Ko Wen-Chin, Choy Cheuk-Sing, Lin Wei-Ning, Chang Shu-Wei, Liou Jian-Chiun, Tung Tao-Hsin, Hsieh Chih-Yu, Chang Jia-Feng
College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan.
Division of Cardiology, Department of Internal Medicine, Cathay General Hospital, Taipei 106, Taiwan.
J Clin Med. 2018 Sep 24;7(10):300. doi: 10.3390/jcm7100300.
BACKGROUND: Interactions and joint effects of galectin-3 and vascular cell adhesion molecule 1 (VCAM-1) on risks of all-cause and cardiovascular (CV) mortality remain unclear in patients with maintenance hemodialysis (MHD). METHODS: Unadjusted and adjusted hazard ratios (aHRs) of mortality risks were analyzed between higher and lower concentration groups of serum galectin-3 and VCAM-1. The modification effect between serum galectin-3 and VCAM-1 on mortality risk was investigated using an interaction product term. RESULTS: During follow-up, galectin-3 and VCAM-1 were associated with incremental risks of all-cause mortality (aHR: 1.038 (95% confidence interval (CI): 1.001⁻1.077) and 1.002 (95% CI: 1.001⁻1.003), respectively). Nonetheless, VCAM-1 but not galectin-3 predicted CV mortality (aHR: 1.043 (95% CI: 0.993⁻1.096) and 1.002 (95% CI: 1.001⁻1.003), respectively). In the interaction analysis, patients with combined higher galectin-3 (>29.5 ng/mL) and VCAM-1 (>1546.9 ng/mL) were at the greatest risk of all-cause and CV mortality (aHR: 4.6 (95% CI: 1.6⁻13.4), and 4.2 (95% CI: 1.3⁻14.4), respectively). The interactions between galectin-3 and VCAM-1 with respect to all-cause and CV mortality were statistically significant ( < 0.01 and < 0.05, respectively). CONCLUSION: Galectin-3 and VCAM-1 could serve as a promising dual biomarker for prognostic assessment, considering their joint effects on pathogenesis of leukocyte trafficking and atherothrombosis.
背景：在维持性血液透析（MHD）患者中，半乳糖凝集素-3与血管细胞黏附分子1（VCAM-1）对全因死亡和心血管（CV）死亡风险的相互作用及联合效应仍不明确。 方法：分析血清半乳糖凝集素-3和VCAM-1高浓度组与低浓度组之间死亡风险的未调整和调整后风险比（aHRs）。使用交互作用乘积项研究血清半乳糖凝集素-3和VCAM-1对死亡风险的修饰作用。 结果：在随访期间，半乳糖凝集素-3和VCAM-1分别与全因死亡风险增加相关（aHR：1.038（95%置信区间（CI）：1.001⁻1.077）和1.002（95%CI：1.001⁻1.003））。然而，VCAM-1而非半乳糖凝集素-3可预测CV死亡（aHR：1.043（95%CI：0.993⁻1.096）和1.002（95%CI：1.001⁻1.003））。在交互作用分析中，血清半乳糖凝集素-3（>29.5 ng/mL）和VCAM-1（>1546.9 ng/mL）均较高的患者全因死亡和CV死亡风险最高（aHR分别为4.6（95%CI：1.6⁻13.4）和4.2（95%CI：1.3⁻14.4））。半乳糖凝集素-3和VCAM-1在全因死亡和CV死亡方面的交互作用具有统计学意义（分别<0.01和<0.05）。 结论：考虑到半乳糖凝集素-3和VCAM-1对白细胞运输和动脉粥样硬化血栓形成发病机制的联合作用，它们可作为一种有前景的双重生物标志物用于预后评估。
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