eatinine-based eGFR (eGFRcr) <60 ml/min/1.73m2 from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study, Cox proportional hazards regression was used to determine hazard ratios of mortality by plasma concentrations of soluble tumor necrosis factor receptors 1 and 2 (TNFR1, TNFR2), soluble urokinase-type plasminogen activator receptor (suPAR), kidney injury molecule 1 (KIM-1), chitinase 3-like 1 (YKL-40), and monocyte chemotactic protein 1 (MCP-1). Covariates included sociodemographic and clinical factors, urine albumin-to-creatinine ratio (UACR), and creatinine- and cystatin C-based eGFR (eGFRcr-cys). Results: At baseline, mean age was 70 years, 47% were men, 53% self-identified as Black, mean±SD eGFRcr-cys was 41±13 ml/min/1.73m2, and median (IQR) UACR was 32 (9, 224) mg/g. Correlations with eGFRcr-cys were stronger for TNFR1, TNFR2, and suPAR (r=-0.72 to -0.76) than for KIM-1, YKL-40, and MCP-1 (r=-0.10 to -0.40). With a median follow-up of seven years, 332 participants died. In models adjusted for sociodemographic and clinical factors, each SD higher baseline concentration of plasma TNFR1 (HR=1.28; 95% CI: 1.20, 1.38), TNFR2 (HR=1.61; 95% CI: 1.42, 1.82), suPAR (HR=1.33; 95% CI: 1.22, 1.44), KIM-1 (HR=1.20; 95% CI: 1.08, 1.33), and YKL-40 (HR=1.23; 95% CI: 1.11, 1.38) was associated with higher risk of all-cause mortality, whereas MCP-1 was not. Upon further adjustment for baseline eGFRcr-cys and UACR, only the associations for TNFR1 (HR=1.16; 95%CI: 1.04, 1.29), TNFR2 (HR=1.34; 95%CI: 1.12, 1.60), and suPAR (HR=1.23; 95% CI: 1.11, 1.36) persisted. Conclusions: Among adults with diabetes and CKD, higher plasma TNFR1, TNFR2, and suPAR were associated with all-cause mortality, independent of baseline kidney function. Copyright © 2024 by the American Society of Nephrology...

中文翻译：

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REGRARDS 研究中糖尿病和慢性肾脏病的肾脏健康和死亡率的血浆生物标志物。


基于饮食的 eGFR (eGFRcr) <60 ml/min/1.73m2 来自中风地理和种族差异原因 (REGARDS) 队列研究，Cox 比例风险回归用于确定可溶性肿瘤坏死血浆浓度的死亡率风险比因子受体 1 和 2 (TNFR1、TNFR2)、可溶性尿激酶型纤溶酶原激活剂受体 (suPAR)、肾损伤分子 1 (KIM-1)、几丁质酶 3 样 1 (YKL-40) 和单核细胞趋化蛋白 1 (MCP) -1）。协变量包括社会人口统计学和临床​​因素、尿白蛋白与肌酐比值 (UACR) 以及基于肌酐和胱抑素 C 的 eGFR (eGFRcr-cys)。结果：基线时，平均年龄为 70 岁，47% 为男性，53% 自认为是黑人，平均值±SD eGFRcr-cys 为 41±13 ml/min/1.73m2，中位 (IQR) UACR 为 32 ( 9, 224) 毫克/克。 TNFR1、TNFR2 和 suPAR（r=-0.72 至 -0.76）与 eGFRcr-cys 的相关性强于 KIM-1、YKL-40 和 MCP-1（r=-0.10 至 -0.40）。中位随访时间为七年，有 332 名参与者死亡。在根据社会人口统计学和临床​​因素调整的模型中，每个 SD 血浆 TNFR1 (HR=1.28; 95% CI: 1.20, 1.38)、TNFR2 (HR=1.61; 95% CI: 1.42, 1.82)、suPAR (HR= 1.33；95% CI：1.22，1.44）、KIM-1（HR=1.20；95% CI：1.08，1.33）和 YKL-40（HR=1.23；95% CI：1.11，1.38）与较高风险相关的全因死亡率，而 MCP-1 则不然。进一步调整基线 eGFRcr-cys 和 UACR 后，仅与 TNFR1 (HR=1.16; 95%CI: 1.04, 1.29)、TNFR2 (HR=1.34; 95%CI: 1.12, 1.60) 和 suPAR (HR= 1.23；95% CI：1.11，1.36）持续存在。结论：在患有糖尿病和 CKD 的成人中，较高的血浆 TNFR1、TNFR2 和 suPAR 与全因死亡率相关，与基线肾功能无关。 版权所有 © 2024 美国肾脏病学会...