Inflammatory biomarkers and decline in kidney function in the elderly: the Cardiovascular Health Study
Inflammatory biomarkers and decline in kidney function in the elderly: the Cardiovascular Health Study
复制标题
DOI：
10.1093/ndt/gfp429
复制
发表时间：
2010-01-01
影响因子：
6.1
通讯作者：
Shlipak, Michael G.
中科院分区：
文献类型：
--
作者：
Keller, Christopher;Katz, Ronit;Shlipak, Michael G.
方法。这项研究包括来自心血管健康研究的4128名受试者。在基线、3年后和7年后测量胱抑素C；符合条件的受试者至少有两项测量。以胱抑素c为基础估算肾小球滤过率（eGFR(cysC)），并将快速肾功能下降定义为eGFR（cysC）年损失>.3 mL/min/1.73 m(2)。预测因子包括10种炎症和促凝生物标志物：c反应蛋白、白细胞介素-6、细胞间粘附分子-1、白细胞计数、纤维蛋白原、因子VII、因子VIII、d -二聚体、纤溶蛋白-抗纤溶蛋白复合物和血清白蛋白。在研究期间，1059名受试者（26%）肾功能迅速下降。与其他9种炎症或促凝生物标志物相比，血清白蛋白与肾功能快速下降呈一致的负相关[最终调整logistic回归模型：每标准差低白蛋白快速下降的几率增加1.14倍（95% CI 1.06-1.23）]。与最高四分位数相比，最低四分位数的白蛋白快速下降的比值比为1.55 （95% CI 1.23-1.96）。在调整CRP、IL-6和纤维蛋白原的白蛋白模型后，这些关联仍然存在。与其他9种炎症和促凝剂标志物相比，通过基于胱抑素c的eGFR测量，只有较低的血清白蛋白基线水平与肾功能的快速下降一致相关。
Methods. This study included 4128 subjects from the Cardiovascular Health Study. Cystatin C was measured at baseline, 3 years later and 7 years later; eligible subjects had at least two measures. Cystatin C-based estimated glomerular filtration rate (eGFR(cysC)) was estimated, and rapid kidney function decline was defined as an annual loss of eGFR(cysC) > 3 mL/min/1.73 m(2). Predictors included ten inflammatory and procoagulant biomarkers: C-reactive protein, interleukin-6, intercellular adhesion molecule-1, white blood cell count, fibrinogen, factor VII, factor VIII, D-dimer, plasmin-antiplasmin complex and serum albumin.Results. During the study, 1059 subjects (26%) had a rapid decline in kidney function. In contrast to the other nine inflammatory or procoagulant biomarkers, serum albumin had a consistent and inverse association with rapid kidney function decline [final adjusted logistic regression model: 1.14-fold increased odds (95% CI 1.06-1.23) of rapid decline per standard deviation lower albumin]. The lowest quartile of albumin had an odds ratio of 1.55 (95% CI 1.23-1.96) for rapid decline compared with the highest quartile. These associations persisted after adjusting the albumin models for CRP, IL-6 and fibrinogen.Conclusions. In contrast to nine other inflammatory and procoagulant markers, only lower baseline levels of serum albumin were consistently associated with a rapid decline in kidney function, as measured by cystatin C-based eGFR.