Controlling Nutritional Status Score is Associated with All-Cause Mortality in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis
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Purpose: The controlling nutritional status (CONUT) score was developed to detect undernutrition in patients. Here, we investigatedwhether the CONUT score estimated at diagnosis could help predict poor outcomes [all-cause mortality, relapse, and endstagerenal disease (ESRD)] of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Materials and Methods: We retrospectively reviewed and collated data, including baseline characteristics, clinical manifestations(to calculate AAV-specific indices), and laboratory results, from 196 newly diagnosed AAV patients. Serum albumin, peripherallymphocyte, and total cholesterol levels (at diagnosis) were used to calculate CONUT scores. Results: In total, 111 patients had high CONUT scores (≥3), which showed higher frequency of myeloperoxidase-ANCA andANCA positivity, and demonstrated higher AAV-specific indices. The optimal cut-offs of CONUT score (at diagnosis) for predictingall-cause mortality and ESRD were ≥3.5 and ≥2.5, respectively. Patients with CONUT scores higher than the cut-off at diagnosis exhibitedlower cumulative and ESRD-free survival rates compared to those with lower scores than the cut-off. In multivariable analyses,diabetes mellitus [hazard ratio (HR): 4.394], five-factor score (HR: 3.051), and CONUT score ≥3.5 (HR: 4.307) at diagnosis wereindependent predictors of all-cause mortality, while only serum creatinine (HR: 1.714) was an independent predictor of ESRD occurrence. Conclusion: CONUT score at diagnosis is associated with all-cause mortality in AAV patients.
Abstract
Purpose: The controlling nutritional status (CONUT) score was developed to detect undernutrition in patients. Here, we investigatedwhether the CONUT score estimated at diagnosis could help predict poor outcomes [all-cause mortality, relapse, and endstagerenal disease (ESRD)] of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Materials and Methods: We retrospectively reviewed and collated data, including baseline characteristics, clinical manifestations(to calculate AAV-specific indices), and laboratory results, from 196 newly diagnosed AAV patients. Serum albumin, peripherallymphocyte, and total cholesterol levels (at diagnosis) were used to calculate CONUT scores. Results: In total, 111 patients had high CONUT scores (≥3), which showed higher frequency of myeloperoxidase-ANCA andANCA positivity, and demonstrated higher AAV-specific indices. The optimal cut-offs of CONUT score (at diagnosis) for predictingall-cause mortality and ESRD were ≥3.5 and ≥2.5, respectively. Patients with CONUT scores higher than the cut-off at diagnosis exhibitedlower cumulative and ESRD-free survival rates compared to those with lower scores than the cut-off. In multivariable analyses,diabetes mellitus [hazard ratio (HR): 4.394], five-factor score (HR: 3.051), and CONUT score ≥3.5 (HR: 4.307) at diagnosis wereindependent predictors of all-cause mortality, while only serum creatinine (HR: 1.714) was an independent predictor of ESRD occurrence. Conclusion: CONUT score at diagnosis is associated with all-cause mortality in AAV patients.
