Hypomagnesemia Is a Risk Factor for Cardiovascular Disease- and Noncardiovascular Disease-Related Mortality in Peritoneal Dialysis Patients

2021 ◽  
pp. 1-8
Author(s):  
Fengping Zhang ◽  
Xianfeng Wu ◽  
Yueqiang Wen ◽  
Xiaojiang Zhan ◽  
Fen Fen Peng ◽  
...  
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Subgroup Analysis ◽  
Statistical Significance ◽  
Serum Magnesium ◽  
Cvd Risk ◽  
All Cause Mortality ◽  
The Difference ◽  
Death Causes ◽  
Related Mortality

<b><i>Purpose:</i></b> Recent research has shown that hypomagnesemia is associated with increased all-cause mortality in hemodialysis patients. However, the relationship between the long-term prognosis of peritoneal dialysis (PD) and the study is not yet clear. This study will analyze the effects of hypomagnesemia on all-cause, cardiovascular diseases (CVD), and non-CVD mortality in PD patients. <b><i>Method:</i></b> In a retrospective cohort study, 1,004 samples were selected from 7 PD centers in China. Based on the baseline blood magnesium level at the beginning of stable dialysis, all patients were classified into blood magnesium &#x3c;0.7 mmol/L group, 0.7–1.2 mmol/L group, and &#x3e;1.2 mmol/L group (the end event was death). The Kaplan-Meier method was used to calculate the difference in cumulative survival rate; the Cox proportional hazard model was used to analyze the risk factors of all-cause, CVD, and non-CVD death causes. <b><i>Results:</i></b> Cox multiple regression analysis results (reference comparison of 0.7–1.2 mmol/L group): patients with serum magnesium &#x3c;0.7 mmol/L have a higher risk ratio of all-cause mortality (HR = 1.580, 95% CI: 1.222–2.042, <i>p</i> = 0.001), and it is also obvious after correction by multiple models (HR = 1.578, 95% CI: 1.196–2.083, <i>p</i> = 0.001). Subgroup analysis of the causes of death was as follows: CVD risk (HR = 1.628, 95% CI: 1.114–2.379, <i>p</i> = 0.012) and non-CVD risk (HR = 1.521, 95% CI: 1.011–2.288, <i>p</i> = 0.044). Further analysis of the causes of infection-related death in non-CVD is also significant (HR = 1.919, 95% CI: 1.131–3.1257, <i>p</i> = 0.016). On the other hand, the serum magnesium&#x3e;1.2 mmol/L group had lower all-cause mortality after correction (HR = 0.687, 95% CI: 0.480–0.985, <i>p</i> = 0.041), and subgroup analysis of the cause of death had no statistical significance (<i>p</i> &#x3e; 0.05). <b><i>Conclusions:</i></b> Hypomagnesemia (serum magnesium &#x3c;0.7 mmol/L) during stable dialysis in PD patients is a risk factor for CVD- and non-CVD-related mortality, especially infection-related death causes.

Abstract P269: Cardio-Ankle Vascular Index and the Risk of Cardiovascular Outcomes and All-cause Mortality: A Systematic Review

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Kunihiro Matsushita ◽  
Ning Ding ◽  
Esther Kim
Keyword(s):  
Systematic Review ◽  
Arterial Stiffness ◽  
Cohort Studies ◽  
Statistical Significance ◽  
Risk Of Bias ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Stiffness Evaluation ◽  
All Cause Mortality ◽  
Cross Sectional Studies

