美国成人白蛋白-胆红素评分与心血管风险的关系

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2025-06-04 DOI:10.1016/j.hrtlng.2025.05.019

Tao Tang MD , Yu Feng MD , Aline M. Thomas PhD , Shen Li MD, PhD

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引用次数: 0

摘要

背景肝功能障碍在心血管疾病（CVD）中发挥着重要作用，但缺乏有效实用的CVD筛查临床生物标志物。白蛋白-胆红素（ALBI）评分是一种新的肝损害生物标志物，在心力衰竭中具有重要的预后价值。目的探讨ALBI评分与心血管危险的关系。方法：这项具有全国代表性的研究纳入了2001-2018年全国健康与营养检查调查中20岁及以上的成年人。ALBI评分采用公式（log10胆红素[umol/L] * 0.66 ~ 0.85 *白蛋白[g/dL]）计算。结果是心血管疾病患病率和死亡率。采用加权多变量回归分析确定ALBI评分与预后之间的关系。结果对43194名成人进行数据分析。最初共发现4923例心血管疾病，在平均8.9年的随访期间，发生了1878例心血管疾病相关死亡。每标准差较高的ALBI评分与心血管疾病患病率升高（OR 1.18, 95% CI 1.13-1.23）和死亡率升高（HR 1.25, 95% CI 1.17-1.33）相关。ALBI评分第二分位或最高分位与最低分位的CVD患病率比值比分别为1.12 （95% CI 0.99-1.26）和1.35 (95% CI 1.21-1.51) (P为趋势和lt；0.001)。相应的心血管疾病死亡率风险比分别为1.05 （95% CI 0.88-1.26）和1.31 (95% CI 1.12-1.53) (P为趋势和lt；0.001)。结论：在美国成年人中，较高的ALBI评分与CVD患病率和死亡率增加相关。肝功能障碍的ALBI评分可作为CVD危险分层的有效标志。

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Association of albumin-bilirubin score with cardiovascular risk among adults in the US

Background

Liver dysfunction plays a significant role in cardiovascular disease (CVD), yet it lacks effective and practical clinical biomarkers for CVD screening. Albumin-bilirubin (ALBI) score, a novel liver impairment biomarker, has demonstrated significant prognostic value in heart failure.

Objective

To evaluate the association between the ALBI score and cardiovascular risk.

Methods

This nationally representative study included adults 20 years or older in age from the National Health and Nutritional Examination Survey 2001–2018. ALBI score was calculated using the formula (log₁₀ bilirubin [umol/L] * 0.66 - 0.85 * albumin [g/dL]). Outcomes were CVD prevalence and mortality. Weighted multivariable regression analyses were performed to determine the associations between ALBI score and outcomes.

Results

Data for 43194 adults were analyzed. A total of 4923 CVD were initially identified, and 1878 CVD-related deaths occurred over an average follow-up period of 8.9 years. A per standard deviation higher ALBI score was associated with an elevated CVD prevalence (OR 1.18, 95 % CI 1.13–1.23) and mortality (HR 1.25, 95 % CI 1.17–1.33). The odds ratios for CVD prevalence comparing the second or highest tertile to the lowest tertile of ALBI scores were 1.12 (95 % CI 0.99–1.26) and 1.35 (95 % CI 1.21–1.51), respectively (P for trend < 0.001). The corresponding hazard ratios for CVD mortality were 1.05 (95 % CI 0.88–1.26) and 1.31 (95 % CI 1.12–1.53), respectively (P for trend < 0.001).

Conclusions

A higher ALBI score was associated with an increased risk of CVD prevalence and mortality among US adults. The ALBI score of liver dysfunction may serve as an effective marker for CVD risk stratification.

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.