Usefulness of serum interleukin-18 in predicting cardiovascular mortality in patients with chronic kidney disease--systems and clinical approach.
Usefulness of serum interleukin-18 in predicting cardiovascular mortality in patients with chronic kidney disease--systems and clinical approach.
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DOI：
10.1038/srep18332
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发表时间：
2015-12-16
影响因子：
4.6
通讯作者：
Formanowicz P
中科院分区：
文献类型：
--
作者：
Formanowicz D;Wanic-Kossowska M;Pawliczak E;Radom M;Formanowicz P
本研究的目的是检查血清白细胞介素-18（IL-18）是否可预测慢性肾脏病（CKD）各阶段患者和前一年内急性心肌梗死（AMI）病史患者的2年心血管死亡率。糖尿病是排除的关键因素之一。研究发现，IL-18血清浓度升高至临界点（1584.5 pg/mL）以上，研究患者的心血管死亡风险增加20.63倍。在预测心血管死亡率方面，血清IL-18浓度上级优于已知的心血管风险参数，如高敏C反应蛋白（hsCRP）、颈动脉内膜中层厚度（CIMT）、肾小球滤过率、白蛋白、铁蛋白、N末端脑利钠肽原（NT-proBNP）。对IL-18的最佳预测是4个变量，如CIMT、NT-proBNP、白蛋白和hsCRP，因为它们预测其浓度为89.5%。结论：IL-18可能是前一年有AMI病史的非糖尿病CKD患者两年随访中心血管死亡的重要指标和预测因子。IL-18在动脉粥样硬化斑块形成过程中的重要性已经通过基于Petri网理论语言表达的形式化模型的系统分析得到证实。
The aim of this study was to check if serum interleukin-18 (IL-18) predicts 2-year cardiovascular mortality in patients at various stages of chronic kidney disease (CKD) and history of acute myocardial infarction (AMI) within the previous year. Diabetes mellitus was one of the key factors of exclusion. It was found that an increase in serum concentration of IL-18 above the cut-off point (1584.5 pg/mL) was characterized by 20.63-fold higher risk of cardiovascular deaths among studied patients. IL-18 serum concentration was found to be superior to the well-known cardiovascular risk parameters, like high sensitivity C-reactive protein (hsCRP), carotid intima media thickness (CIMT), glomerular filtration rate, albumins, ferritin, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in prognosis of cardiovascular mortality. The best predictive for IL-18 were 4 variables, such as CIMT, NT-proBNP, albumins and hsCRP, as they predicted its concentration at 89.5%. Concluding, IL-18 seems to be important indicator and predictor of cardiovascular death in two-year follow-up among non-diabetic patients suffering from CKD, with history of AMI in the previous year. The importance of IL-18 in the process of atherosclerotic plaque formation has been confirmed by systems analysis based on a formal model expressed in the language of Petri nets theory.