Introduction: Arterial stiffness is widely used as an index of arteriosclerosis and is associated with cardiovascular disease (CVD). Recently, cardio-ankle vascular index (CAVI) was developed as a measurement of arterial stiffness that is independent of blood pressure at the time of arterial stiffness evaluation. The associations of CAVI with CVD events and all-cause mortality have not been extensively assessed. We therefore systematically reviewed the studies reporting CAVI and relevant outcomes. Methods: We searched for both prospective and cross-sectional studies using MEDLINE, Embase, and Cochrane from inception to April 11, 2017. Two independent reviewers screened the retrieved papers, extracted relevant data and assessed the risk of bias. Any discrepancy was solved by discussion or a third reviewer. Heterogeneity among studies was assessed using the I 2 statistic. We pooled the results of studies that were sufficiently homogeneous. Results: Among 1,519 records, we identified 9 cohort studies (n=5,292) and 17 cross-sectional eligible studies (n=7,309). All 9 cohort studies reported the outcome of composited CVD (498 cases), but the categorization/modeling of CAVI was not consistent across those studies. The pooled hazard ratio (HR) of CVD for the highest vs. lowest CAVI category in 3 studies was borderline significant (pooled HR=1.34 [0.95, 1.87], p=0.092) (I 2 = 25.2%, p=0.263). For 3 studies examining the continuous association between CAVI and CVD, 1standard deviation (SD) increment of CAVI was significantly associated with CVD risk (pooled HR=1.22 [1.03, 1.45], p=0.023) (I 2 = 27.1%, p=0.253). Only 3 cohort studies investigated CAVI and all-cause mortality, and none of them reported a significant association. All 17 cross-sectional studies reported higher CAVI values in patients with CVD compared to those without CVD, with statistical significance in most studies. Conclusions: CAVI was generally higher in patients with CVD compared to their counterparts. In terms of the prospective prognostic value of CAVI, we found a limited number of studies, but they indicated a modest association between CAVI and CVD risk. Our systematic review highlighted the need for large prospective studies to assess the usefulness of CAVI as a predictor of CVD and mortality.

scholarly journals Serum magnesium and cardiovascular mortality in peritoneal dialysis patients: a 5-year prospective cohort study

2018 ◽  
Vol 120 (4) ◽  
pp. 415-423 ◽  
Author(s):  
Hongjian Ye ◽  
Peiyi Cao ◽  
Xiaodan Zhang ◽  
Jianxiong Lin ◽  
Qunying Guo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Prospective Cohort Study ◽  
Cardiovascular Mortality ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Serum Magnesium ◽  
Study Endpoint ◽  
Lower Serum ◽  
All Cause Mortality

AbstractThe aim of this study was to explore the association between serum Mg and cardiovascular mortality in the peritoneal dialysis (PD) population. This prospective cohort study included prevalent PD patients from a single centre. The primary outcome of this study was cardiovascular mortality. Serum Mg was assessed at baseline. A total of 402 patients (57 % male; mean age 49·3±14·9 years) were included. After a median of 49·9 months (interquartile range: 25·9–68·3) of follow-up, sixty-two patients (25·4 %) died of CVD. After adjustment for conventional confounders in multivariate Cox regression models, being in the lower quartile for serum Mg level was independently associated with a higher risk of cardiovascular mortality, with hazards ratios of 2·28 (95 % CI 1·04, 5·01), 1·41 (95 % CI 0·63, 3·16) and 1·62 (95 % CI 0·75, 3·51) for the lowest, second and third quartiles, respectively. A similar trend was observed when all-cause mortality was used as the study endpoint. Further analysis showed that the relationships between lower serum Mg and higher risk of cardiovascular and all-cause mortality were present only in the female subgroup, and not among male patients. The test for interaction indicated that the associations between lower serum Mg and cardiovascular and all-cause mortality differed by sex (P=0·008 andP=0·011, respectively). In conclusion, lower serum Mg was associated with a higher risk of cardiovascular and all-cause mortality in the PD population, especially among female patients.

Analysis of Midterm Outcomes of Endovascular Aneurysm Repair in Octogenarians From the ENGAGE Registry

2020 ◽  
Vol 27 (5) ◽  
pp. 836-844 ◽  
Author(s):  
Bibombe P. Mwipatayi ◽  
Olufemi A. Oshin ◽  
Joseph Faraj ◽  
Ramon L. Varcoe ◽  
Jackie Wong ◽  
...  
Keyword(s):  
Endovascular Procedures ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Endovascular Aneurysm Repair ◽  
Patient Characteristics ◽  
Risk Scores ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Aneurysm Repair ◽  
Related Mortality

