Association of Serum Amyloid A with Kidney Outcomes and All-Cause Mortality in American Indians with Type 2 Diabetes.
Association of Serum Amyloid A with Kidney Outcomes and All-Cause Mortality in American Indians with Type 2 Diabetes.
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DOI：
10.1159/000481269
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发表时间：
2017
影响因子：
4.2
通讯作者：
Tuttle KR
中科院分区：
文献类型：
--
作者：
Saulnier PJ;Dieter BP;Tanamas SK;McPherson SM;Wheelock KM;Knowler WC;Looker HC;Meek RL;Nelson RG;Tuttle KR
血清淀粉样蛋白A（SAA）诱导肾脏细胞炎症和凋亡，与糖尿病肾病（DKD）的病理变化密切相关。较高的血清SAA浓度与2型糖尿病和晚期DKD患者终末期肾病（ESRD）和死亡风险增加相关。我们探讨了SAA在没有DKD或早期DKD的美国印第安人2型糖尿病患者中的预后价值。在随访开始时获得的血清样品中测量SAA浓度。采用多变量比例风险模型，在调整传统风险因素后，检查SAA浓度三分位数之间ESRD或死亡风险的大小。使用C统计量评估SAA相对于传统危险因素的额外预测值。在256名受试者中（平均值± SD肾小球滤过率[碘酞酸盐]=148±45 ml/min，中位[IQR]尿白蛋白/肌酐=39 [14-221] mg/g），76名受试者在中位随访15.2年和15.7年期间发生ESRD，125名受试者死亡。在多变量比例风险回归后，两个SAA最高三分位数的参与者合并显示ESRD风险降低53（风险比[HR]=0.47，95%CI 0.29-0.78），死亡风险降低30%（HR=0.70，95%CI 0.48-1.02），尽管死亡风险的降低没有统计学意义。在ESRD模型中添加SAA将C统计量从0.814增加到0.815（P=0.005）。在患有2型糖尿病的美洲印第安人中，较高的循环SAA浓度与ESRD风险降低相关。
Serum amyloid A (SAA) induces inflammation and apoptosis in kidney cells and associates with pathologic changes of diabetic kidney disease (DKD). Higher serum SAA concentrations were previously associated with increased risk of end-stage renal disease (ESRD) and death in persons with type 2 diabetes and advanced DKD. We explored the prognostic value of SAA in American Indians with type 2 diabetes without DKD or with early DKD. SAA concentration was measured in serum samples obtained at the start of follow-up. Multivariate proportional hazards models were employed to examine the magnitude of the risk of ESRD or death across tertiles of SAA concentration after adjustment for traditional risk factors. The C statistic was used to assess the additional predictive value of SAA relative to traditional risk factors. Of 256 participants (mean ± SD glomerular filtration rate [iothalamate]=148±45 ml/min, and median [IQR] urine albumin/creatinine=39 [14–221] mg/g), 76 developed ESRD and 125 died during median follow-up of 15.2 and 15.7 years, respectively. After multivariable proportional hazards regression, participants in the two highest SAA tertiles combined exhibited a 53% lower risk of ESRD (Hazard Ratio [HR]=0.47, 95%CI 0.29–0.78), and a 30% lower risk of death (HR=0.70, 95%CI 0.48–1.02), compared with participants in the lowest SAA tertile, although the lower risk of death was not statistically significant. Addition of SAA to the ESRD model increased the C statistic from 0.814 to 0.815 (P=0.005). Higher circulating SAA concentration is associated with a reduced risk of ESRD in American Indians with type 2 diabetes.
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影响因子：
13
作者：
De Buck M;Gouwy M;Wang JM;Van Snick J;Proost P;Struyf S;Van Damme J
通讯作者：
Van Damme J
影响因子：
8.2
作者：
Brosius FC;Tuttle KR;Kretzler M
通讯作者：
Kretzler M
影响因子：
2
作者：
Pencina, MJ;D'Agostino, RB
通讯作者：
D'Agostino, RB
影响因子：
6.1
作者：
Meek, Rick L.;LeBoeuf, Renee C.;Tuttle, Katherine R.
通讯作者：
Tuttle, Katherine R.
DOI：
10.4049/jimmunol.0901363
发表时间：
2009-07-15
期刊：
Journal of immunology (Baltimore, Md. : 1950)
影响因子：
--
作者：
Bauernfeind FG;Horvath G;Stutz A;Alnemri ES;MacDonald K;Speert D;Fernandes-Alnemri T;Wu J;Monks BG;Fitzgerald KA;Hornung V;Latz E
通讯作者：
Latz E