Connective tissue growth factor and susceptibility to renal and vascular disease risk in type 1 diabetes
Connective tissue growth factor and susceptibility to renal and vascular disease risk in type 1 diabetes
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DOI：
10.1210/jc.2007-2544
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发表时间：
2008-05-01
影响因子：
5.8
通讯作者：
Wilson, Peter W. F.
中科院分区：
文献类型：
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作者：
Jaffa, Ayad A.;Usinger, William R.;Wilson, Peter W. F.
目的：探讨结缔组织生长因子（CTGF）在1型糖尿病患者肾脏和血管并发症中的相关性和意义。方法和结果：我们测量了来自糖尿病控制和并发症试验/糖尿病干预和并发症流行病学（DCCT/EDIC）研究队列的1050例1型糖尿病患者血液和尿液中CTGF和CTGFN片段的水平。我们发现高血压糖尿病患者的血浆log CTGF N片段水平明显高于正常者（P < 0.0005）。多元回归分析显示，CTGF - N片段水平与对数白蛋白排泄率呈正相关且独立（P = 0.0001）。在分类分析中，大量白蛋白尿患者的CTGF - N片段水平高于伴有或不伴有微量白蛋白尿的糖尿病患者（P < 0.0001）。单因素和多元回归分析表明，log CTGF - N片段与颈总动脉和颈内动脉内膜-中膜厚度存在独立且显著的相关性。血浆CTGF N片段和大量蛋白尿同时升高的患者颈动脉内膜-中膜厚度增加的相对风险高于血浆CTGF N片段和大量蛋白尿正常的患者（相对风险= 4.76,95%可信区间为2.21-10.25,P < 0.0001）。结论：血浆CTGF是糖尿病肾脏及血管疾病的危险标志物。
Objective: We explored the relevance and significance of connective tissue growth factor (CTGF) as a determinant of renal and vascular complications among type 1 diabetic patients.Methods and Results: We measured the circulating and urinary levels of CTGF and CTGFN fragment in 1050 subjects with type 1 diabetes from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study cohort. We found that hypertensive diabetic subjects have significantly higher levels of plasma log CTGF N fragment relative to normotensive subjects (P < 0.0005). Multiple regression analysis showed a positive and independent association between CTGF N fragment levels and log albumin excretion rate (P = 0.0001). In categorical analysis, patients with macroalbuminuria had higher levels of CTGF N fragment than diabetic subjects with or without microalbuminuria (P < 0.0001). Univariate and multiple regression analyses demonstrated an independent and significant association of log CTGF N fragment with the common and internal carotid intima-media thickness. The relative risk for increased carotid intima-media thickness was higher in patients with concomitantly elevated plasma CTGF N fragment and macroalbuminuria relative to patients with normal plasma CTGF N fragment and normal albuminuria (relative risk = 4.76; 95% confidence interval, 2.21-10.25; P < 0.0001).Conclusion: These findings demonstrate that plasma CTGF is a risk marker of diabetic renal and vascular disease.