Plasma growth differentiation factor-15 independently predicts all-cause and cardiovascular mortality as well as deterioration of kidney function in type 1 diabetic patients with nephropathy.
Plasma growth differentiation factor-15 independently predicts all-cause and cardiovascular mortality as well as deterioration of kidney function in type 1 diabetic patients with nephropathy.
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DOI：
10.2337/dc09-2174
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发表时间：
2010-07
期刊：
影响因子：
16.2
通讯作者：
Rossing P
中科院分区：
文献类型：
--
作者：
Lajer M;Jorsal A;Tarnow L;Parving HH;Rossing P
生长分化因子-15（GDF-15）参与炎症和凋亡。在心脏中响应于缺血和动脉粥样硬化斑块中诱导表达。本研究的目的是研究GDF-15水平与全因死亡率、心血管死亡率和发病率、肾小球滤过率（GFR）下降和终末期肾病（ESRD）进展的关系。该研究是一项前瞻性观察性随访研究，包括451例1型糖尿病合并糖尿病肾病患者（274名男性，年龄42.1 ± 0.5岁[平均值± SD]，糖尿病病程28.3 ± 8.9年，GFR 76 ± 33 ml/min/1.73 m2）和440例长期1型糖尿病和持续正常白蛋白尿患者的对照组（232例男性，年龄45.4 ± 11.5岁，糖尿病病程27.7 ± 10.1年）。患者随访8.1（0.0-12.9）年（中位数[范围]）。在正常白蛋白尿患者中，GDF-15高于中位数预测校正后（年龄、收缩压[sBP]和估计的GFR）的全因死亡风险增加（风险比[HR] 3.6 [95%CI 1.3-10.3]; P = 0.014）。糖尿病肾病患者中，（第四个四分位数）与较低（第一四分位数）GDF-15水平预测全因死亡率（经协变量校正的[性别、年龄、吸烟、血压、A1 C、胆固醇、GFR、N-末端激素原B型利钠肽、抗高血压治疗和既往心血管事件]; HR 4.86 [95% CI 1.37-17.30]）以及致死性和非致死性心血管事件（校正HR分别为5.59 [1.23-25.43]和3.55 [1.08-11.64]）。此外，较高的GDF-15水平预测GFR下降更快（P < 0.001），但不是ESRD的发展。较高水平的GDF-15是糖尿病肾病患者全因和心血管死亡率和发病率的预测因子。此外，更高水平的GDF-15与肾功能的更快恶化相关。
Growth deferentiation factor-15 (GDF-15) is involved in inflammation and apoptosis. Expression is induced in the heart in response to ischemia and in atherosclerotic plaques. The aim of this study was to investigate GDF-15 levels in relation to all-cause mortality, cardiovascular mortality and morbidity, decline in glomerular filtration rate (GFR), and progression toward end-stage renal disease (ESRD). The study was a prospective observational follow-up study including 451 type 1 diabetic patients with diabetic nephropathy (274 men, aged 42.1 ± 0.5 years [means ± SD], diabetes duration 28.3 ± 8.9 years, GFR 76 ± 33 ml/min/1.73 m2) and a control group of 440 patients with longstanding type 1 diabetes and persistent normoalbuminuria (232 men, aged 45.4 ± 11.5 years, duration of diabetes 27.7 ± 10.1 years). The patients were followed for 8.1 (0.0–12.9) years (median [range]). Among normoalbuminuric patients, GDF-15 above the median predicted an adjusted (age, systolic blood pressure [sBP], and estimated GFR) increased risk of all-cause mortality (hazard ratio [HR] 3.6 [95% CI 1.3–10.3]; P = 0.014). Among patients with diabetic nephropathy, higher (fourth quartile) versus lower (first quartile) GDF-15 levels predict all-cause mortality (covariate-adjusted [sex, age, smoking, blood pressure, A1C, cholesterol, GFR, N-terminal prohormone B-type natriuretic peptide, antihypertensive treatment, and previous cardiovascular events]; HR 4.86 [95% CI 1.37–17.30]) as well as fatal and nonfatal cardiovascular events (adjusted HR 5.59 [1.23–25.43] and 3.55 [1.08–11.64], respectively). In addition, higher GDF-15 levels predict faster decline in GFR (P < 0.001) but not development of ESRD. Higher levels of GDF-15 are a predictor of all-cause and cardiovascular mortality and morbidity in patients with diabetic nephropathy. Furthermore, higher levels of GDF-15 are associated with faster deterioration of kidney function.
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DOI：
10.1073/pnas.94.26.14730
发表时间：
1997-12-23
影响因子：
11.1
作者：
Oliver, PM;Fox, JE;Maeda, N
通讯作者：
Maeda, N
影响因子：
20.1
作者：
Kempf, T;Eden, M;Wollert, KC
通讯作者：
Wollert, KC
影响因子：
37.8
作者：
Lloyd-Jones, DM;Larson, MG;Levy, D
通讯作者：
Levy, D
影响因子：
37.8
作者：
Wollert, Kai C.;Kempf, Tibor;Wallentin, Lars
通讯作者：
Wallentin, Lars
影响因子：
6.1
作者：
Tarnow, Lise;Groop, Per-Henrik;Vionnet, Nathalie
通讯作者：
Vionnet, Nathalie