Berezina Tetiana A, Obradovic Zeljko, Boxhammer Elke, Berezin Alexander A, Lichtenauer Michael, Berezin Alexander E
Department of Nephrology, "Vita Center", 3, Sedov Str., 69000 Zaporozhye, Ukraine.
Klinik Barmelweid, Department of Psychosomatic Medicine and Psychotherapy, 5017 Barmelweid, Switzerland.
J Clin Med. 2023 Mar 13;12(6):2231. doi: 10.3390/jcm12062231.
Adropin is a multifunctional secreted protein, which is involved in the metabolic modulation of the heart-brain-kidney axis in heart failure (HF). The aim of the study was to detect the plausible predictive value of serum levels of adropin for chronic kidney disease (CKD) grades 1-3 in type 2 diabetes mellitus (T2DM) patients with chronic HF. We enrolled 417 T2DM individuals with chronic HF and subdivided them into two groups depending on the presence of CKD. The control group was composed of 25 healthy individuals and 30 T2DM patients without HF and CKD. All eligible patients underwent an ultrasound examination. Adropin was detected by ELISA in blood samples at the study baseline. We found that adropin levels in T2DM patients without HF and CKD were significantly lower than in healthy volunteers, but they were higher than in T2DM patients with known HF. The optimal cut-off point for adropin levels was 2.3 ng/mL (area under the curve [AUC] = 0.86; 95% CI = 0.78-0.95; sensitivity = 81.3%, specificity = 77.4%). The multivariate logistic regression adjusted for albuminuria/proteinuria showed that serum levels of adropin <2.30 ng/mL (OR = 1.55; = 0.001) independently predicted CKD. Conclusions: Low levels of adropin in T2DM patients with chronic CH seem to be an independent predictor of CKD at stages 1-3.
内脂素是一种多功能分泌蛋白，参与心力衰竭（HF）时心脏-脑-肾轴的代谢调节。本研究旨在检测血清内脂素水平对慢性心力衰竭的2型糖尿病（T2DM）患者1-3期慢性肾脏病（CKD）的潜在预测价值。我们纳入了417例患有慢性心力衰竭的T2DM个体，并根据是否存在CKD将他们分为两组。对照组由25名健康个体和30名无心力衰竭及CKD的T2DM患者组成。所有符合条件的患者均接受了超声检查。在研究基线时通过酶联免疫吸附测定（ELISA）检测血样中的内脂素。我们发现，无心力衰竭及CKD的T2DM患者的内脂素水平显著低于健康志愿者，但高于已知患有心力衰竭的T2DM患者。内脂素水平的最佳截断点为2.3 ng/mL（曲线下面积[AUC]=0.86；95%可信区间=0.78-0.95；敏感性=81.3%，特异性=77.4%）。经蛋白尿/蛋白尿校正的多因素逻辑回归分析显示，血清内脂素水平<2.30 ng/mL（比值比[OR]=1.55；P=0.001）可独立预测CKD。结论：患有慢性CH的T2DM患者内脂素水平低似乎是1-3期CKD的独立预测因素。
