0 ± 1.1 |
Plasma uric acid (μmol/L) | 430.3 ± 101.0 |
Plasma creatinine (μmol/L) | 766.7 ± 277.5 |
RRF (ml/min/1.73m2) | 3.7 ± 3.0 |
Inflammation-based prognostic scores
Prognostic score | All patients (n = 1501) | Survival patients (n = 1155) | All-cause mortality (n = 346) | CVD mortality (n = 168) |
---|---|---|---|---|
GPS | ||||
0 | 909 (60.6%) | 845 (73.2%) | 64 (18.5%) | 26 (15.5%) |
1 | 456 (30.4%) | 272 (23.5%) | 184 (53.2%) | 89 (53.0%) |
2 | 136 (9.1%) | 38 (3.3%) | 98 (28.3%) | 53 (31.5%) |
PNI | ||||
0 | 604 (40.2%) | 537 (46.5%) | 67 (19.4%) | 29 (17.3%) |
1 | 897 (59.8%) | 618 (53.5%) | 279 (80.6%) | 139 (82.7%) |
PI | ||||
0 | 1213 (80.8%) | 1016 (88.0%) | 197 (56.9%) | 89 (53.0%) |
1 | 253 (16.9%) | 130 (11.3%) | 123 (35.6%) | 68 (40.5%) |
2 | 35 (2.3%) | 9 (0.8%) | 26 (7.5%) | 11 (6.5%) |
Prognostic score | All patients (n = 1501) | Diabetic patients (n = 326) | Non-diabetic Patients (n = 1175) | P value |
---|---|---|---|---|
GPS | ||||
0 | 909 (60.6%) | 104 (31.9%) | 805 (68.5%) | < 0.001 |
1 | 456 (30.4%) | 175 (53.7%) | 281 (23.9%) | |
2 | 136 (9.1%) | 47 (14.4%) | 89 (7.6%) | |
PNI | ||||
0 | 604 (40.2%) | 75 (23.0%) | 529 (45.0%) | < 0.001 |
1 | 897 (59.8%) | 251 (71.0%) | 646 (55.0%) | |
PI | ||||
0 | 1213 (80.8%) | 233 (71.5%) | 980 (83.4%) | < 0.001 |
1 | 253 (16.9%) | 79 (24.2%) | 174 (14.8%) | |
2 | 35 (2.3%) | 14 (4.3%) | 21 (1.8%) |
Patient survival
Univariate (All-cause mortality) | Univariate (CVD mortality) | |||
---|---|---|---|---|
HR (95%CI) | P value | HR (95%CI) | P value | |
Age | 1.06 (1.05–1.07) | < 0.001 | 1.07 (1.06–1.08) | < 0.001 |
Gender (Male) | 0.92 (0.74–1.13) | 0.429 | 0.96 (0.71–1.30) | 0.790 |
Smoke | 1.16 (0.88–1.52) | 0.300 | 1.18 (0.80–1.73) | 0.401 |
Body mass index(kg/m2) | 1.06 (1.03–1.09) | < 0.001 | 1.07 (1.03–1.12) | 0.002 |
Systolic BP (mmHg) | 1.01 (1.00–1.01) | 0.013 | 1.01 (1.00–1.02) | 0.003 |
Diastolic BP (mmHg) | 0.98 (0.97–0.98) | < 0.001 | 0.98 (0.97–0.99) | < 0.001 |
Hypertension | 2.86 (2.29–3.56) | < 0.001 | 3.92 (2.81–5.48) | < 0.001 |
Diabetes mellitus | 3.35 (2.71–4.14) | < 0.001 | 4.45 (3.29–6.03) | < 0.001 |
Cardiovascular disease | 3.54 (2.84–4.43) | < 0.001 | 4.96 (3.65–6.73) | < 0.001 |
Infection | 3.46 (2.43–4.94) | < 0.001 | 2.64 (1.50–4.66) | 0.001 |