Purpose: To assess periprocedural results and secondary endovascular procedure outcomes over 5 years in patients aged ≥80 vs <80 years undergoing endovascular aneurysm repair (EVAR). Materials and Methods: Data from the Endurant Stent Graft Natural Selection Global post-market registry (ENGAGE) were used for the analyses. A total of 1263 consecutive patients were enrolled in the prospective, observational, single-arm registry and divided into 2 groups according to age: ≥80 years (290, 22.9%) and <80 years (973, 77.1%). Baseline patient characteristics, risk scores according to the Society for Vascular Surgery (SVS) reporting standards, American Society of Anesthesiologists (ASA) classification, quality of life assessments [EuroQol 5 (EQ5D) index], and treatment outcomes, including all-cause mortality, aneurysm-related mortality, major adverse events, secondary endovascular procedures, and endoleaks were compared between groups. Results: Octogenarians were classified into the highest category of the SVS risk stratification system; however, this did not result in a significant difference in the 30-day mortality [1.4% (4/290) vs 1.2% (12/973) for controls; p=0.85] or major adverse event rates [5.2% (15/290) vs 3.6% (35/973), p=0.23]. Multivariable analysis confirmed that age ≥80 years, pulmonary disease, large aneurysm diameter, and renal insufficiency were significantly associated with all-cause mortality, whereas diameter was the only parameter associated with increased aneurysm-related mortality. The differences in freedom from secondary endovascular procedures over 5 years between octogenarians and controls did not reach statistical significance (88.5% vs 83.2%, p=0.07). Conclusion: EVAR can be performed in individuals aged ≥80 years with no statistically significant difference in midterm aneurysm-related deaths compared with younger patients. The findings in this elderly patient cohort show that EVAR can be safely performed with acceptable morbidity rates in octogenarians.

scholarly journals Systematic Review and Meta-Analysis of Linezolid versus Daptomycin for Treatment of Vancomycin-Resistant Enterococcal Bacteremia

2013 ◽  
Vol 58 (2) ◽  
pp. 734-739 ◽  
Author(s):  
Eleni P. Balli ◽  
Chris A. Venetis ◽  
Spiros Miyakis
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Mortality Data ◽  
Prospective Data ◽  
Content Type ◽  
All Cause Mortality ◽  
Vancomycin Resistant ◽  
Event Rates ◽  
Related Mortality

ABSTRACTLimited therapeutic options exist for the treatment of vancomycin-resistantEnterococcus(VRE) bacteremia; the most commonly used are daptomycin and linezolid. We attempted a systematic review and meta-analysis of the comparative efficacy of those two agents. Studies comparing daptomycin to linezolid treatment for VRE bacteremia, published until August 2012, were identified from the MEDLINE, EMBASE, CENTRAL, ISI Web of Science, and SCOPUS databases. All comparative studies on patients older than 18 years of age that provided mortality data were considered eligible for this systematic review and meta-analysis. Τhe primary outcome of the meta-analysis was 30-day all-cause mortality. Ten retrospective studies including 967 patients were identified. Patients treated with daptomycin had significantly higher 30-day all-cause mortality (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.08 to 2.40) and infection-related mortality (OR, 3.61; 95% CI, 1.42 to 9.20) rates than patients treated with linezolid. When data from all 10 studies were combined, overall mortality was also significantly increased among patients treated with daptomycin (OR, 1.41; 95% CI, 1.06 to 1.89). These findings were confirmed when odds ratios adjusted for potential confounders were pooled. Relapse rates among patients treated with daptomycin were also higher (OR, 2.51; 95% CI, 0.94 to 6.72), although this difference did not reach statistical significance. Adverse event rates were not significantly different between the two groups. Notwithstanding the absence of randomized prospective data, available evidence suggests that mortality rates may be higher with daptomycin than with linezolid among patients treated for VRE bacteremia.

scholarly journals Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254942
Author(s):  
Seok Hui Kang ◽  
A. Young Kim ◽  
Jun Young Do
Keyword(s):  
Peritoneal Dialysis ◽  
Lean Mass ◽  
Operating Characteristic ◽  
Cox Regression ◽  
Statistical Significance ◽  
Characteristic Curve ◽  
Lower Extremities ◽  
Reactive Protein ◽  
All Cause Mortality ◽  
Upper And Lower Extremities

