Predictive effects of urinary liver-type fatty acid-binding protein for deteriorating renal function and incidence of cardiovascular disease in type 2 diabetic patients without advanced nephropathy.
Predictive effects of urinary liver-type fatty acid-binding protein for deteriorating renal function and incidence of cardiovascular disease in type 2 diabetic patients without advanced nephropathy.
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DOI：
10.2337/dc12-1298
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发表时间：
2013-05
期刊：
影响因子：
16.2
通讯作者：
Maegawa H
中科院分区：
文献类型：
--
作者：
Araki S;Haneda M;Koya D;Sugaya T;Isshiki K;Kume S;Kashiwagi A;Uzu T;Maegawa H
在2型糖尿病患者进展为晚期肾病之前，预测其肾功能衰竭和心血管疾病的发生率对于改善预后至关重要。我们研究了与肾小管间质损害相关的尿肝型脂肪酸结合蛋白（L-FABP）对肾脏和心血管预后的预测作用。在1996年至2000年期间入组了血清肌酐≤1.0 mg/dL且无明显蛋白尿的日本2型糖尿病患者（n = 618），并随访至2011年。采用酶联免疫吸附试验测定基线尿L-FABP。主要终点为肾脏和心血管复合物（血液透析、心肌梗死、心绞痛、卒中、脑出血和外周血管疾病）。次要肾脏结局是估计肾小球滤过率（eGFR）下降50%的发生率，进展至eGFR <30 mL/min/1.73 m2，以及eGFR的年下降率。在12年的中位随访期间，发生了103个主要终点。主要终点的发生率随着尿L-FABP的增加而逐步增加。在考克斯比例风险分析中，尿L-FBAP最高三分位数患者的校正风险比为1.93（95% CI 1.13-3.29）。即使在正常白蛋白尿和微量白蛋白尿中单独分析，也观察到这种关系。尿L-FABP最高三分位数的患者也表现出较高的继发性肾脏结局发生率。我们的研究结果表明，尿L-FABP可能是无晚期肾病的2型糖尿病患者肾脏和心血管预后的预测指标。
To improve prognosis, it is important to predict the incidence of renal failure and cardiovascular disease in type 2 diabetic patients before the progression to advanced nephropathy. We investigated the predictive effects of urinary liver-type fatty acid–binding protein (L-FABP), which is associated with renal tubulointerstitial damage, in renal and cardiovascular prognosis. Japanese type 2 diabetic patients (n = 618) with serum creatinine ≤1.0 mg/dL and without overt proteinuria were enrolled between 1996 and 2000 and followed up until 2011. Baseline urinary L-FABP was measured with an enzyme-linked immunosorbent assay. The primary end points were renal and cardiovascular composites (hemodialysis, myocardial infarction, angina pectoris, stroke, cerebral hemorrhage, and peripheral vascular disease). The secondary renal outcomes were the incidence of a 50% decline in estimated glomerular filtration rate (eGFR), progression to an eGFR <30 mL/min/1.73 m2, and the annual decline rate in eGFR. During a 12-year median follow-up, 103 primary end points occurred. The incidence rate of the primary end point increased in a stepwise manner with increases in urinary L-FABP. In Cox proportional hazards analysis, the adjusted hazard ratio in patients with the highest tertile of urinary L-FBAP was 1.93 (95% CI 1.13–3.29). This relationship was observed even when analyzed separately in normoalbuminuria and microalbuminuria. Patients with the highest tertile of urinary L-FABP also demonstrated a higher incidence of the secondary renal outcomes. Our results indicate that urinary L-FABP may be a predictive marker for renal and cardiovascular prognosis in type 2 diabetic patients without advanced nephropathy.
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影响因子：
16.2
作者：
Kamijo-Ikemori A;Sugaya T;Yasuda T;Kawata T;Ota A;Tatsunami S;Kaise R;Ishimitsu T;Tanaka Y;Kimura K
通讯作者：
Kimura K
影响因子：
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作者：
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Rossing, Peter
影响因子：
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作者：
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通讯作者：
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影响因子：
158.5
作者：
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通讯作者：
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影响因子：
1.2
作者：
Hidaka, H;Terada, M;Kikkawa, R
通讯作者：
Kikkawa, R