Residual renal function | 0.97 (0.92–1.01) | 0.12 | 0.94 (0.88–1.01) | 0.09 |
Calcium (mmol/L) | 0.31 (0.21–0.45) | < 0.001 | 0.28 (0.16–0.49) | < 0.001 |
Phosphorus (mmol/L) | 1.01 (0.85–1.20) | 0.902 | 0.94 (0.73–1.20) | 0.610 |
iPTH (pg/mL) | 1.00 (1.00–1.00) | 0.229 | 1.00 (1.00–1.00) | 0.626 |
Hemoglobin (g/L) | 0.99 (0.99–1.00) | 0.001 | 0.99 (0.98–0.99) | < 0.001 |
Total cholesterol (mmol/L) | 1.04 (0.97–1.13) | 0.257 | 1.12 (1.02–1.23) | 0.022 |
Total triglycerides (mmol/L) | 1.12 (1.03–1.21) | 0.008 | 1.16 (1.04–1.29) | 0.007 |
HDL-C (mmol/L) | 0.58 (0.44–0.77) | < 0.001 | 0.62 (0.42–0.93) | 0.021 |
LDL-C (mmol/L) | 1.05 (0.95–1.16) | 0.341 | 1.12 (0.99–1.28) | 0.070 |
Serum uric acid (μmol/L) | 1.00 (1.00–1.00) | 0.069 | 1.00 (1.00–1.00) | 0.007 |
Serum creatinine (μmol/L) | 1.00 (1.00–1.00) | < 0.001 | 1.00 (1.00–1.00) | < 0.001 |
GPS | ||||
0 | reference | Reference | ||
1 | 6.37 (4.79–8.48) | < 0.001 | 7.46 (4.81–11.56) | < 0.001 |
2 | 14.66 (10.68–20.13) | < 0.001 | 19.09 (11.91–30.57) | < 0.001 |
PNI | ||||
0 | reference | Reference | ||
1 | 2.84 (2.17–3.70) | < 0.001 | 3.27 (2.19–4.88) | < 0.001 |
PI | ||||
0 | reference | Reference | ||
1 | 3.48 (2.78–4.37) | < 0.001 | 4.26 (3.10–5.85) | < 0.001 |
2 | 5.29 (3.51–7.98) | < 0.001 | 5.08 (2.71–9.53) | < 0.001 |
Multivariate (All-cause mortality) | Multivariate (CVD mortality) | |||
---|---|---|---|---|
HR (95%CI) | P value | HR (95%CI) | P value | |
GPS | ||||
0 | reference | Reference | ||
1 | 3.94 (2.90–5.35) | < 0.001 | 4.41 (2.76–7.03) | < 0.001 |
2 | 7.56 (5.35–10.67) | < 0.001 | 9.64 (5.72–16.26) | < 0.001 |
PNI | ||||
0 | Reference | reference | ||
1 | 1.82 (1.36–2.43) | < 0.001 | 1.63 (1.06–2.51) | 0.027 |
PI | ||||
0 | reference | reference | ||
1 | 2.08 (1.63–2.65) | < 0.001 | 2.57 (1.81–3.66) | < 0.001 |
2 | 3.03 (2.00–4.60) | < 0.001 | 3.85 (1.99–7.46) | < 0.001 |
Comparison of prognostic values of inflammation-based scores
Prognostic score | Area under the ROC curve | 95% CI | P value (vs. GPS) |
---|---|---|---|
All-cause mortality | |||
GPS | 0.798 | 0.770–0.826 | |
PNI | 0.636 | 0.604–0.667 | < 0.001 |
PI | 0.658 | 0.622–0.694 | < 0.001 |
CVD mortality | |||
GPS | 0.781 | 0.744–0.817 | |
PNI | 0.629 | 0.589–0.670 | < 0.001 |
PI | 0.658 | 0.609–0.706 | < 0.001 |