title: Associations among Serum Beta 2 Microglobulin, Malnutrition, Inflammation, and Advanced Cardiovascular Event in Patients with Chronic Kidney Disease.
abstract: OBJECTIVE
  This study examines the associations among serum β2 microglobulin (B2M), malnutrition, inflammation, and atherosclerosis (MIA) in those with chronic kidney disease (CKD).
  
  
  METHODS
  CKD patients who were followed in Taoyuan General Hospital from 2009 to 2015 were enrolled. Demographic and biochemical data, including B2M and C-reactive protein (CRP) were reviewed. The participants were stratified according to B2M tertiles. Adjusted hazard ratios (AHRs) and cumulative survival curves for death and MIA syndrome were evaluated by Cox hazard model and Kaplan-Meier method. We also calculated the area under the curve for the receiver operating characteristic curve (AUROC).
  
  
  RESULTS
  From a total of 312 CKD patients, mean follow-up time was 39.7 months. Compared to those with lowest tertile of B2M, the highest tertile group had lower serum albumin, hemoglobin, and estimated glomerular filtration rate. After multivariate adjustment, the associations among tertiles of B2M, death or dialysis, cardiovascular events (CVEs), and MIA syndrome remained significant. The AHRs for the highest tertile group in death or dialysis, CVEs, and MIA syndrome were 25.91 and 65.84 and 152.50(all Ps <0.05).The AUROC for B2M in death or dialysis, CVEs, and MIA syndrome were greater than that for creatinine. The best cut-off value of B2M for predicting death or dialysis, CVEs, and MIA syndrome were 5.39 mg/dL(sensitivity: 67.1%, specificity 62.5%), 4.21 mg/dL(sensitivity: 85.1%, specificity 52.1%), and 5.40 mg/dL(sensitivity: 79.7%, specificity 64.1%).
  
  
  CONCLUSIONS
  In those with CKD, serum B2M was more sensitive than creatinine in predicting CVEs and MIA syndrome.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Wu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan.
authors.forename: Lin-Chien
authors.initials: LC
authors.lastname: Lee
authors.affiliation: Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan.
authors.forename: Wei-Jie
authors.initials: WJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D012189:Retrospective Studies; D001613:beta 2-Microglobulin / Q000097:blood*
chemical_list: D001613:beta 2-Microglobulin
keywords: C-reactive protein; MIA syndrome; Mortality; cardiovascular event; β2 microglobulin