IL-33 and ST2 levels in chronic kidney disease: Associations with inflammation, vascular abnormalities, cardiovascular events, and survival.
IL-33 and ST2 levels in chronic kidney disease: Associations with inflammation, vascular abnormalities, cardiovascular events, and survival.
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DOI：
10.1371/journal.pone.0178939
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Yilmaz MI
中科院分区：
文献类型：
--
作者：
Gungor O;Unal HU;Guclu A;Gezer M;Eyileten T;Guzel FB;Altunoren O;Erken E;Oguz Y;Kocyigit I;Yilmaz MI
炎症的增加与慢性肾脏病（CKD）阶段的增加有关，对血管损伤和心血管疾病具有非常重要的影响。在本研究中，我们旨在调查 CKD 不同阶段的 IL-33 和 ST2 水平，并确定它们对血管损伤和心血管事件 (CVE) 的影响。这是一项观察性队列研究，从 238 名 CKD（1-5 期）患者中获取血清 IL-33 和 ST2。我们检查了 CKD 患者 IL-33/ST2 水平的变化，以及与内皮功能障碍替代指标的关系。致命和非致命 CVE 的记录时间平均为 24 个月。我们还进行了 COX 回归分析，以确定 IL-33/ST2 水平与 CVE 和生存率的关联。 IL-33 和 ST2 水平显着升高，估计肾小球滤过率 (eGFR) 降低。从 CKD 1 期到 5 期，血流介导的扩张 (FMD) 显着减少。 IL-33 和 ST2 水平与 FMD 相关，ST2 是预测因子。多变量 Cox 分析显示，糖尿病、吸烟、蛋白尿和血红蛋白、Hs-CRP、IL-33 和 ST2 的存在与 CVE 风险相关。 Kaplan-Meier 生存曲线显示，与 IL-33 和 ST2 水平高于中值的患者相比，IL-33 和 ST2 水平低于中值（IL-33 = 132.6 ng/L，ST2 = 382.9 pg/mL）的患者具有更高的累积生存期（对数秩检验，p = 0.000）。这是第一项证明血清 IL-33 和 ST2 与 CKD 患者血管损伤、心血管事件和生存相关的研究。
Increased inflammation, associated with the increase in chronic kidney disease (CKD) stage, has a very important influence in vascular injury and cardiovascular diseases. In this study, we aimed to investigate the levels of IL-33 and ST2 in the different stages of CKD and to determine their effect on vascular damage and cardiovascular events (CVE). This was an observational cohort study in which serum IL-33 and ST2 were obtained from 238 CKD (stages 1–5) patients. We examined the changes in IL-33/ST2 levels in CKD patients, as well as the association with a surrogate of endothelial dysfunction. Fatal and non-fatal CVE were recorded for a mean of 24 months. We also performed a COX regression analysis to determine the association of IL-33/ST2 levels with CVE and survival. IL-33 and ST2 levels were significantly increased and estimated glomerular filtration rates (eGFR) were decreased. Flow-mediated dilatation (FMD) was significantly decreased from stage 1 to stage 5 CKD. IL-33 and ST2 levels were associated with FMD, and ST2 was a predictor. Multivariate Cox analysis showed that the presence of diabetes mellitus, smoking, and proteinuria and haemoglobin, Hs-CRP, IL-33, and ST2 were associated with the risk of CVE. Kaplan-Meier survival curves showed that patients with IL-33 and ST2 levels below the median value (IL-33 = 132.6 ng/L, ST2 = 382.9 pg/mL) had a higher cumulative survival compared with patients who had IL-33 and ST2 levels above the median value (log-rank test, p = 0.000). This is the first study that demonstrates that serum IL-33 and ST2 are associated with vascular injury, cardiovascular events, and survival in CKD patients.