참고문헌 (27)
- Jennette JC, "2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides", Arthritis Rheum, 65, pp.1~11 (2013)
- Jennette JC, "Nomenclature of systemic vasculitides. Proposal of an international consensus conference", Arthritis Rheum, 37, pp.187~192 (1994)
- Tan JA, "Mortality in ANCA-associated vasculitis : ameta-analysis of observational studies", Ann Rheum Dis, 76, pp.1566~1574 (2017)
- Elefante E, "One year in review 2017 : systemic vasculitis", Clin Exp Rheumatol, 35(Suppl 103), pp.5~26 (2017)
- Kristensen T, "The relation between histopathological classification and renal outcome, ANCA subtype and treatment regimens in ANCA-associated vasculitis", Clin Exp Rheumatol, 34(3 Suppl 97), pp.S105~110 (2016)
- Furuta S, "Comparison of the phenotype and outcome of granulomatosis with polyangiitis between UK and Japanese cohorts", J Rheumatol, 44, pp.216~222 (2017)
- Furuta S, "Comparison of phenotype and outcome in microscopic polyangiitis between Europe and Japan", J Rheumatol, 41, pp.325~333 (2014)
- 문재승, "C-Reactive Protein to Serum Albumin Ratio Is an Independent Predictor of All-Cause Mortality in Patients with ANCA-Associated Vasculitis", Yonsei Medical Journal, 59(7), pp.865~871 (2018), 연세대학교의과대학[DOI]
- Ahn SS, "Clinical role of albumin to globulin ratio in microscopic polyangiitis : a retrospective monocentric study", Clin Rheumatol, 38, pp.487~494 (2019)
- Ahn SS, "Neutrophil to lymphocyte ratio at diagnosis can estimate vasculitis activity and poor prognosis in patients with ANCA-associated vasculitis : a retrospective study", BMC Nephrol, 19, pp.187~ (2018)
- 유주영, "Delta Neutrophil Index Is Associated with Vasculitis Activity and Risk of Relapse in ANCA-Associated Vasculitis", Yonsei Medical Journal, 59(3), pp.397~405 (2018), 연세대학교의과대학[DOI]
- Kim Y, "Systemic immune-inflammation index could estimate the cross-sectional high activity and the poor outcomes in immunosuppressive drugnaïve patients with antineutrophil cytoplasmic antibody-associated vasculitis", Nephrology, 24, pp.711~717 (2019)
- Choi H, "Low serum complement 3 level is associated with severe ANCA-associated vasculitis at diagnosis", Clin Exp Nephrol, 23, pp.223~230 (2019)
- Ignacio de Ulíbarri J, "CONUT: a tool for controlling nutritional status. First validation in a hospital population", Nutr Hosp, 20, pp.38~45 (2005)
- Liang RF, "The prognostic role of controlling nutritional status scores in patients with solid tumors", Clin Chim Acta, 474, pp.155~158 (2017)
- Nakagomi A, "Nutritional status is associated with inflammation and predicts a poor outcome in patients with chronic heart failure", J Atheroscler Thromb, 23, pp.713~727 (2016)
- Victoria A. Rus, "Altered nutritional status, inflammation and systemic vulnerability in patients with acute myocardial infarction undergoing percutaneous coronary revascularisation: A prospective study in a level 3 cardiac critical care unit", Nutrition & Dietetics (2019), Wiley[DOI]
- Mukhtyar C, "Modification and validation of the Birmingham Vasculitis Activity Score(version 3)", Ann Rheum Dis, 68, pp.1827~1832 (2009)
- Stone JH, "A disease-specific activity index for Wegener’s granulomatosis:modification of the Birmingham Vasculitis Activity Score. International Network for the Study of the Systemic Vasculitides (INSSYS)", Arthritis Rheum, 44, pp.912~920 (2001)
- Guillevin L, "The Five-Factor Score revisited: assessment of prognoses of systemic necrotizing vasculitides based on the French Vasculitis Study Group (FVSG) cohort", Medicine(Baltimore), 90, pp.19~27 (2011)
- Mukhtyar C, "Remission in antineutrophil cytoplasmic antibody-associated systemic vasculitis", Clin Exp Rheumatol, 24(6 Suppl 43), pp.S-93~98 (2006)
- Hasegawa M, "A retrospective study on the outcomes of MPO-ANCAassociated vasculitis in dialysis-dependent patients", Mod Rheumatol, 26, pp.110~114 (2016)
- Titeca-Beauport D, "Early predictors of one-year mortality in patients over 65 presenting with ANCA-associated renal vasculitis : a retrospective, multicentre study", BMC Nephrol, 19, pp.317~ (2018)
- Murray CJ, "The state of US health, 1990-2010 : burden of diseases, injuries, and risk factors", JAMA, 310, pp.591~608 (2013)
- Nago N, "Low cholesterol is associated with mortality from stroke, heart disease, and cancer : the Jichi Medical School Cohort Study", J Epidemiol, 21, pp.67~74 (2011)
- Kronmal RA, "The relationship between cholesterol level and myocardial infarction or mortality risk in patients with coronary artery disease. A report from the Coronary Artery Surgery Study (CASS) registry", Ann Epidemiol, 2, pp.129~136 (1992)
- 배종면, "Low Cholesterol is Associated with Mortality from Cardiovascular Diseases: A Dynamic Cohort Study in Korean Adults", Journal of Korean Medical Science, 27(1), pp.58~63 (2012), 대한의학회