Progression of diabetic nephropathy: Role of plasma homocysteine and plasminogen activator inhibitor-1
| Autor: | Coen D.A. Stehouwer, Jef J. Emeis, Tom Teerlink, Hans-Henrik Parving, Lise Tarnow, Peter Rossing, Peter Hovind |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Homocysteine Urology Renal function Nephropathy Cohort Studies Diabetic nephropathy chemistry.chemical_compound Diabetes mellitus Internal medicine Plasminogen Activator Inhibitor 1 medicine Humans Diabetic Nephropathies Prospective Studies Prospective cohort study Type 1 diabetes business.industry medicine.disease Diabetes Mellitus Type 1 Endocrinology chemistry Nephrology Plasminogen activator inhibitor-1 Disease Progression Regression Analysis Female business Biomarkers Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | American Journal of Kidney Diseases. 38:1376-1380 |
| ISSN: | 0272-6386 |
| DOI: | 10.1053/ajkd.2001.29261 |
| Popis: | Among patients with diabetic nephropathy, the decline in glomerular filtration rate (GFR) varies substantially, ranging from 2 to 20 mL/min per year. Identification of predictors of progression in diabetic nephropathy is important. Plasma total homocysteine (tHcy) rises with urinary albumin excretion rate in diabetes, and plasminogen activator inhibitor-1 (PAI-1) has been correlated with increased matrix accumulation in various glomerulopathies. In this prospective observational cohort study, we evaluated the importance of baseline tHcy and PAI-1 as predictors of the rate of decline in GFR. Baseline tHcy and PAI-1 were measured in 157 type 1 diabetic patients with diabetic nephropathy (92 men; mean age, 41 +/- 10 years; mean diabetes duration, 27 +/- 8 years; median GFR, 80 mL/min/1.73 m(2) [range, 23 to 143 mL/min/1.73 m(2)]). Hereafter, GFR was measured yearly with a plasma clearance technique for at least 3 years (median, 7 years [range, 3.0 to 8.3 years]). The mean rate of decline in GFR was 3.7 +/- 0.3 mL/min per year. A linear regression analysis revealed a borderline significant relationship between rate of decline in GFR and tHcy (P = 0.069) and PAI-1 (P = 0.087). Analysis of the rate of decline in GFR and tertiles of tHcy and PAI-1 revealed that increasing levels of tHcy were correlated with a significantly faster decline in GFR (P = 0.025), whereas increasing levels of PAI-1 were not. After adjustment for other well-established risk factors for progression of nephropathy in a multiple linear regression analysis, however, neither tHcy levels nor PAI-1 levels were independent predictors of rate of decline in GFR. |
| Databáze: | OpenAIRE |
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