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JASN:可溶性TNFR-1浓度与肾功能长期下降的关系

2018-10-09 xing.T MedSci原创

由此可见,血清sTNFR-1浓度升高与十年内eGFR下降速度加快有关,并且与先前已知的肾病进展危险因素无关。

TNF受体-1(TNFR-1)在内皮细胞功能障碍和炎症中起致病作用,在肾小球和肾小管周围毛细血管内皮细胞表面表达。在一确诊的糖尿病肾病患者中较高的可溶性TNF受体-1(sTNFR-1)浓度与肾病进展相关。然而,没有研究评估sTNFR-1在基线时没有血管疾病的多民族人群中长期肾功能变化中的作用。

近日,肾脏病领域权威杂志Journal of the American Society of Nephrology上发表一篇研究文章,研究人员评估了一项前瞻性队列研究中2548例动脉粥样硬化多种族研究(MESA)参与者的基线sTNFR-1浓度与10年eGFR下降(≥40%下降和年度比例下降)之间的关联。在参与者入组和研究第3、5和10年测定了血清肌酸酐浓度。

参与者的平均年龄为61岁,53%为女性,平均基线eGFR为79毫升/分钟/1.73平方米。血清sTNFR-1与基线eGFR呈负相关。中位随访时间为9.3年,110名参与者的eGFR下降≥40%;sTNFR1浓度每增加一个SD与eGFR下降40%的风险较高相关(校正风险比为1.43; 95%置信区间[95%CI]为1.16-1.77; P<0.001)。sTNFR-1水平最高的三分位数与调整后的年均eGFR下降1.94%(95%CI为1.79-2.09)相关。由人口统计学指标、高血压糖尿病和基线CKD状态定义的亚组之间的这种关联持续存在。

由此可见,血清sTNFR-1浓度升高与十年内eGFR下降速度加快有关,并且与先前已知的肾病进展危险因素无关。

原始出处:

Pavan K. Bhatraju,et al. Association of Soluble TNFR-1 Concentrations with Long-Term Decline in Kidney Function: The Multi-Ethnic Study of Atherosclerosis.JASN,2018.https://jasn.asnjournals.org/content/early/2018/10/03/ASN.2018070719

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    2019-02-15 zhaojie88
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    2019-03-08 yese
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    2018-10-11 snowpeakxu
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