Diabetes Care：2型糖尿病肾病患者生物标志物对发病率和死亡率的预测性能如何？

2017-03-26 xing.T MedSci原创

由此可见，生物标志物GDF-15、NTproBNP和hs-TNT与肾脏风险独立相关，而NT-proBNP独立预测心血管风险。

尽管2型糖尿病（T2DM）肾病患者具有较高的肾脏和心血管并发症风险，但其相关的生物学标志物尚未被确定。因为肾损害可能会增加生物标记物的水平，这可能混淆了生物标志物水平与风险之间的关系。为了探讨在这样的背景下生物标志物的预测价值，研究人员分析了2型糖尿病肾病患者中生长分化因子15（GDF-15）、B型钠尿肽前体(NT-proBNP)和超敏肌钙蛋白-T（hs-TnT）的基础水平与肾脏和心血管风险之间的相关性。研究结果于近日发表于糖尿病领域权威杂志Diabetes Care上。

来自于舒洛地特大量白蛋白尿（Sun-MACRO）试验中的861例2型糖尿病患者被招募进行事后分析。基础血清GDF-15、NT-proBNP和hs-TNT与肾脏和心血管事件之间的相关性是采用Cox多元回归和C统计量进行分析。肾基础模型包括白蛋白肌酐比值（ACR）、血清肌酐、血红蛋白、年龄、性别。心血管基础模型包括舒张压、ACR、胆固醇、年龄和性别。

参与者平均（±SD）估算的肾小球滤过率为33±9毫升/分钟/ 1.73平方米，血清中GDF-15的中位浓度为3228皮克/毫升（四分位距为2345-4310皮克/毫升）、NTproBNP为380纳克/升（155-989纳克/升），以及hs-TNT为30纳克/升（20-47纳克/升）。在多元回归分析中，GDF-15（风险比[HR]为1.83，P=0.04）、NTproBNP（HR为2.34，P=0.004）和hs-TNT（HR为2.09，P=0.014）与肾脏事件有关，而NTproBNP（HR为3.45，P＜0.001）与心血管事件相关。C统计量有所改善在加入了NTproBNP和hs-TNT到肾脏模型中（0.793 vs. 0.741，P=0.04）。对于心血管事件，单独加入NTproBNP，其C统计量就有所改善（0.722 vs. 0.658，P=0.018）。

由此可见，生物标志物GDF-15、NTproBNP和hs-TNT与肾脏风险独立相关，而NT-proBNP独立预测心血管风险。

原始出处：

Arash Bidadkosh,et al. Predictive Properties of Biomarkers GDF-15, NTproBNP, and hs-TnT on Morbidity and Mortality in Type 2 Diabetes Patients With Nephropathy.Diabetes Care 2017 Mar; dc162175. https://doi.org/10.2337/dc16-2175

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2018-02-28 gostraight

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2017-11-10 lifestar

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2017-11-03 hukaixun

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73 0
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2017-11-28 ms5439512287675881

#BET#

56 0
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2017-10-03 柳叶一刀

#DIA#

62 0
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2017-05-24 heli0118

#预测性能#

53 0
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2017-08-15 木头人513

#Diabetes#

0 0
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2017-03-28 智智灵药

#生物标志#

63 0
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2017-03-28 zhu_jun9842

#生物标志#

59 0
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2017-03-28 yeye5224619

#2型糖尿病肾病#

109 0

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Diabetes Care：2型糖尿病肾病患者生物标志物对发病率和死亡率的预测性能如何？

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