INSERM Centre d'Investigations Cliniques-1433, Université de Lorraine, Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT, Nancy, France.
Department of Nephrology, University Hospital of Nancy, Vandoeuvre les Nancy, Nancy, France.
Ann Transplant. 2023 Apr 25;28:e938137. doi: 10.12659/AOT.938137.
BACKGROUND Cardiovascular (CV) mortality remains high despite the improvement of kidney function after kidney transplantation. In heart failure (HF), high concentrations of biomarkers of fibrosis, related to cardiac and/or vascular impairment, are associated with CV outcomes, but their significance in kidney transplantation is still unclear. Our aim was to investigate the association of procollagen type I C-terminal pro-peptide (PICP) and galectin-3 (Gal-3), markers of fibrosis, with arterial stiffness measured by pulse wave velocity (PWV) and CV morbi-mortality in kidney transplantation recipients from the prospective monocenter TRANSARTE study (Transplantation and Arteries), which compared the evolution of arterial stiffness in transplanted patients and patients remained on dialysis. MATERIAL AND METHODS PICP and Gal-3 were measured at 2 years after transplantation in 44 kidney transplantation patients. Spearman's rank-order correlation analysis was conducted to assess the relationship between biomarkers and PWV. Association of biomarkers with CV morbi-mortality was evaluated using Cox regression analysis adjusted for age, renal function, and PWV. RESULTS There was no significant correlation between PWV and PICP (r=-0.16, P=0.3) or Gal-3 (r=0.03, P=0.85). Gal-3, after adjusting for key prognostic factors, including PWV, was significantly associated with CV morbi-mortality [HR (95% CI)=4.30 (1.01-18.22), P=0.048], whereas PICP was not significantly associated with outcome. CONCLUSIONS In multivariable adjusted analysis, elevated Gal-3 concentrations were associated with CV morbi-mortality in kidney transplantation patients, whereas PICP was not. As Gal-3 was not related to PWV, other sources of fibrosis (eg, cardiac fibrosis) may be underlying the prognostic value of Gal-3 in kidney transplantation.
尽管肾移植后肾功能有所改善，但心血管（CV）死亡率仍然很高。在心力衰竭（HF）中，与心脏和/或血管损伤相关的纤维化生物标志物浓度升高与 CV 结局相关，但它们在肾移植中的意义仍不清楚。我们的目的是研究纤维化标志物Ⅰ型前胶原羧基端前肽（PICP）和半乳糖凝集素-3（Gal-3）与脉搏波速度（PWV）测量的动脉僵硬以及 CV 发病率和死亡率的相关性在来自前瞻性单中心 TRANSARTE 研究（移植与动脉）的肾移植受者中，该研究比较了移植患者和仍在透析的患者的动脉僵硬的演变。
在肾移植后 2 年，对 44 例肾移植患者测量了 PICP 和 Gal-3。进行 Spearman 秩相关分析以评估生物标志物与 PWV 之间的关系。使用 Cox 回归分析调整年龄、肾功能和 PWV 后，评估生物标志物与 CV 发病率和死亡率的相关性。
PWV 与 PICP（r=-0.16，P=0.3）或 Gal-3（r=0.03，P=0.85）之间无显著相关性。在调整了包括 PWV 在内的关键预后因素后，Gal-3 与 CV 发病率和死亡率显著相关[HR（95%CI）=4.30（1.01-18.22），P=0.048]，而 PICP 与结果无显著相关性。
在多变量调整分析中，升高的 Gal-3 浓度与肾移植患者的 CV 发病率和死亡率相关，而 PICP 则没有。由于 Gal-3 与 PWV 无关，纤维化的其他来源（例如，心脏纤维化）可能是 Gal-3 在肾移植中具有预后价值的基础。
