Clinical predictive biomarkers for normoalbuminuric diabetic kidney disease

被引：34

作者：

Gohda, Tomohito ^{[1
]}

Nishizaki, Yuji ^{[2
]}

Murakoshi, Maki ^{[1
]}

Nojiri, Shuko ^{[2
]}

Yanagisawa, Naotake ^{[2
]}

Shibata, Terumi ^{[1
]}

Yamashita, Mami ^{[3
,5
]}

Tanaka, Kanako ^{[3
]}

Yamashita, Yoshinori ^{[4
]}

Suzuki, Yusuke ^{[1
]}

Kamei, Nozomu ^{[3
,6
]}

机构：

[1] Juntendo Univ, Fac Med, Dept Nephrol, Bunkyo Ku, 2-1-1 Hongo, Tokyo 1138421, Japan

[2] Juntendo Univ, Med Technol Innovat Ctr, Bunkyo Ku, 2-1-1 Hongo, Tokyo 1138421, Japan

[3] Natl Hosp Org, Kure Med Ctr & Chugoku Canc Ctr, Dept Endocrinol & Diabetol, 3-1 Aoyama Cho, Kure, Hiroshima 7370023, Japan

[4] Natl Hosp Org, Kure Med Ctr & Chugoku Canc Ctr, Inst Clin Res, 3-1 Aoyama Cho, Kure, Hiroshima 7370023, Japan

[5] Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Dept Endocrinol Infect Dis Control & Prevent, Minami Ku, 1-2-3 Kasumi Cho, Hiroshima 7348551, Japan

[6] Hiroshima Red Cross Hosp & Atom Bomb Survivors Ho, Dept Endocrinol & Metab, Naka Ku, 1-9-6 Senda Machi, Hiroshima 7308619, Japan

来源：

DIABETES RESEARCH AND CLINICAL PRACTICE | 2018年 / 141卷

关键词：

TNF-alpha; TNFR; Biomarker; Normoalbuminuria; DKD; ANKLE VASCULAR INDEX; TNF RECEPTORS 1; FUTURE CARDIOVASCULAR EVENTS; ARTERIAL STIFFNESS; RENAL-FUNCTION; OSTEOPROTEGERIN; INSUFFICIENCY; NEPHROPATHY; PROGRESSION; MORTALITY;

D O I：

10.1016/j.diabres.2018.04.026

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Aims: A portion of patients with diabetes mellitus follow the progression of a nonalbuminuria-based pathway; i.e., normoalbuminuric diabetic kidney disease (NA-DKD). However, the risk factors which determine NA-DKD are not yet fully understood. This cross-sectional study was therefore aimed to investigate the association between various biomarker levels and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus and normoalbuminuria (T2D-NA). Methods: We measured cardiovascular disease (CVD) [serum osteoprotegerin (OPG), plasma brain natriuretic peptide (BNP), cardio-ankle vascular index (CAVI)], tubular damage [urinary L-type fatty acid binding protein (L-FABP)], and inflammatory [serum tumor necrosis factor (TNF) alpha and its receptors (TNFRs)] biomarkers in 314 patients with T2D-NA. Results: The biomarkers of CVD and inflammation showed a significant negative correlation with eGFR. In a logistic multivariate model, none of the biomarkers, except TNF alpha and TNFRs, were associated with reduced renal function (eGFR < 60 mL/min/1.73 m(2)) after adjustment for possible biological and clinical covariates. However, the association observed in TNF alpha was lost after adjusting for TNFR and other covariates. Conclusions: In patients with T2D-NA, elevated levels of circulating TNFRs, but not of TNF alpha, were strongly associated with reduced renal function, independently of all relevant covariates. (C) 2018 Elsevier B.V. All rights reserved.

引用

页码：62 / 68

页数：7

共 31 条

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