Serum adiponectin predicts all-cause mortality and end stage renal disease in patients with type I diabetes and diabetic nephropathy
Serum adiponectin predicts all-cause mortality and end stage renal disease in patients with type I diabetes and diabetic nephropathy
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DOI：
10.1038/ki.2008.201
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发表时间：
2008-09-01
影响因子：
19.6
通讯作者：
Rossing, Peter
中科院分区：
文献类型：
--
作者：
Jorsal, Anders;Tarnow, Lise;Rossing, Peter
1型糖尿病患者的脂联素水平升高，尤其是在存在微血管病变的情况下。在此，我们确定血清脂联素水平和8种脂联素基因多态性对I型糖尿病患者死亡率、心血管事件和终末期肾病的预测价值。这项对I型糖尿病患者进行的前瞻性、观察性随访研究包括438例明显糖尿病肾病患者，并与440例白蛋白排泄正常的I型糖尿病患者进行比较。这两组平均随访8年，性别、年龄和糖尿病病程基本匹配。对373例患者进行的考克斯回归分析显示，血清脂联素log 10变化一个标准差，全因死亡率的协变量调整风险比为1.46。与心血管事件无关;然而，在协变量校正分析中，血清脂联素水平可预测终末期肾病。在878名患者中发现的8种基因多态性中，有2种与血清脂联素水平升高相关，但没有一种多态性与肾脏或心血管结局相关。这些研究表明，高血清脂联素水平可预测I型糖尿病患者的死亡率和进展为终末期肾病。
Adiponectin levels are increased in patients with type I diabetes especially in the presence of microangiopathy. Here we determined the predictive value of serum adiponectin levels and 8 adiponectin gene polymorphisms for mortality, cardiovascular events and end-stage renal disease in type I diabetic patients. This prospective, observational follow-up study of type I diabetics consisted of 438 patients with overt diabetic nephropathy that were compared to 440 type I patients with normal albumin excretion. These two groups were followed an average of 8 years and generally matched for gender, age and duration of diabetes. Cox regression analysis of 373 patients showed a covariate-adjusted hazard ratio for all-cause mortality of 1.46 for a change of one standard deviation in log10 of serum adiponectin. There was no association with cardiovascular events; however, serum adiponectin levels predicted end stage renal disease in a covariate-adjusted analysis. Two of eight gene polymorphisms, found in the 878 patients, were associated with increased serum adiponectin levels but none of the polymorphisms were associated with a renal or cardiovascular outcome. These studies show that high serum adiponectin levels predict mortality and progression to end stage renal disease in type I diabetic patients.