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首页> 外文期刊>Clinical kidney journal. >Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study
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Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study

机译：生物标记物是否可以预测糖尿病终末期肾脏疾病的心血管终点？前瞻性纵向研究

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Background Diabetic patients on hemodialysis are at high risk of death from cardiovascular disease, and research has suggested that various biologic markers of inflammation, oxidative stress and hemostasis may give added value to clinical information for predicting cardiovascular event (CVE)-free survival. This information could be particularly important in evaluating this population for renal transplant, given the scarcity of organs. We hypothesized that in diabetic patients undergoing renal replacement therapy (RRT) these biologic markers would prove useful in predicting event-free follow-up in a prospective study. Methods One hundred and fifty diabetic (76 type 1, 74 type 2) and 27 non-diabetic stable RRT patients were followed for 0.04–13.69 years for CVE (myocardial infarction, coronary arterial intervention, peripheral arterial bypass or amputation, cerebrovascular accident or carotid artery intervention), cardiac and all-cause mortality. Measured biologic markers of inflammation included the following: Il-6, C reactive protein, fibrinogen; of hemostasis: fibrinogen, plasminogen activator inhibitor (PAI), fibrinolytic activity, von Willebrand factor VII (vWF), platelet-selectin, viscosity and of oxidative stress: advanced glycated end products and antibody to oxidized low-density lipoprotein. For each, upper versus lower tertiles were compared for duration of event-free follow-up. Results Cardiovascular events prior to study entry occurred in 51.3% of DM1, 54.0% of DM2 and 25.9% of DM0 patients. Subsequent cardiovascular events were noted in 31.6% of DM1, 45.9% of DM2 and 11.1% of DM0 patients. All mean levels of biologic markers at baseline were abnormal (P 0.05). Conclusions In this RRT population, all biologic marker levels except PAI did not improve clinical prediction of events.
机译：背景技术接受血液透析的糖尿病患者极有可能死于心血管疾病，并且研究表明，炎症，氧化应激和止血的各种生物学指标可能为临床信息提供附加价值，以预测无心血管事件（CVE）的生存。鉴于器官稀缺，该信息对于评估该人群的肾脏移植可能特别重要。我们假设在接受肾脏替代疗法（RRT）的糖尿病患者中，这些生物标记物将被证明可用于预测前瞻性研究中的无事件随访。方法对150例糖尿病（76型1、74型2型）和27例非糖尿病稳定RRT患者进行CVE（心肌梗塞，冠状动脉介入治疗，外周动脉搭桥或截肢，脑血管意外或颈动脉狭窄）的0.04-13.69岁动脉介入治疗），心脏和全因死亡率。炎症的生物学指标包括：Il-6，C反应蛋白，纤维蛋白原;止血指标：纤维蛋白原，纤溶酶原激活物抑制剂（PAI），纤溶活性，血管性血友病因子VII（vWF），血小板选择素，粘度和氧化应激：高级糖化终产物和抗氧化的低密度脂蛋白抗体。对于每种情况，比较上三分位数和下三分位数的无事件随访时间。结果进入研究前的心血管事件发生在51.3％的DM1、54.0％的DM2和25.9％的DM0患者中。 DM1 31.6％，DM2 45.9％和DM0 11.1％的患者随后发生心血管事件。基线时所有生物标志物的平均水平均异常（P <0.05）。结论在该RRT人群中，除PAI以外的所有生物标志物水平均不能改善事件的临床预测。

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