Background Few studies have considered optimal adjusted lean mass indices for prediction of clinical outcomes in peritoneal dialysis (PD) patients. We aimed to evaluate clinical variables using various adjusted indices in PD patients. Methods Total 528 incident PD patients were included. Lean mass was measured using dual energy X-ray absorptiometry. Appendicular lean mass (ALM) was calculated using the sum for both upper and lower extremities. Each ALM index was calculated using ALM per body weight (ALM/BW), height squared (ALM/Ht2), or body mass index (ALM/BMI). Limb/trunk lean mass (LTLM) ratio was defined as the sum for both upper and lower extremities divided by trunk lean mass. Results A total of 528 patients were analyzed men: 286, women: 242. In area under the receiver operating characteristic curve analyses, LTLM alone was associated with 1 year mortality. In the LTLM ratio, the cut-off value for 1-year mortality was ≤ 0.829 in men and ≤ 0.717 in women, respectively. In both sexes, LTLM ratio alone showed statistical significance in all-cause mortality in both univariate and multivariate Cox-regression analyses. Compared with other indices, the LTLM ratio was independent of edema and fat in both sexes. Edema- and C-reactive protein-adjusted correlation analysis showed that LTLM ratio alone was associated with serum albumin in men. Although statistical significance was not obtained for women, the correlation coefficient was highest for the LTLM ratio compared with other indices. Conclusion Among various indices using lean mass, LTLM ratio was independent of volume status and fat mass and was associated with mortality in incident PD patients.

Epidemiology of GB Virus C/Hepatitis G Virus Infection in Patients on Peritoneal Dialysis

2002 ◽  
Vol 22 (3) ◽  
pp. 405-410 ◽  
Author(s):  
Fabrizio Fabrizi ◽  
Amedeo F. Vecchi De ◽  
Giovanna Lunghi ◽  
Silvia Finazzi ◽  
Sergio Bisegna ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Donors ◽  
Statistical Significance ◽  
Chronic Hemodialysis ◽  
Control Group ◽  
Rt Pcr ◽  
Gamma Glutamyl Transpeptidase ◽  
Hepatitis G Virus ◽  
The Difference ◽  
Virus C

Background A new genus in the family Flaviviridae has recently been discovered; it has provisionally been designated GBV-C/HGV. As determined by virologic techniques [reverse-transcription polymerase chain reaction (RT-PCR)], infection with GBV-C/HGV is frequent in renal transplant (RT) recipients and in patients on chronic hemodialysis (HD). The epidemiology of GBV-C/HGV infection in patients on peritoneal dialysis is scarce and mostly based on RT-PCR technology. Purpose We report on the prevalence (as detected by serologic and virologic techniques) and the risk factors for GBV-C/HGV infection in a cohort of patients on continuous ambulatory peritoneal dialysis (CAPD). We also tested a control group of blood donors. Methods Infection by GBV-C/HGV was assessed by serologic and virologic techniques. Cases of GBV-C/HGV viremia (GBV-C/HGV RNA) were detected by RT-PCR. Antibodies to the envelope protein of GBV-C/HGV (anti-E2 GBV-C/HGV antibody) were analyzed by serologic methods. Results We found a high frequency [17/85 (20%)] of GBV-C/HGV. The rates of GBV-C/HGV viremia and anti-E2 GBV-C/HGV positivity were 10.5% (9/85) and 10.5% (9/85) respectively. In most patients [17/18 (94%)], the presence of anti-E2 GBV-C/HGV antibody was associated with clearance of GBV-C/HGV from serum. No relationship was noted between anti-E2 GBV-C/HGV antibody (or GBV-C/HGV viremia) and age, sex, race, time on dialysis, anti-HCV antibody, HBsAg status, and anti-HIV positivity. The frequency of GBV-C/HGV infection in CAPD patients was much higher than that in blood donors, even if the difference did not approach statistical significance. No associations between GBV-C/HGV positivity and biochemical liver tests [aminotransferase and gamma glutamyl transpeptidase (GGT)] were apparent. Conclusions Infection by GBV-C/HGV as detected by RT-PCR and anti-E2 antibody was common in patients on CAPD and in controls alike. No association was seen between GBV-C/HGV and various demographic or clinical factors. The clinical significance of GBV-C/HGV in CAPD remains unclear. Larger investigations are in progress.

Relation between neutrophil-to-lymphocyte ratio and mortality in patients with hypertrophic cardiomyopathy

2020 ◽  
Vol 14 (18) ◽  
pp. 1693-1701
Author(s):  
Ziqiong Wang ◽  
Liming Zhao ◽  
Sen He
Keyword(s):  
Risk Factor ◽  
Hypertrophic Cardiomyopathy ◽  
Mortality Rate ◽  
Subgroup Analysis ◽  
Prognostic Value ◽  
Independent Risk Factor ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Third ◽  
All Cause Mortality

