移植肾功能受者循环结合珠蛋白与代谢综合征。
Circulating Haptoglobin and Metabolic Syndrome in Renal Transplant Recipients.
机构信息
Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
Top Institute Food and Nutrition, Nieuwe Kanaal 9-A, 6709 PA, Wageningen, The Netherlands.
出版信息
Sci Rep. 2017 Oct 27;7(1):14264. doi: 10.1038/s41598-017-14302-2.
Haptoglobin (Hp) is an acute phase protein that has recently been linked to components of the metabolic syndrome (MetS). We aimed to evaluate Hp as marker of MetS, and to assess its association with long-term outcome in renal transplant recipients (RTR). We measured plasma Hp in a prospective cohort of 699 stable RTR and 149 healthy controls. Median plasma Hp concentration in RTR was 1.4 [interquartile range (IQR), 1.0-1.8] g/L, which was higher compared to 1.1 [0.9-1.4] g/L in controls (P < 0.001). Hp was independently associated with the MetS (β = 0.10) (P = 0.005). During follow-up of 5.4 [4.8-6.1] years, 150 (21%) recipients died, of whom 60 (9%) due to cardiovascular causes, and 83 (12%) RTR developed graft failure. High (≥2.0 g/L) and low (≤0.9 g/L) plasma Hp were associated with increased risk of mortality (HR's 2.3 [1.3-4.1] and 1.9 [1.0-3.5], resp.), predominantly cardiovascular. The association of high Hp lost significance upon adjustment for inflammation markers (HR 1.5 [0.8-2.7]), while low Hp was independently associated with mortality (HR 2.2 [1.2-4.0]). Hp was not associated with graft failure (P = 0.49). In conclusion, plasma Hp is independently associated with MetS in RTR. Importantly, high and low Hp are associated with increased mortality risk, independent of MetS.
结合蛋白（Hp）是一种急性相蛋白，最近与代谢综合征（MetS）的成分有关。我们旨在评估 Hp 作为 MetS 的标志物，并评估其与肾移植受者（RTR）的长期预后的关系。我们在一个由 699 例稳定的 RTR 和 149 例健康对照组成的前瞻性队列中测量了血浆 Hp。RTR 中 Hp 的血浆中位数浓度为 1.4 [四分位距（IQR），1.0-1.8] g/L，与对照组的 1.1 [0.9-1.4] g/L 相比更高（P<0.001）。Hp 与 MetS 独立相关（β=0.10）（P=0.005）。在 5.4 [4.8-6.1] 年的随访中，150 例（21%）受者死亡，其中 60 例（9%）死于心血管原因，83 例（12%）RTR 发生移植物失功。高（≥2.0 g/L）和低（≤0.9 g/L）的 Hp 血浆浓度与死亡率增加相关（HR 分别为 2.3 [1.3-4.1] 和 1.9 [1.0-3.5]），主要是心血管原因。当调整炎症标志物后，高 Hp 的相关性失去意义（HR 1.5 [0.8-2.7]），而低 Hp 与死亡率独立相关（HR 2.2 [1.2-4.0]）。Hp 与移植物失功无关（P=0.49）。总之，血浆 Hp 与 RTR 中的 MetS 独立相关。重要的是，高和低 Hp 与死亡率风险增加相关，与 MetS 无关。
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