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肾移植后血液白细胞介素-10与心血管死亡率及全因死亡率的关系

The Relationship Between Blood Interleukin-10 and Cardiovascular Mortality and All-Cause Mortality After Kidney Transplantation.

作者信息

Gao Chen, Peng Fenghua, Xie Xubiao, Peng Longkai

机构信息

Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2021 Apr 12;14:1481-1489. doi: 10.2147/RMHP.S309764. eCollection 2021.

Abstract

BACKGROUND

Circulating interleukin (IL)-10 is associated with adverse cardiovascular events in chronic kidney disease (CKD). Whether IL-10 predicts cardiovascular and all-cause mortality after kidney transplantation (KT) is unknown.

METHODS

The association between plasma IL-10 and cardiovascular and all-cause mortality was analyzed in a prospective cohort, which included 418 stable kidney transplant recipients, at a median of 3.6 (range=1.2-8.4) years after transplantation. Multivariate Cox regression models were performed to adjusting related confounding factors.

RESULTS

Median level of IL-10 in KT patient was 22.3 pg/mL. Multivariate Cox regression analysis revealed that serum levels IL-10 were significantly and independently associated with cardiovascular mortality after adjusting for age, gender, BMI, current smoker, current drinker, cause of kidney disease, systolic and diastolic BP, laboratory indexes and medication (HR=1.26, 95% CI 1.19-2.08, -trend<0.001). The multivariate Cox analysis also suggested that serum levels IL-10 were independently associated with all-cause mortality (HR=1.25, 95% CI 1.11-1.8, -trend=0.023) after controlling these same related confounding factors. Sensitivity and stratified analysis showed that the significant association can be affected by history of acute rejection.

CONCLUSION

Plasma IL-10 is independently and significant associated with cardiovascular and all-cause mortality after kidney transplantation. The significant association is independent of cardiovascular risk factors and other related confounding factors.

摘要

背景

循环白细胞介素(IL)-10与慢性肾脏病(CKD)的不良心血管事件相关。IL-10是否能预测肾移植(KT)后的心血管和全因死亡率尚不清楚。

方法

在一个前瞻性队列中分析血浆IL-10与心血管和全因死亡率之间的关联,该队列包括418名稳定的肾移植受者,移植后中位时间为3.6年(范围=1.2 - 8.4年)。采用多变量Cox回归模型调整相关混杂因素。

结果

KT患者中IL-10的中位水平为22.3 pg/mL。多变量Cox回归分析显示,在调整年龄、性别、体重指数、当前吸烟者、当前饮酒者、肾脏疾病病因、收缩压和舒张压、实验室指标及用药情况后,血清IL-10水平与心血管死亡率显著且独立相关(HR = 1.26,95% CI 1.19 - 2.08,P趋势<0.001)。多变量Cox分析还表明,在控制这些相同的相关混杂因素后,血清IL-10水平与全因死亡率独立相关(HR = 1.25,95% CI 1.11 - 1.8,P趋势 = 0.023)。敏感性和分层分析表明,这种显著关联可能受急性排斥反应史的影响。

结论

血浆IL-10与肾移植后的心血管和全因死亡率独立且显著相关。这种显著关联独立于心血管危险因素和其他相关混杂因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfbe/8053705/9f4d26d76d18/RMHP-14-1481-g0001.jpg

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