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JASN：早期和晚期糖尿病肾病患者血浆标志物与肾功能下降相关！

2017-05-06 xing.T MedSci原创

DKD标志物肾功能下降
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总之，在在早期或晚期DKD患者中，TNFR-1、TNFR-2和KIM-1与eGFR下降高风险之间存在独立相关性。此外，将这些生物标志物纳入到临床预后模型中可以显著提高对肾脏结局的鉴别能力。

不同病理生理机制的生物标志物可能改善2型糖尿病患者糖尿病肾病（DKD）发生和进展的危险分层。为了评估这些生物学标志物，研究人员进行了一项巢式病例对照研究（190例DKD患者和190例匹配的对照者），以及采用早期（ACCORD）和晚期（VA NEPHRON-D）DKD随机对照试验的参与者留存的基础血浆样品进行了一项前瞻性队列研究（n=1156）。研究人员评估了血浆中肿瘤坏死因子受体-1（TNFR-1）、TNFR-2和肾损伤分子-1（KIM-1）基线水平与DKD发生（ACCORD）和DKD进展（VA-NEPHRON-D）之间的相关性。

在基础时，研究人员发现晚期DKD患者（NEPHRON-D）TNFR-1、TNFR-2和KIM-1平均浓度要比早期DKD患者（ACCORD）要高出大约2倍。在这两个队列中，达到肾脏结局的患者TNFR-1、TNFR-2和KIM-1的基线水平要高于那些没有达到肾脏结局的患者。TNFR-1、TNFR-2和KIM-1水平增倍与肾脏结局的风险之间的相关性在两个队列中同样显著。将这些生物学标志物纳入到临床模型在预测肾脏结局上其曲线下面积（SEM）在NEPHRON-D中从0.68（0.02）增加到了0.75（0.02）。对文献的系统评价结果表明这些炎症生物标志物和DKD肾脏结局之间的相关性存在高度一致。

总之，在在早期或晚期DKD患者中，TNFR-1、TNFR-2和KIM-1与eGFR下降高风险之间存在独立相关性。此外，将这些生物标志物纳入到临床预后模型中可以显著提高对肾脏结局的鉴别能力。

原始出处：

Steven G. Coca,et al. Plasma Biomarkers and Kidney Function Decline in Early and Established Diabetic Kidney Disease. JASN, 2017, http://jasn.asnjournals.org/content/early/2017/05/04/ASN.2016101101.abstract

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    2018-09-04 小石榴

    学习了

    0

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    2017-08-10 chenhongpeng

    #ASN#

    0

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    2018-01-28 hukaixun

    #标志物#

    0

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encodeId=e48a19499455, content=什么时候用于临床？, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3ywTqWUXPMtV5GE17mG4e4NneoTGY3OVj0y1bqCerSR142iayaqgUK6jU1nVxD23AyNSHWAsic7RTGg/0, createdBy=ea001978292, createdName=自认为还有良知的医生, createdTime=Sun May 07 12:04:12 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-11-23 yese

    #肾功能#

    0

  5. 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    2018-02-18 gostraight

    #肾病患者#

    0

  6. 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    2017-05-11 lou.minghong

    学习了

    0

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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue May 09 18:19:48 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537204, encodeId=e19b153e204f5, content=<a href='/topic/show?id=fc66824e015' target=_blank style='color:#2F92EE;'>#肾功能下降#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82470, encryptionId=fc66824e015, topicName=肾功能下降)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ceb912833334, createdName=syscxl, createdTime=Mon May 08 06:44:00 CST 2017, time=2017-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194994, encodeId=e48a19499455, content=什么时候用于临床？, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3ywTqWUXPMtV5GE17mG4e4NneoTGY3OVj0y1bqCerSR142iayaqgUK6jU1nVxD23AyNSHWAsic7RTGg/0, createdBy=ea001978292, createdName=自认为还有良知的医生, createdTime=Sun May 07 12:04:12 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-10 卡圣

    学习了，谢谢

    0

  8. 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encodeId=e48a19499455, content=什么时候用于临床？, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3ywTqWUXPMtV5GE17mG4e4NneoTGY3OVj0y1bqCerSR142iayaqgUK6jU1nVxD23AyNSHWAsic7RTGg/0, createdBy=ea001978292, createdName=自认为还有良知的医生, createdTime=Sun May 07 12:04:12 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-09 虈亣靌

    深刻研究其中的含义

    0

  9. 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encodeId=e48a19499455, content=什么时候用于临床？, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3ywTqWUXPMtV5GE17mG4e4NneoTGY3OVj0y1bqCerSR142iayaqgUK6jU1nVxD23AyNSHWAsic7RTGg/0, createdBy=ea001978292, createdName=自认为还有良知的医生, createdTime=Sun May 07 12:04:12 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-08 syscxl

    #肾功能下降#

    0

  10. 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encodeId=e48a19499455, content=什么时候用于临床？, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3ywTqWUXPMtV5GE17mG4e4NneoTGY3OVj0y1bqCerSR142iayaqgUK6jU1nVxD23AyNSHWAsic7RTGg/0, createdBy=ea001978292, createdName=自认为还有良知的医生, createdTime=Sun May 07 12:04:12 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
    2017-05-07 自认为还有良知的医生

    什么时候用于临床？

    0

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