Elevated serum retinol-binding protein 4 concentrations are associated with chronic kidney disease but not with the higher carotid intima-media thickness in type 2 diabetic subjects

Abstract Objective The study aimed to assess whether serum retinol-binding protein 4 (RBP4) is associated with a risk of cardiovascular (CV) events in chronic kidney disease (CKD) patients. Methods One hundred sixty-nine patients with CKD were followed for a mean of 36 months (range, 5–39 months). Serum RBP4 and other laboratory indicators were measured at baseline. The relationship between RBP4 and the risk of CV events was evaluated by using Cox regression analysis. Results Patients with higher serum RBP4 levels had a higher rate of CV events and a higher mortality in a univariate analysis (P < 0.001). The multivariate Cox proportional hazard analysis revealed that RBP4 (hazard ratio, 2.259; 95% confidence interval, 2.067–5.489; P = 0.002) is an independent prognostic factor for CV events in patients with CKD. Kaplan-Meier analysis demonstrated that patients with RBP4 above the median value (>33.86 mg/L) had a higher rate of CV events than did patients with RBP4 at or below the median value (≤33.86 mg/L; P < 0.001). Conclusion RBP4 levels are associated with CV events in patients with CKD. Elevated serum RBP4 levels may indicate an increased risk of CV complications in CKD patients.

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Carotid Intima-Media Thickness and Visit-to-Visit HbA1c Variability Predict Progression of Chronic Kidney Disease in Type 2 Diabetic Patients with Preserved Kidney Function

Journal of Diabetes Research ◽

10.1155/2016/3295747 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Akiko Takenouchi ◽

Ayaka Tsuboi ◽

Miki Kurata ◽

Keisuke Fukuo ◽

Tsutomu Kazumi

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Function ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

Glycemic Variability ◽

Carotid Intima Media Thickness ◽

Diabetic Patients ◽

Type 2 Diabetic Patients

Background/Aims. Subclinical atherosclerosis and long-term glycemic variability have been reported to predict incident chronic kidney disease (CKD) in the general population. However, these associations have not been investigated in patients with type 2 diabetes with preserved kidney function.Methods. We prospectively followed up 162 patients with type 2 diabetes (mean age, 62.3 years; 53.6% men) and assessed whether carotid intima-media thickness (IMT) measured by B-mode ultrasound and visit-to-visit HbA1c variability are associated with deterioration of CKD (incident CKD defined as estimated GFR [eGFR] < 60 mL/min/1.73 m2and progression of CKD stages) over a median follow-up of 6.0 years. At baseline, 25 patients (15.4%) had CKD. Cox proportional hazards regression models were used for identifying associated factors of CKD deterioration.Results.Estimated GFR decreased from75.8±16.3to67.4±18.2 mL/min/1.73 m2(p<0.01). Of 162 patients, 32 developed CKD and 8 made a progression of CKD stages. Multivariate Cox regression analysis revealed that carotid IMT (HR: 4.0, 95% CI: 1.1–14.226.7, andp=0.03) and coefficient of variation of HbA1c (HR: 1.12, 95%: 1.04–1.21, andp=0.003) were predictors of deterioration of CKD independently of age, mean HbA1c, urinary albumin/creatinine ratio, baseline eGFR, uric acid, and leucocyte count.Conclusions.Subclinical atherosclerosis and long-term glycemic variability predict deterioration of chronic kidney disease (as defined by incident or worsening CKD) in type 2 diabetic patients with preserved kidney function.

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