Aim: We assessed the prognostic value of neutrophil-to-lymphocyte ratio (NLR) for all-cause mortality in patients with hypertrophic cardiomyopathy (HCM). Methods & results: A total of 354 HCM patients were enrolled. There were 44 all-cause mortality in total. Patients in the third tertile of NLR had the highest all-cause mortality rate of 5.2 per 100 person-years. Patients in tertile 3 had a significantly higher risk of all-cause mortality with adjusted hazard ratio of 2.4 (95% CI: 1.0–5.4; p = 0.040) when compared with that of patients in tertile 1. No significant interactions between NLR and other variables were observed during subgroup analysis. Conclusion: NLR was an independent risk factor for all-cause mortality in HCM patients.

scholarly journals Serum Sodium Modifies the Association of Systolic Blood Pressure with Mortality in Peritoneal Dialysis Patients

2020 ◽  
Vol 45 (6) ◽  
pp. 916-925
Author(s):  
Yagui Qiu ◽  
Hongjian Ye ◽  
Li Fan ◽  
Xunhua Zheng ◽  
Wei Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Serum Sodium ◽  
Subgroup Analysis ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Dialysis Patients ◽  
Baseline Serum ◽  
All Cause Mortality ◽  
Cv Disease

<b><i>Introduction:</i></b> High serum sodium is associated with increased blood pressure (BP) in dialysis patients, which is a risk factor for cardiovascular (CV) disease. However, the interaction between serum sodium and BP and their association with clinical outcomes in peritoneal dialysis (PD) patients is uncertain. <b><i>Methods:</i></b> We analyzed a retrospective cohort of 1,656 incident PD patients from January 2006 to December 2013, who were followed up until December 2018. Cox proportional hazards regression models were used to evaluate the association of serum sodium and BP with all-cause and CV mortality. A priori interaction between serum sodium and systolic BP (SBP) was explored, and a subgroup analysis was performed by stratifying SBP into the following 3 groups: &#x3c;110, 110–130, and &#x3e;130 mm Hg. <b><i>Results:</i></b> Mean baseline serum sodium was 140.2 ± 3.6 mmol/L, mean SBP was 137 ± 20 mm Hg, and diastolic BP was 85 ± 14 mm Hg. During a median (range) follow-up time of 46.5 (2.6–154.3) months, 507 patients died, 252 of whom died due to CV disease. SBP did not predict all-cause and CV mortality when BP was assessed as a continuous variable. However, SBP &#x3e;130 or &#x3c;110 mm Hg was associated with higher risk of all-cause and CV mortality compared with SBP of 110–130 mm Hg. There was a significant interaction between baseline serum sodium and SBP for all-cause mortality (<i>p</i> for interaction = 0.016). In subgroup analysis, among those with SBP &#x3e;130 mm Hg, the risk of all-cause mortality was elevated in those with serum sodium ≥140 mmol/L (adjusted hazard ratio [aHR] 1.45 [95% confidence interval (CI): 1.07–1.98]), but not for those with serum sodium &#x3c;140 mmol/L (aHR 1.27 [95% CI: 0.89–1.82]). Conversely, among those with SBP &#x3c;110 mm Hg, those with serum sodium &#x3c;140 mmol/L had an elevated risk of mortality (aHR 1.99 [95% CI: 1.31–3.02]), but not those with serum sodium ≥140 mmol/L (aHR 1.15 [95% CI: 0.74–1.79]) (<i>p</i> for interaction = 0.028). <b><i>Conclusion:</i></b> The association of BP with mortality was modified by serum sodium levels in PD patients. Further studies are needed to evaluate whether individualized BP control based on serum sodium levels contributes to improve patient outcomes.

scholarly journals LA HIPERTRIGLICERIDEMIA EN LA ENFERMEDAD CORONARIA ¿ES UN FACTOR DE RIESGO?

2016 ◽  
Vol 73 (1) ◽  
Author(s):  
L Sonzini ◽  
O Corzo ◽  
F Alfonso ◽  
M Yorio
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Triglyceride Level ◽  
Ldl Cholesterol ◽  
Control Group ◽  
Cvd Risk ◽  
Obesity And Overweight ◽  
The Difference ◽  
De Medicina

