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Found 1 result for Uric acid elevation in pediatric patients with dilated cardiomyopathy and prediction of mortality
发现1个扩张型心肌病儿童患者尿酸升高的结果并预测死亡率
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. 2024 Jul 23:11:1404755.
doi: 10.3389/fcvm.2024.1404755. eCollection 2024.  电子收藏2024.

Uric acid elevation in pediatric patients with dilated cardiomyopathy and prediction of mortality
扩张型心肌病患儿尿酸升高与死亡率的关系

Yong Han #  1 , Cheng Chen #  1 , Suyuan Qin  1 , Dongli Liu  1 , Yusheng Pang  1
韩勇  #   1 、陈成  #   1 、秦素媛   1 、刘东丽   1 、庞宇生   1
Affiliations   从属关系

Uric acid elevation in pediatric patients with dilated cardiomyopathy and prediction of mortality

Yong Han et al. Front Cardiovasc Med. .

Abstract

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Background and aims:Pediatric dilated cardiomyopathy (DCM) is a primary cause of heart failure, highlighting the urgent need for effective prognostic markers.
背景和目的：小儿扩张型心肌病（DCM）是心力衰竭的主要原因，迫切需要有效的预后指标。

Methods:We performed a single-center retrospective study involving 145 children diagnosed with DCM, with a median follow-up period of 4.0 months (interquartile range: 6.2-108.4 months). The relationship between serum uric acid (SUA) levels and all-cause mortality was assessed using Kaplan-Meier survival curves, multivariate Cox proportional hazard models, and restricted cubic spline (RCS) models.
方法：我们进行了一项单中心回顾性研究，涉及145名诊断为扩张型心肌病的儿童，中位随访期为4.0个月（四分位距：6.2-108.4个月）。使用Kaplan-Meier生存曲线、多变量考克斯比例风险模型和限制三次样条（RCS）模型评估血清尿酸（SUA）水平与全因死亡率之间的关系。

Results:Of the 145 children with DCM (median age 5.7 years; 61.4% male), 45 (31%) died within 1 year, and 65 (44.8%) died during the maximum follow-up period. In adjusted multivariate Cox regression models, each log2 SUA increase was linked to a higher risk of 1-year mortality [hazard ratio (HR), 2.66; 95% confidence interval (CI), 1.41-5.01] and overall mortality (HR, 1.97; 95% CI, 1.15-3.37). The highest SUA tertile showed a greater risk of mortality at 1 year (HR, 4.26; 95% CI: 1.5-12.06) and during the maximum follow-up (HR, 2.56; 95% CI: 1.06-6.16) compared with the lowest tertile. RCS models indicated an inverted L-shaped association between baseline SUA levels and overall mortality risk, with age-stratified analyses revealing a linear and U-shaped relationship in children ≤10 and >10 years, respectively. Further age-stratified analyses highlighted the modifying effect of age on this association.
结果：在145名DCM儿童（中位年龄5.7岁; 61.4%为男性）中，45名（31%）在1年内死亡，65名（44.8%）在最长随访期内死亡。在校正的多变量考克斯回归模型中，每增加1个log 2 SUA与1年死亡率[风险比（HR），2.66; 95%置信区间（CI），1.41-5.01]和总死亡率（HR，1.97; 95% CI，1.15-3.37）的风险升高相关。与最低三分位数相比，最高SUA三分位数显示1年时（HR，4.26; 95% CI：1.5-12.06）和最长随访期间（HR，2.56; 95% CI：1.06-6.16）的死亡风险更高。RCS模型显示基线SUA水平与总体死亡风险之间呈倒L形相关，年龄分层分析显示≤10岁和>10岁儿童分别呈线性和U形关系。进一步的年龄分层分析强调了年龄对这种关联的修正作用。

Conclusion:Elevated SUA levels are a significant predictor of mortality in pediatric DCM, with a pronounced impact on children under 10 years of age. Therefore, SUA levels could serve as potential biomarkers for risk stratification in this population.
结论：SUA水平升高是儿童DCM死亡率的重要预测因子，对10岁以下儿童有显著影响。因此，SUA水平可作为该人群危险分层的潜在生物标志物。

Keywords: children; dilated cardiomyopathy; heart failure; mortality; serum uric acid.
关键词：儿童;扩张型心肌病;心力衰竭;死亡率;血尿酸。

