Carlsson Axel C, Carrero Juan-Jesús, Stenvinkel Peter, Bottai Matteo, Barany Peter, Larsson Anders, Ärnlöv Johan
Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Blood Purif. 2015;39(4):259-65. doi: 10.1159/000381664. Epub 2015 Apr 29.
BACKGROUND/AIMS: Although both endostatin and cathepsins S have been associated with higher mortality, data in patients with end-stage renal disease (ESRD) are scarce.
A longitudinal cohort study of 207 prevalent patients undergoing hemodialysis.
Cathepsins S and L were associated with soluble receptors for tumor necrosis factor (sTNFR1 and sTNFR2, rho between 0.28 and 0.43, p < 0.001 for all). Weaker or absent associations between endostatin, cathepsins S and L were seen with other inflammatory biomarkers, that is, CRP, interleukin 6, pentraxin 3, and TNF. In Cox and Laplace regression models adjusted for age, sex, dialysis vintage, and diabetes: standard deviation increments of endostatin was associated with a lower mortality (hazard ratio 0.75, 95% confidence interval (CI) 0.57-0.98), and with 6.8 months longer median survival.
The high levels of endostatin, cathepsins S and L, and their associations with sTNFR1 and sTNFR2 warrant further studies exploring mortality, and the angiogenic and inflammatory pathways in ESRD.
背景/目的：尽管内皮抑素和组织蛋白酶S均与较高的死亡率相关，但终末期肾病（ESRD）患者的数据却很匮乏。
对207例接受血液透析的现患患者进行纵向队列研究。
组织蛋白酶S和L与肿瘤坏死因子的可溶性受体（sTNFR1和sTNFR2，相关系数介于0.28至0.43之间，所有p均<0.001）相关。在内皮抑素、组织蛋白酶S和L与其他炎症生物标志物（即CRP、白细胞介素6、五聚素3和TNF）之间，观察到的相关性较弱或不存在相关性。在针对年龄、性别、透析时间和糖尿病进行校正的Cox回归模型和拉普拉斯回归模型中：内皮抑素标准差的增加与较低的死亡率相关（风险比0.75，95%置信区间（CI）0.57 - 0.98），且中位生存期延长6.8个月。
内皮抑素、组织蛋白酶S和L的高水平及其与sTNFR1和sTNFR2的相关性，值得进一步研究以探索ESRD中的死亡率以及血管生成和炎症途径。
