Gurung Resham L, Liu Jian-Jun, Liu Sylvia, Lee Janus, Zheng Huili, Chan Clara, Ang Keven, Lim Su Chi
Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
Cardiovascular and Metabolic Disorders Signature Research Program, Duke-NUS Medical School, Singapore.
Diabetes. 2025 Jun 1;74(6):998-1006. doi: 10.2337/db24-0699.
We investigated the association between plasma angiogenin and the risk of progression to end-stage kidney disease (ESKD) in patients with type 2 diabetes (T2D) and attempted to infer the causal relationship between plasma angiogenin and chronic kidney disease. A total of 1,863 outpatients with T2D were included in this prospective cohort study. ESKD was defined as a composite of progression to sustained estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m2, maintenance dialysis, or death due to renal causes. The secondary outcome was rapid kidney function decline defined as a eGFR decline of 5 mL/min/1.73 m2 or greater per year. Over a median follow-up of 9.3 years, 125 incident ESKD events were identified. Elevated plasma angiogenin levels were associated with an increased risk of incident ESKD (adjusted hazard ratio 1.25 [95% CI 1.01-1.55], per 1 SD) independent of cardiorenal risk factors including baseline eGFR and albuminuria. A high level of plasma angiogenin was also associated with an increased risk for rapid kidney function decline (adjusted odds ratio 1.31 [95% CI 1.07-1.61], per 1 SD). A two-sample Mendelian randomization approach suggested a potential causal relationship between plasma angiogenin and chronic kidney disease. Plasma angiogenin may be a novel biomarker and potential therapeutic target for progressive kidney disease in patients with T2D.
We investigated the association of plasma angiogenin with the risk of incident end-stage kidney disease (ESKD) in patients with type 2 diabetes. A high level of plasma angiogenin is independently associated with an increased risk for incident ESKD. A two-sample Mendelian randomization analysis suggested angiogenin may be causally involved in pathogenesis of chronic kidney disease. Plasma angiogenin may be a novel biomarker and potential therapeutic target for treatment of progressive kidney disease in patients with diabetes.
我们研究了2型糖尿病（T2D）患者血浆血管生成素与进展至终末期肾病（ESKD）风险之间的关联，并试图推断血浆血管生成素与慢性肾脏病之间的因果关系。本前瞻性队列研究共纳入1863例T2D门诊患者。ESKD定义为进展至持续估计肾小球滤过率（eGFR）<15 mL/min/1.73 m²、维持性透析或因肾脏原因死亡的综合情况。次要结局是肾功能快速下降，定义为eGFR每年下降5 mL/min/1.73 m²或更多。在中位随访9.3年期间，共确定了125例新发ESKD事件。血浆血管生成素水平升高与新发ESKD风险增加相关（校正风险比1.25 [95%CI 1.01 - 1.55]，每1个标准差），独立于包括基线eGFR和蛋白尿在内的心脏肾脏危险因素。血浆血管生成素水平高还与肾功能快速下降风险增加相关（校正优势比1.31 [95%CI 1.07 - 1.61]，每1个标准差）。两样本孟德尔随机化方法提示血浆血管生成素与慢性肾脏病之间存在潜在因果关系。血浆血管生成素可能是T2D患者进行性肾病的新型生物标志物和潜在治疗靶点。
我们研究了2型糖尿病患者血浆血管生成素与新发终末期肾病（ESKD）风险之间的关联。血浆血管生成素水平高与新发ESKD风险增加独立相关。两样本孟德尔随机化分析提示血管生成素可能因果性参与慢性肾脏病的发病机制。血浆血管生成素可能是糖尿病患者进行性肾病治疗的新型生物标志物和潜在治疗靶点。
