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可溶性血浆蛋白ST2和CD163作为瑞典15至34岁糖尿病患者肾病的早期生物标志物:一项前瞻性队列研究。

Soluble plasma proteins ST2 and CD163 as early biomarkers of nephropathy in Swedish patients with diabetes, 15-34 years of age: a prospective cohort study.

作者信息

Samuelsson My, Dereke Jonatan, Svensson Maria K, Landin-Olsson Mona, Hillman Magnus

机构信息

Department of Clinical Sciences, Diabetes Research Laboratory, Lund University, BMC, B11, 221 84 Lund, Sweden.

Department of Medical Sciences, Uppsala University, Uppsala, Sweden.

出版信息

Diabetol Metab Syndr. 2017 May 25;9:41. doi: 10.1186/s13098-017-0240-2. eCollection 2017.

Abstract

BACKGROUND

The aim of this study was to investigate plasma levels of sST2 and sCD163 to determine whether they at an early stage could predict development of diabetic nephropathy and/or diabetic retinopathy in patients at clinical onset.

METHODS

Patients diagnosed with diabetes mellitus at age 15-34 years between 1987 and 1988 (n = 220) were included. Data such as BMI, smoking, HbA1c and islet cell antibodies were collected at time of diagnosis. Within the 10 year follow-up period, 112 patients (51%) developed following diabetes related complications; retinopathy (n = 91), nephropathy (n = 12) or both (n = 9). Plasma concentrations of sST2 and sCD163 were measured at time of diagnosis and levels compared between different complication groups.

RESULTS

Plasma levels of sST2 were significantly higher in patients who later developed nephropathy (n = 21; 1012 [773-1493] pg/ml) compared to those who did not (n = 199; 723 [449-1084] pg/ml; p = 0.006). A tendency for higher plasma levels of sCD163 was observed but not statistically significant (p = 0.058).

CONCLUSIONS

sST2 and sCD163 show promise as potential biomarkers for the development of nephropathy already at clinical onset. sST2 and/or sCD163 could possibly be part of a biomarker panel aimed to find patients at high risk of developing nephropathy. Both markers need to be investigated in a larger prospective study.

摘要

背景

本研究旨在调查可溶性生长刺激表达基因2蛋白(sST2)和可溶性细胞分化抗原163(sCD163)的血浆水平,以确定它们在临床发病早期是否能够预测糖尿病肾病和/或糖尿病视网膜病变的发生。

方法

纳入1987年至1988年间确诊为糖尿病的15至34岁患者(n = 220)。在诊断时收集体重指数、吸烟情况、糖化血红蛋白和胰岛细胞抗体等数据。在10年随访期内,112名患者(51%)出现了糖尿病相关并发症;视网膜病变(n = 91)、肾病(n = 12)或两者皆有(n = 9)。在诊断时测量sST2和sCD163的血浆浓度,并比较不同并发症组之间的水平。

结果

与未发生肾病的患者(n = 199;723 [449 - 1084] pg/ml;p = 0.006)相比,后来发生肾病的患者(n = 21;1012 [773 - 1493] pg/ml)的sST2血浆水平显著更高。观察到sCD163血浆水平有升高趋势,但无统计学意义(p = 0.058)。

结论

sST2和sCD163有望成为临床发病时肾病发生的潜在生物标志物。sST2和/或sCD163可能是旨在发现肾病高风险患者的生物标志物组合的一部分。这两种标志物都需要在更大规模的前瞻性研究中进行调查。

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