Associations of VEGF and its receptors sVEGFR-1 and-2 with cardiovascular disease and survival in prevalent haemodialysis patients
Associations of VEGF and its receptors sVEGFR-1 and-2 with cardiovascular disease and survival in prevalent haemodialysis patients
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DOI：
10.1093/ndt/gfp315
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发表时间：
2009-11-01
影响因子：
6.1
通讯作者：
Axelsson, Jonas
中科院分区：
文献类型：
--
作者：
Guo, Qunying;Carrero, Juan Jesus;Axelsson, Jonas
背景血管内皮生长因子（VEGF）最近被证明是预测生存的流行血液透析患者。可溶性VEGF受体（sVEGFR）-1和-2是VEGF活性的循环内源性调节剂。因此，我们研究了sVEGFR-1和sVEGFR-2与血液透析（HD）患者存活率之间的关系。在185例流行性HD患者中测定了VEGF系统的组分（ELISA），并测定了与临床特征、生化标志物和生存率相关的水平。随访时间平均31（20-37）个月。缺血性心脏病与sVEGFR-2水平降低独立相关（OR = 2.75，P = 0.02），sVEGFR-1与IL-6（p = 0.22，P = 0.003）和白色细胞计数（p = 0.22，P = 0.002）呈正相关。在生存分析中，sVEGFR-1水平高的患者比低水平的患者有更高的全因死亡率（Kaplan-Meier卡方= 5.6，P = 0.02）和更高的调整死亡风险（考克斯HR = 1.93，P = 0.009）。结论。在第一项sVEGFR-1和sVEGFR-2在CKD中的临床研究中，我们发现了sVEGFR和心脏疾病之间的新关联。这可能具有临床意义，因为高sVEGFR-1是全因死亡率的独立风险因素。
Background. Vascular endothelial growth factor (VEGF) was recently shown to predict survival in prevalent haemodialysis patients. Soluble VEGF receptors (sVEGFR)-1 and -2 are circulating endogenous modulators of VEGF activity. We thus studied the relationship between sVEGFR-1 and -2 and survival in a cohort of prevalent haemodialysis (HD) patients.Methods. Components of the VEGF system were measured (ELISAs) in 185 prevalent HD patients and levels related to clinical characteristics, biochemical markers and survival. The patients were followed up prospectively for a median 31 (20-37) months.Results. While ischaemic heart disease was independently associated with a lower sVEGFR-2 (OR = 2.75, P = 0.02), sVEGFR-1 was positively associated with IL-6 (p = 0.22, P = 0.003) and white blood cell count (p = 0.22, P = 0.002). In survival analysis, the patients with a high sVEGFR-1 level had a higher all-cause mortality (Kaplan-Meier Chi-Square = 5.6, P = 0.02) and a higher adjusted mortality risk (Cox HR = 1.93, P = 0.009) than those with low levels.Conclusion. In the first clinical study of sVEGFR-1 and -2 in CKD, we found novel associations between the sVEGFRs and cardiac disease. This may be of clinical importance, as a high sVEGFR-1 was an independent risk factor for all-cause mortality.