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首页> 外文期刊>Diabetes care >Serum Uromodulin Predicts Less Coronary Artery Calcification and Diabetic Kidney Disease Over 12 Years in Adults With Type 1 Diabetes: The CACTI Study
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Serum Uromodulin Predicts Less Coronary Artery Calcification and Diabetic Kidney Disease Over 12 Years in Adults With Type 1 Diabetes: The CACTI Study

机译：血清Uromodulin预测成人1型糖尿病12年的冠状动脉钙化和糖尿病肾病：仙人掌研究

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OBJECTIVENovel biomarkers are needed to better predict coronary artery calcification (CAC), a marker of subclinical atherosclerosis, and diabetic kidney disease (DKD) in type 1 diabetes. We evaluated the associations between serum uromodulin (SUMOD [a biomarker associated with anti-inflammatory and renal protective properties]), CAC progression, and DKD development over 12 years.RESEARCH DESIGN AND METHODSParticipants (n = 527, 53% females) in the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study were examined during 2002-2004, at a mean age of 39.6 9.0 years and a median duration of diabetes of 24.8 years. Urine albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) determined by the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine equation were measured at baseline and after a mean follow-up period of 12.1 1.5 years. Elevated albumin excretion was defined as ACR 30 mg/g, rapid GFR decline (3 mL/min/1.73 m(2)/year), and impaired GFR as eGFR 60 mL/min/1.73 m(2). SUMOD was measured on stored baseline plasma samples (Meso Scale Discovery). CAC was measured using electron beam computed tomography. CAC progression was defined as a change in the square root-transformed CAC volume of 2.5.RESULTSHigher baseline SUMOD level conferred lower odds of CAC progression (odds ratio 0.68; 95% CI 0.48-0.97), incident elevated albumin excretion (0.37; 0.16-0.86), rapid GFR decline (0.56; 0.35-0.91), and impaired GFR (0.44; 0.24-0.83) per 1 SD increase in SUMOD (68.44 ng/mL) after adjustment for baseline age, sex, systolic blood pressure, LDL cholesterol, and albuminuria/GFR. The addition of SUMOD to models with traditional risk factors also significantly improved the prediction performance for CAC progression and incident DKD.CONCLUSIONSHigher baseline SUMOD level predicted lower odds of both CAC progression and incident DKD over 12 years in adults with type 1 diabetes.
机译：需要对象的生物标志物，以更好地预测冠状动脉钙化（CAC），亚临床动脉粥样硬化的标志物和1型糖尿病中的糖尿病肾病（DKD）。我们评估了血清尿素调节蛋白（Sumod [与抗炎和肾脏保护性能相关的生物标志物]）的关联，CAC进展和DKD开发超过12年。冠状动脉中的研究设计和方法（n = 527,53％）在2002-2004期间检查了1型糖尿病（仙人掌）研究中的动脉钙化，平均年龄为39.6岁9.0岁，中位糖尿病患者248岁。通过CKD-EPI（慢性肾脏疾病流行病学协作）测定的尿白霉 - 致肌酐比（ACR）和估计的肾小球过滤速率（EGFR）在基线和平均随访时间为12.1〜5年后测定。升高的白蛋白排泄被定义为ACR 30mg / g，GFR迅速下降（＆ 3ml / min / 1.73m（2）/年），并且GFR作为EGFR＆LT; 60ml / min / 1.73m（2）受损。在储存的基线等离子体样本（Meso Scale Discovery）上测量Sumod。使用电子束计算机断层扫描测量CAC。 CAC进展定义为平方根转化的CAC体积的变化2.5.ResultShigher基线Sumod水平赋予CAC进展的少量较低（差距为0.68; 95％CI 0.48-0.97），入射升高的白蛋白排泄（0.37; 0.16- 0.86），GFR快速下降（0.56; 0.35-0.91），GFR受损（0.44; 0.24-0.83）每1 SD在调整后的基线时代，性别，收缩压，LDL胆固醇后的SUMOD（68.44 ng / ml）增加和白蛋白尿/ GFR。将Sumod添加到具有传统风险因素的模型也显着改善了CAC进展和事件DKD的预测性能。结论高度的基准SUMOD水平预测CAC进展和1型糖尿病型成年人的CAC进展和事件DKD的几率较低。

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