Ardic Melis, Gul Cuma Bulent
Department of Nephrology, Bursa Yuksek Ihtisas Training and Research Hospital, 16350 Bursa, Turkey.
Departments of Nephrology, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, Turkey.
J Clin Med. 2025 Jun 3;14(11):3953. doi: 10.3390/jcm14113953.
Contrast-induced acute kidney injury (CI-AKI) remains a frequent and serious complication after cardiac catheterization. Sirtuin-1 (SIRT1), a NAD+-dependent deacetylase, plays a central role in renal protection against ischemia-reperfusion injury, inflammation, and vascular dysfunction. We aimed to investigate whether serum SIRT1 levels could serve as an early diagnostic biomarker for CI-AKI. This prospective case-control study included 50 patients undergoing elective percutaneous coronary intervention (PCI) for stable angina. Serum SIRT1 levels were measured at baseline, 24 h, and 72 h post-PCI. The occurrence of CI-AKI was defined by a standard rise in serum creatinine, and patients were stratified accordingly. Although SIRT1 levels tended to be lower in patients who developed CI-AKI (n = 17) compared to those without (n = 33), the differences were not statistically significant at any time point ( > 0.05). However, a significant between-group difference was observed in the 72-h change in SIRT1 levels (Δ0-72 h, = 0.037), with a greater decline in the CI-AKI group. Multivariable logistic regression also revealed a trend-level inverse association between 72-h SIRT1 levels and CI-AKI (β = -0.536, = 0.099). While SIRT1 is biologically plausible as a renal protective factor, our findings suggest that serial SIRT1 measurement may offer added value as a dynamic biomarker rather than a static diagnostic tool. Confirmatory trials incorporating serial SIRT1 measurements may help translate this molecular signal into clinically actionable tools for early detection of CI-AKI.
造影剂诱导的急性肾损伤（CI-AKI）仍然是心脏导管插入术后常见且严重的并发症。沉默调节蛋白1（SIRT1）是一种依赖烟酰胺腺嘌呤二核苷酸（NAD+）的脱乙酰酶，在肾脏抵御缺血再灌注损伤、炎症和血管功能障碍方面发挥着核心作用。我们旨在研究血清SIRT1水平是否可作为CI-AKI的早期诊断生物标志物。这项前瞻性病例对照研究纳入了50例因稳定型心绞痛接受择期经皮冠状动脉介入治疗（PCI）的患者。在PCI术前基线、术后24小时和72小时测量血清SIRT1水平。CI-AKI的发生通过血清肌酐的标准升高来定义，并据此对患者进行分层。尽管发生CI-AKI的患者（n = 17）与未发生CI-AKI的患者（n = 33）相比，SIRT1水平往往较低，但在任何时间点差异均无统计学意义（> 0.05）。然而，观察到两组之间SIRT1水平在72小时的变化存在显著差异（Δ0-72小时，P = 0.037），CI-AKI组下降幅度更大。多变量逻辑回归还显示，72小时SIRT1水平与CI-AKI之间存在趋势性负相关（β = -0.536，P = 0.099）。虽然SIRT1作为一种肾脏保护因子在生物学上是合理的，但我们的研究结果表明，连续测量SIRT1作为一种动态生物标志物可能比静态诊断工具具有更大的价值。纳入连续SIRT1测量的验证性试验可能有助于将这种分子信号转化为用于早期检测CI-AKI的临床可行工具。
