血清神经丝轻链水平与慢性肾脏病的关系：来自国家健康和营养调查（2013-2014 周期）的横断面人群研究。

Association between serum neurofilament light chain levels and chronic kidney disease: a cross-sectional population-based study from the National Health and Nutrition Examination Survey (2013-2014 cycle).

机构信息

Graduate School of Xinjiang Medical University, Urumqi, China.

Department of General Surgery, Children's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hospital of Beijing Children's Hospital, Urumqi, China.

出版信息

Ren Fail. 2024 Dec;46(2):2427178. doi: 10.1080/0886022X.2024.2427178. Epub 2024 Nov 24.

DOI:10.1080/0886022X.2024.2427178

PMID:39581996

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11590190/

Abstract

BACKGROUND

The relationships of serum neurofilament light chain (NfL) levels with chronic kidney disease (CKD) and renal function indicators remain controversial, and comprehensive studies with large sample sizes are lacking.

METHODS

In total, 2,051 participants aged 20 to 75 years were identified from the National Health and Nutrition Examination Survey (2013-2014 cycle). Logistic regression models were used to assess the associations between serum NfL levels and CKD, whereas multivariate linear models were used to investigate the relationships between serum NfL levels and two kidney function indicators, namely, estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR). Adjustments were made to account for potential confounding variables in the analysis. Subgroup analyses stratified by age and sex were conducted. When sNfL is incorporated into the model as continuous variables, a log transformation is applied.

RESULTS

The present study included a cohort of 2,051 individuals ranging in age from 20 to 75 years. After covariate adjustment, multivariable logistic regression revealed a significant association between high serum NfL levels and an increased prevalence of CKD (OR 1.60; 95% CI 1.40-1.82; < 0.0001), which remained significant when analyzed by quartiles (p for trend <0.0001). There was a statistically significant inverse correlation between the serum NfL level and the eGFR (β=-6.34; 95% CI -8.32 to -4.37; < 0.0001), as well as a positive correlation between the serum NfL level and the UACR (β = 84.67; 95% CI 19.52-149.83; < 0.0001). Furthermore, when stratified by age, there were significant interactions of serum NfL levels with CKD, the eGFR, and the UACR (p for interaction = 0.008, 0.016, and 0.020, respectively).

CONCLUSION

Serum NfL levels are positively associated with the prevalence of CKD and the UACR but negatively correlated with the eGFR, particularly in older patients.

摘要

背景

血清神经丝轻链（NfL）水平与慢性肾脏病（CKD）和肾功能指标的关系仍存在争议，且缺乏大样本量的综合研究。

方法

共纳入 2051 名年龄在 20 至 75 岁的参与者，这些参与者均来自美国国家健康与营养调查（2013-2014 年周期）。采用 logistic 回归模型评估血清 NfL 水平与 CKD 之间的相关性，采用多元线性模型评估血清 NfL 水平与两种肾功能指标（即估算肾小球滤过率[eGFR]和尿白蛋白-肌酐比[UACR]）之间的关系。在分析中，对潜在的混杂变量进行了调整。对年龄和性别进行分层的亚组分析。当 sNfL 作为连续变量纳入模型时，应用对数转换。

结果

本研究共纳入了 2051 名年龄在 20 至 75 岁的个体。在调整了协变量后，多变量 logistic 回归显示，高血清 NfL 水平与 CKD 患病率增加显著相关（OR 1.60；95%CI 1.40-1.82； < 0.0001），且在四分位组分析时仍具有统计学意义（趋势检验 P<0.0001）。血清 NfL 水平与 eGFR 呈显著负相关（β=-6.34；95%CI -8.32 至 -4.37； < 0.0001），与 UACR 呈显著正相关（β=84.67；95%CI 19.52-149.83； < 0.0001）。此外，按年龄分层时，血清 NfL 水平与 CKD、eGFR 和 UACR 之间存在显著的交互作用（交互检验 P 值分别为 0.008、0.016 和 0.020）。