Background and aims:Pediatric dilated cardiomyopathy (DCM) is a primary cause of heart failure, highlighting the urgent need for effective prognostic markers.
背景和目的：小儿扩张型心肌病（DCM）是心力衰竭的主要原因，迫切需要有效的预后指标。

Methods:We performed a single-center retrospective study involving 145 children diagnosed with DCM, with a median follow-up period of 4.0 months (interquartile range: 6.2-108.4 months). The relationship between serum uric acid (SUA) levels and all-cause mortality was assessed using Kaplan-Meier survival curves, multivariate Cox proportional hazard models, and restricted cubic spline (RCS) models.
方法：我们进行了一项单中心回顾性研究，涉及145名诊断为DCM的儿童，中位随访期为4.0个月（四分位距：6.2-108.4个月）。采用Kaplan-Meier生存曲线、多变量考克斯比例风险模型和限制性三次样条（RCS）模型评估血清尿酸（SUA）水平与全因死亡率之间的关系。

Results:Of the 145 children with DCM (median age 5.7 years; 61.4% male), 45 (31%) died within 1 year, and 65 (44.8%) died during the maximum follow-up period. In adjusted multivariate Cox regression models, each log2 SUA increase was linked to a higher risk of 1-year mortality [hazard ratio (HR), 2.66; 95% confidence interval (CI), 1.41-5.01] and overall mortality (HR, 1.97; 95% CI, 1.15-3.37). The highest SUA tertile showed a greater risk of mortality at 1 year (HR, 4.26; 95% CI: 1.5-12.06) and during the maximum follow-up (HR, 2.56; 95% CI: 1.06-6.16) compared with the lowest tertile. RCS models indicated an inverted L-shaped association between baseline SUA levels and overall mortality risk, with age-stratified analyses revealing a linear and U-shaped relationship in children ≤10 and >10 years, respectively. Further age-stratified analyses highlighted the modifying effect of age on this association.
结果：在145名DCM儿童（中位年龄5.7岁; 61.4%为男性）中，45名（31%）在1年内死亡，65名（44.8%）在最长随访期内死亡。在调整后的多变量考克斯回归模型中，每log 2 SUA增加与1年死亡率[风险比（HR），2.66; 95%置信区间（CI），1.41-5.01]和总死亡率（HR，1.97; 95%CI，1.15-3.37）的较高风险有关。与最低三分位数相比，最高SUA三分位数显示1年时（HR，4.26; 95% CI：1.5-12.06）和最长随访期间（HR，2.56; 95% CI：1.06-6.16）的死亡风险更高。RCS模型显示基线SUA水平与总体死亡风险之间呈倒L形相关，年龄分层分析显示≤10岁和>10岁儿童分别呈线性和U形关系。进一步的年龄分层分析强调了年龄对这种关联的修正作用。

Conclusion:Elevated SUA levels are a significant predictor of mortality in pediatric DCM, with a pronounced impact on children under 10 years of age. Therefore, SUA levels could serve as potential biomarkers for risk stratification in this population.
结论：SUA水平升高是儿童DCM死亡率的重要预测因子，对10岁以下儿童有显著影响。因此，SUA水平可作为该人群危险分层的潜在生物标志物。

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Conflict of interest statement
利益冲突声明

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
作者声明，该研究是在没有任何商业或财务关系的情况下进行的，这些关系可能被解释为潜在的利益冲突。

Figures  图

Figure 1
Figure 1
Distribution of baseline uric acid values in the study population. Changes of mean baseline uric acid levels according to age and sex.
Figure 2
Figure 2
Kaplan–Meier plots of mortality in children with dilated cardiomyopathy. Kaplan–Meier curves for (A) 1-year mortality and (B) overall mortality. SUA, serum uric acid.
Figure 3
Figure 3
Hazard ratios for all-cause mortality based on baseline serum uric acid levels. Restricted cubic spline models for (A) the whole cohort, (B) individuals ≤10 years, and (C) individuals >10 years. Adjusted for all covariates in Table 2 Model 3. Ref, reference; SUA, serum uric acid.
Figure 4
Figure 4
Subgroup analysis of the risk of mortality in children with dilated cardiomyopathy. Subgroup analysis for (A) 1-year mortality and (B) overall mortality. Adjusted for all covariates in Table 2 Model 3. NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; eGFR, estimated glomerular filtration rate.
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References

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Uric acid elevation in pediatric patients with dilated cardiomyopathy and prediction of mortality
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