Association Of Fibrinogen-albumin Ratio With Left Ventricular Hypertrophy In Patients With Stage 3-5 Chronic Kidney Disease

Objective:To investigate the prevalence of left ventricular hypertrophy in patients with stage 3-5chronic kidney disease in our center,to explore the relationship between the level of fibrinogen-albumin ratio and left ventricular hypertrophy in patients with stage 3-5chronic kidney disease in our center,and to analyze and explore the risk factors of left ventricular hypertrophy in patients with stage 3-5 chronic kidney disease in our center.Methods:The inpatients with stage 3-5 chronic kidney disease who visited our center from July2018 to March 2020 were included,and general clinical data were collected and biochemical indicators were tested;Helical CT scan obtained coronary Agatston score,and evaluated the calcification points of each vessel,the sum was coronary calcification score,and the calcium score greater than 100 was defined as coronary calcification;Ultrasound cardiac ultrasound calculates the left ventricular ejection fraction,detects the thickness of the ventricular septum,the thickness of the posterior wall of the left ventricle,the left ventricular end-diastolic inner diameter,and determines whether there is heart valve calcification.According to the above data,the left ventricular mass index was calculated according to the recommended standards of the American and European echocardiography societies,and the left ventricular mass index≥125 g/m~2 for men,≥110 g/m~2for women(LVH group),and non-hypertrophic group(non-LVH group)for comparison.After testing,the left ventricular mass index and fibrinogen-albumin ratio did not conform to the normal distribution,and the correlation between left ventricular mass index and fibrinogen-albumin ratio level was analyzed by Spearman correlation analysis.Binary logistic regression analysis was used to evaluate the risk factors for left ventricular hypertrophy in patients with chronic kidney disease,and the odds ratio(OR)and 95%confidence interval(CI)of each risk factor were calculated,and the receiver operating characteristics(ROC)curve was plottedResults:1.Compared with the non-left ventricular hypertrophy group(84.40(67.52,107.06)),the left ventricular hypertrophy group(97.65(73.31,143.29))had a higher fibrinogen-albumin ratio level(P=0.003);2.Correlation analysis showed that the left ventricular mass index was negatively correlated with blood lymphocyte count(r=-0.269 P=0.000),corrected calcium level(r=-0.219 P=0.003),left ventricular mass index was negatively correlated with fibrinogen-albumin ratio(r=0.194,P=0.010),serum uric acid(r=0.167,P=0.025),urea nitrogen(r=0.257,P=0.000),serum inorganic phosphorus(r=0.159,P=0.033),lactate dehydrogenase(r=0.269,P=0.001),fibrinogen(r=0.220,P=0.003),D-dimer(r=0.220,P=0.003)were positively correlated,and P was<0.05;3.High fibrinogen-albumin ratio level(OR=1.012,95%CI:1.003～1.020 P=0.006),history of hypertension(OR=5.348,95%CI:1.634～17.499P=0.006),valve calcification(OR=3.392,95%CI:1.490～7.722 P=0.004),coronary calcification(OR=2.675,95%CI:1.180～6.064 P=0.018),high blood uric acid level(OR=1.004,95%CI:1.000～1.007 P=0.026)are independent risk factors for left ventricular hypertrophy in patients with stage 3-5 chronic kidney disease.4.Fibrinogen-albumin ratio predicts the ROC curve area under the ROC curve of left ventricular hypertrophy in patients with stage 3-5 chronic kidney disease is 0.630,P=0.003;lymphocyte count,blood uric acid,coronary calcification,valve calcification,hypertension,fibrinogen-albumin ratio combined factors predict the ROC curve area under the ROC curve of left ventricular hypertrophy is 0.833,P<0.000.Conclusion:The fibrinogen-albumin ratio was significantly positively correlated with the left ventricular mass index in patients with stage 3-5 chronic kidney disease in this center,and was an independent risk factor for left ventricular hypertrophy in patients with stage3-5 chronic kidney disease.Lymphocyte count,blood uric acid,coronary calcification,valvular calcification,hypertension,and fibrinogen-albumin ratio are independent risk factors for left ventricular hypertrophy in patients with stage 3 to 5 of chronic kidney disease.The combined indexes of the above six have certain diagnostic value and predictive value for patients with left ventricular hypertrophy in patients with stage 3-5chronic kidney disease.