Lower urinary connective tissue growth factor levels and incident CKD stage 3 in the general population.
Lower urinary connective tissue growth factor levels and incident CKD stage 3 in the general population.
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DOI：
10.1053/j.ajkd.2010.11.022
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发表时间：
2011-06
期刊：
影响因子：
--
通讯作者：
Fox CS
中科院分区：
文献类型：
--
作者：
O'Seaghdha CM;Hwang SJ;Bhavsar NA;Köttgen A;Coresh J;Astor BC;Fox CS
结缔组织生长因子（CTGF）参与包括糖尿病肾病和肾纤维化在内的肾脏疾病的发展和进展，但也可能在损伤后的系膜修复中发挥作用。目前尚不清楚，在一般人群中，尿CTGF水平是否与估计肾小球滤过率（eGFR）降低至低于60 ml/min/1.73 m2（即慢性肾脏疾病[CKD] 3期）相关。嵌套病例对照。在FHS研究中，100例新发CKD 3期病例和100例年龄和性别匹配的对照;在ARIC研究中，141例病例和135例年龄、性别和种族匹配的对照。在两项研究中，对照组在随访时eGFR ≥ 60 ml/min/1.73 m2。尿CTGF浓度。CKD 3期，定义为eGFR <60 ml/min/1.73m2。对来自Frachial Heart研究和ARIC的储存尿液样本进行CTGF测量。协变量来自Fractional Heart研究和ARIC参与者检查。在心脏病研究中，病例组的中位基线尿CTGF浓度（1.35 ng/mL）低于对照组（2.35 ng/mL;配对t检验P <0.0001）。在对CKD风险因素、基线eGFR和基线尿白蛋白-肌酐比值对数进行校正后，尿CTGF对数每增加1个标准差，CKD 3期事件的多变量校正OR为0.33（95%置信区间[CI] 0.17 - 0.64; P <0.001），无糖尿病的参与者（n = 184）的结果相似。当尿CTGF以尿肌酐为指标时，结果没有实质性差异（多变量校正OR，0.34; 95%CI，0.21 - 0.56; P <0.001）。在ARIC研究中进行的一项独立病例对照研究中，观察到基线尿CTGF浓度较低的CKD 3期事件风险趋势相似，但不显著，在无糖尿病的参与者中观察到最强的结果。在总体和无糖尿病组的荟萃分析中，这种反比关系是稳健的。观察性研究;无法推断因果关系。在一般人群中，较低的尿CTGF浓度先于CKD 3期的发作。需要进一步的工作来充分表征CTGF如何影响CKD的风险。
Connective tissue growth factor (CTGF) is involved in the development and progression of kidney diseases including diabetic nephropathy and kidney fibrosis, but may also play a role in mesangial repair following injury. It is unknown whether, in the general population, urinary CTGF levels are associated with reduction of estimated glomerular filtration rate (eGFR) to less than 60 ml/min/1.73m2 (ie, development of chronic kidney disease [CKD] stage 3). Nested case-control. 100 cases of incident CKD stage 3 and 100 age-and sex-matched controls in the Framingham Heart Study (FHS); 141 cases and 135 age-, sexand race-matched controls in the Atherosclerosis Risk in Communities (ARIC) Study. Controls had eGFR ≥60 ml/min/1.73m2 at follow-up in both studies. Urinary CTGF concentrations. Incident CKD stage 3, defined as eGFR <60 ml/min/1.73m2. Stored urine samples from Framingham Heart Study and ARIC were measured for CTGF. Covariates were obtained from Framingham Heart Study and ARIC participant examinations. In Framingham Heart Study, the median baseline urinary CTGF concentration was lower among cases (1.35 ng/mL) than controls (2.35 ng/mL; paired t-test P<0.0001). The multivariable-adjusted OR for incident CKD stage 3 was 0.33 (95% confidence interval [CI] 0.17–0.64; P<0.001) per 1-standard deviation increase in log urinary CTGF after adjustment for CKD risk factors, baseline eGFR and baseline log urinary albumin-creatinine ratio, with similar results among participants without diabetes (n=184). Results were not materially different when urinary CTGF was indexed to urinary creatinine (multivariable-adjusted OR, 0.34; 95% CI, 0.21–0.56; P<0.001). A similar, but non-significant, trend of risk of incident CKD stage 3 with lower baseline urinary CTGF concentration was observed in an independent case-control study conducted in the ARIC Study, with the strongest results observed among participants free of diabetes. This inverse relationship was robust in meta-analysis of both the overall and diabetes-free groups. Observational study; causality cannot be inferred. Lower urinary CTGF concentrations precede the onset of CKD stage 3 in the general population. Further work is required to fully characterize how CTGF influences risk of CKD.
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影响因子：
19.6
作者：
Chen, J;Wildman, RP;He, J
通讯作者：
He, J
DOI：
10.1097/01.asn.0000070152.11927.4a
发表时间：
2003-07-01
影响因子：
13.6
作者：
Chadban, SJ;Briganti, EM;Atkins, RC
通讯作者：
Atkins, RC
影响因子：
120.7
作者：
Coresh, Josef;Selvin, Elizabeth;Levey, Andrew S.
通讯作者：
Levey, Andrew S.
影响因子：
16.2
作者：
Gilbert, RE;Akdeniz, A;Jerums, G
通讯作者：
Jerums, G
影响因子：
--
作者：
Ensrud, Kristine E.;Lui, Li-Ying;Cummings, Steven R.
通讯作者：
Cummings, Steven R.