Urine clusterin/apolipoprotein J is linked to tubular damage and renal outcomes in patients with type 2 diabetes mellitus.
Urine clusterin/apolipoprotein J is linked to tubular damage and renal outcomes in patients with type 2 diabetes mellitus.
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DOI：
10.1111/cen.13360
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发表时间：
2017-08
影响因子：
3.2
通讯作者：
Kim YB
中科院分区：
文献类型：
--
作者：
Kim SS;Song SH;Kim JH;Jeon YK;Kim BH;Kang MC;Chun SW;Hong SH;Chung M;Kim YK;Kim IJ;Kim YB
本研究的目的是评价尿聚集素/载脂蛋白J（Apo J）与2型糖尿病肾病（DKD）发生和/或进展的关系。入选了159例2型糖尿病患者和20例估计肾小球滤过率（eGFR）≥60 mL/min/1.73 m2的非糖尿病受试者。测定尿聚集素和肾小管损伤标志物的基线值。主要结局是eGFR的年下降率，次要结局是3期或以上慢性肾病（CKD）的发展以及白蛋白尿的持续/进展。入组患者的中位随访时间为3.0（1.0-5.9）年。与非糖尿病受试者相比，2型糖尿病受试者尿液中的基线聚集素水平显著升高。尿聚集素水平与肾小管损伤标志物有显著相关性。在校正临床混杂因素后，检测到eGFR年下降率与尿簇蛋白之间呈正相关。多变量分析进一步表明，尿聚集蛋白与CKD 3期或更高的发展和蛋白尿的持续/进展相关。在伴有蛋白尿的2型糖尿病受试者中，尿聚集蛋白与eGFR年下降率和CKD分期进展相关。尿凝集素反映DKD早期肾小管损害。尿聚集素沿着蛋白尿的增加可能是2型糖尿病DKD进展的独立预测指标。
The objective of this study was to evaluate the association of urine clusterin/apolipoprotein J (Apo J) with the development and/or progression of diabetic kidney disease (DKD) in type 2 diabetes. 159 type 2 diabetic patients and 20 non-diabetic subjects with estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 were enrolled. The baseline values of urine clusterin and tubular damage markers were measured. The primary outcome was the annual decline rate in eGFR and secondary outcomes were the development of chronic kidney disease (CKD) stage 3 or greater and the persistence/progression of albuminuria. The median follow-up duration of enrolled patients was 3.0 (1.0–5.9) years. Baseline clusterin levels in urine were significantly increased in type 2 diabetic subjects compared with those of non-diabetic subjects. The levels of urine clusterin had a significant correlation with urine tubular damage markers. A positive correlation between the annual rate of decline in eGFR and urine clusterin after adjusting for clinical confounding factors was detected. Multivariate analysis further indicated that urine clusterin correlated with the development of CKD stage 3 or greater and persistence/progression of albuminuria. In type 2 diabetic subjects with albuminuria, urine clusterin remained associated with the annual decline rate in eGFR and the progression of CKD stage. Urine clusterin reflects tubular damage in the early-stage of DKD. The increase of urine clusterin along with albuminuria could be an independent predictive marker for the progression of DKD in type 2 diabetes.
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影响因子：
5.1
作者：
Kim, Sang Soo;Song, Sang Heon;Kim, Yong Ki
通讯作者：
Kim, Yong Ki
影响因子：
16.2
作者：
Nauta FL;Boertien WE;Bakker SJ;van Goor H;van Oeveren W;de Jong PE;Bilo H;Gansevoort RT
通讯作者：
Gansevoort RT
影响因子：
120.7
作者：
de Boer, Ian H.;Rue, Tessa C.;Hall, Yoshio N.;Heagerty, Patrick J.;Weiss, Noel S.;Himmelfarb, Jonathan
通讯作者：
Himmelfarb, Jonathan
影响因子：
19.6
作者：
Takase, O.;Minto, A. W. M.;Quigg, R. J.
通讯作者：
Quigg, R. J.
影响因子：
4.2
作者：
Kamijo-Ikemori, Atsuko;Sugaya, Takeshi;Kimura, Kenjiro
通讯作者：
Kimura, Kenjiro