La asociación entre hipertrigliceridemia y enfermedad arterial coronaria (EAC) es controvertida. Objetivo: establecer la  relación entre  el nivel  de triglicéridos  en pacientes con  enfermedad  coronaria, relacionar los valores elevados de triglicéridos con colesterol total, colesterol HDL, colesterol LDL,   sobrepeso   y obesidad en pacientes coronarios. Material  Y Métodos: Se evaluaron retrospectivamente pacientes  con y sin enfermedad coronaria demostrable que fueron asistidos en la consulta pública y privada  en la Cátedra de Medicina I Unidad Académica de Medicina Interna Nº 3 del Hospital Córdoba  y el Servicio de Cardiología de la Clínica Sucre de la ciudad de Córdoba, entre en 1 de enero y 31 de diciembre de 2009. Se consideró pacientes con enfermedad coronaria (casos) aquellos que tuvieron lesiones coronarias significativas las que mostraron una disminución de la luz arterial >50% `por medio de cinecoronariografía. (15)(16) y un grupo control sin enfermedad coronaria objetivable. . Se incluyeron pacientes  entre 30 y 60 años de edad que tuvieran historia clínica completa. Resultados: El número total de pacientes incluidos fue de 100 casos,  64 casos en el grupo de  pacientes coronarios y  36 en los no coronarios. 74% de sexo  masculino, predominancia masculina en pacientes coronarios y femenina en no coronarios.  68%  era mayor de 50 años.  Los valores del lipidograma   no mostraron diferencias estadísticamente significativas en pacientes no coronarios y coronarios Los valores promedio  de TG fueron levemente más elevados en el grupo de no coronarios, aunque no mostraron diferencias estadísticamente significativas (p=0,7162). Conclusión: La hipertrigliceridemia no fue mayor en los pacientes coronarios y no se relacionó con  el índice de masa corporal, en pacientes con sobrepeso y obesos.  Summary: Hypercholesterolemia is a well known risk factor for  coronary cardiovascular disease (CVD). However, the role of triglycerides in CVD risk remains controversial. Objective: to study triglyceride level and its relationship with Cholesterol, HDL and LDL Cholesterol level, obesity and overweight in patients with and without CVD. Material and Methods: we retrospectively studied patients with and without CVD who attended to Córdoba Hospital  and Cardiology unit of Clínica Sucre  at Córdoba city between 1° January to 31 st of December of 2009. We included patients with age between 30 to 60 years old with CVD and a control group. Results: 100 patients were included, 64 with CVD and 36 as a control group. 74% were male and 68% older than 50 years old. Lipid values were not statistically significant in both groups. Triglyceride level was higher in the control group, although the difference was not statistically significant (p=0, 7162). Conclusion: Triglyceride level was not higher in patients with CVD.

scholarly journals The pattern-recognition molecule H-ficolin in relation to diabetic kidney disease, mortality, and cardiovascular events in type 1 diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jakob Appel Østergaard ◽  
Fanny Jansson Sigfrids ◽  
Carol Forsblom ◽  
Emma H. Dahlström ◽  
Lena M. Thorn ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Diabetic Kidney Disease ◽  
Statistical Significance ◽  
Lectin Pathway ◽  
Diabetic Kidney ◽  
All Cause Mortality ◽  
Related Mortality

AbstractH-ficolin recognizes patterns on microorganisms and stressed cells and can activate the lectin pathway of the complement system. We aimed to assess H-ficolin in relation to the progression of diabetic kidney disease (DKD), all-cause mortality, diabetes-related mortality, and cardiovascular events. Event rates per 10-unit H-ficolin-increase were compared in an observational follow-up of 2,410 individuals with type 1 diabetes from the FinnDiane Study. DKD progression occurred in 400 individuals. The unadjusted hazard ratio (HR) for progression was 1.29 (1.18–1.40) and 1.16 (1.05–1.29) after adjustment for diabetes duration, sex, HbA1c, systolic blood pressure, and smoking status. After adding triglycerides to the model, the HR decreased to 1.07 (0.97–1.18). In all, 486 individuals died, including 268 deaths of cardiovascular causes and 192 deaths of complications to diabetes. HRs for all-cause mortality and cardiovascular mortality were 1.13 (1.04–1.22) and 1.05 (0.93–1.17), respectively, in unadjusted analyses. These estimates lost statistical significance in adjusted models. However, the unadjusted HR for diabetes-related mortality was 1.19 (1.05–1.35) and 1.18 (1.02–1.37) with the most stringent adjustment level. Our results, therefore, indicate that H-ficolin predicts diabetes-related mortality, but neither all-cause mortality nor fatal/non-fatal cardiovascular events. Furthermore, H-ficolin is associated with DKD progression, however, not independently of the fully adjusted model.

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