Ozkan Gulsum, Ulusoy Sukru, Menteşe Ahmet, Guvercin Beyhan, Karahan S Caner, Yavuz Adnan, Altay Diler Us, Ocal Mustafa
Department of Nephrology, Hatay Antakya State Hospital, Hatay, Turkey.
Department of Nephrology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
Clin Biochem. 2015 Aug;48(12):768-73. doi: 10.1016/j.clinbiochem.2015.05.003. Epub 2015 May 11.
Cardiovascular (CV) mortality is common in hemodialysis (HD) patients. There are some difficulties involved in determining CV risk. Galectin-3 is a molecule with a demonstrated correlation with CV mortality and which is approved in the stratification of heart failure (HF) risk. The purpose of this study was to assess the previously uninvestigated relationship between galectin-3 and cardiac mortality in HD patients.
Two hundred ninety clinically stable HD patients aged over 18 and on a thrice-weekly intermittent HD program lasting >3 months and 30 healthy individuals were enrolled in this multi-center, prospective, observational study and monitored over 24 months. Blood specimens were collected at the start of the study for the measurement of galectin-3 and other biochemical parameters. At the end of the study, the relations between galectin-3 and other biochemical and demographic parameters and mortality were analyzed.
Galectin-3 levels were significantly higher in the HD group compared to the control group (p < 0.001). All-cause mortality was observed in 63 (21%) patients. At multivariate Cox regression analysis, age, low albumin, low DBP, high galectin-3 and high HsCRP were identified as prognostic determinants of all-cause mortality, while age, low albumin, high galectin-3 and high SBP were identified as prognostic determinants of cardiac mortality.
This study shows, for the first time in the literature, that galectin-3 may be a novel biomarker of cardiac mortality in HD patients. We think that, when supported by further studies, galectin-3 can be a promising biomarker in predicting cardiac mortality in HD patients.
心血管(CV)死亡率在血液透析(HD)患者中很常见。确定CV风险存在一些困难。半乳糖凝集素-3是一种与CV死亡率具有明确相关性的分子,并且已被批准用于心力衰竭(HF)风险分层。本研究的目的是评估此前未被研究的HD患者中半乳糖凝集素-3与心脏死亡率之间的关系。
本多中心、前瞻性、观察性研究纳入了290名年龄超过18岁、接受每周三次间歇性HD治疗且持续时间超过3个月的临床稳定HD患者以及30名健康个体,并对他们进行了24个月的监测。在研究开始时采集血样以测量半乳糖凝集素-3和其他生化参数。在研究结束时,分析了半乳糖凝集素-3与其他生化和人口统计学参数以及死亡率之间的关系。
HD组的半乳糖凝集素-3水平显著高于对照组(p < 0.001)。63名(21%)患者发生了全因死亡。在多变量Cox回归分析中,年龄、低白蛋白、低舒张压、高半乳糖凝集素-3和高超敏C反应蛋白被确定为全因死亡的预后决定因素,而年龄、低白蛋白、高半乳糖凝集素-3和高收缩压被确定为心脏死亡的预后决定因素。
本研究首次在文献中表明,半乳糖凝集素-3可能是HD患者心脏死亡的一种新型生物标志物。我们认为,如果得到进一步研究的支持,半乳糖凝集素-3可能成为预测HD患者心脏死亡的一种有前景的生物标志物。