Serum C-reactive protein and leptin as predictors of kidney disease progression in the Modification of Diet in Renal Disease Study
Serum C-reactive protein and leptin as predictors of kidney disease progression in the Modification of Diet in Renal Disease Study
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DOI：
10.1046/j.1523-1755.2002.00677.x
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发表时间：
2002-12-01
影响因子：
19.6
通讯作者：
Levey, AS
中科院分区：
文献类型：
--
作者：
Sarnak, MJ;Poindexter, A;Levey, AS
背景体外和体内数据表明，炎症和营养状况的标志物可能是慢性肾脏疾病进展的危险因素。我们在肾脏疾病饮食改良（MDRD）研究中调查了较高水平的C反应蛋白（CRP）和瘦素是否是慢性肾脏疾病进展的危险因素。对804例患者的冷冻标本进行了高敏C反应蛋白（CRP）或瘦素检测。CRP和瘦素作为肾小球滤过率（GFR）下降的危险因素进行单因素和多因素分析。基线时，研究A中的平均（中位）CRP（GFR为25 - 55 mL/min/1.73 m（2））和研究B（GFR在13和24 mL/min/1.73 m2之间）为0.48研究A和研究B中的平均（中值）瘦素分别为15.2（9.80）和15.1（7.80）ng/mL。平均随访时间为2.2年。研究A和13的平均GFR下降分别为-4.33和-3.65 mL/min/年。在研究A的多变量分析中，GFR下降率与CRP或瘦素水平之间无显著相关性[0.08 CRP水平每增加2倍，GFR下降减慢（-0.14，0.30）mL/min/年;和0.14（-0.13，0.40）mL/min/年，瘦素水平每增加一倍GFR下降较慢]，或在研究B的多变量分析中[-0.05（-0.28，0.18）mL/min/year GFR下降速度每增加2倍CRP水平;和-0.12（-0.42，0.19）mL/min/year GFR下降速度每增加2倍瘦素水平]。血清CRP和瘦素水平升高不是非糖尿病肾病进展的独立危险因素。
Background. In vitro and in vivo data suggest that markers of inflammation and nutritional status may be risk factors for the progression of chronic kidney disease.Methods. We investigated whether higher levels of C-reactive protein (CRP) and leptin were risk factors for progression of chronic kidney disease in the Modification of Diet in Renal Disease (MDRD) Study. Frozen samples were assayed for high sensitivity C-reactive protein (CRP) or leptin in 804 patients. CRP and leptin were then evaluated as risk factors for glomerular filtration rate (GFR) decline using univariate and multivariable analyses.Results. At baseline, the mean (median) CRP in Study A (GFR between 25 and 55 mL/min/1.73 m(2)) and Study B (GFR between 13 and 24 mL/min/1.73 m(2)) were 0.48 (0.25) and 0.46 (0.20) mg/dL, respectively, while the mean (median) leptin in Study A and Study B were 15.2 (9.80) and 15.1 (7.80) ng/mL, respectively. Mean follow-up time was 2.2 years. The mean GFR decline was -4.33 and -3.65 mL/min/year in Study A and 13, respectively. There was no significant association between the rate of GFR decline with the level of CRP or leptin in multivariable analysis in Study A [0.08 (-0.14, 0.30) mL/min/year slower GFR decline per twofold increase in CRP level; and 0.14 (-0.13, 0.40) mL/min/year slower GFR decline per twofold increase in leptin level], or in multivariable analysis in Study B [-0.05 (-0.28, 0.18) mL/min/year faster GFR decline per twofold increase in CRP level; and -0.12 (-0.42, 0.19) mL/min/year faster GFR decline per twofold increase in leptin level].Conclusions. Higher serum levels of CRP and leptin are not independent risk factors for progression of non-diabetic kidney disease.