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Clinical significance of neutrophil gelatinase-associated lipocalin and sdLDL-C for coronary artery disease in patients with type 2 diabetes mellitus aged ≥ 65 years. Cardiovasc Diabetol 2022; 21:252. [PMID: 36397150 PMCID: PMC9682485 DOI: 10.1186/s12933-022-01668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/14/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Although type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) share many common pathological and physiological characteristics, there are few studies assessing the predictive capacity of novel biomarkers in occurrence and development of CAD in T2DM patients aged ≥ 65 years. In addition, T2DM patients aged ≥ 65 years are prone to CAD. Therefore, it is of great significance to find novel biomarkers for the development CAD in T2DM. METHODS In this retrospective cohort study, 579 T2DM patients aged ≥ 65 years were consecutively enrolled in this work, and 177 of whom had major adverse cardiovascular and cerebrovascular events (MACCE: cardiovascular or cerebrovascular death, acute coronary syndrome, coronary stent implantation, and stroke) during the follow up. Univariate and multivariate factors were employed to analyze the correlation between each variable and the occurrence of MACCE, and the Spearman's rank correlation analysis was performed to assess the relationships between Neutrophil gelatinase-associated lipocalin (NGAL) and small dense low-density lipoprotein-cholesterol (LDL-C) (sdLDL-C). The receiver operating characteristic (ROC) curve was adopted to determine the predictive value of NGAL and sdLDL-C elevation for MACCE in T2DM patients aged ≥ 65 years. RESULTS After a median 48 months follow-up [19, (10 ~ 32) ], the levels of NGAL, sdLDL-C, hemoglobin A1c (HbA1c), LDL-C, and apolipoprotein B (ApoB) were significantly higher while those of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A I (ApoA-I) were lower in MACCE positive group. NGAL correlated to body mass index (BMI) (r = 0.391, P = 0.001) and triglyceride (TG) (r = 0.228, P = 0.032), and high-sensitivity CRP (hsCRP) (r = 0.251, P = 0.007), and neutrophils (r = 0.454, P = 0.001), sdlDL-C level was found to be positively correlated with LDL-C (r = 0.413, P = 0.001), TG (r = 0.432, P = 0.001), and ApoB (r = 0.232, P = 0.002); and it was negatively correlated with HDL-C (r = -0.362, P = 0.031) and ApoA-I (r = -0.402, P = 0.001). Age-adjusted Cox regression analysis showed that NGAL (HR = 1.006, 95% confidence interval (CI): 1.005-1.008, P < 0.001) and sdLDL-C (HR = 1.052, 95% CI: 1.037-1.066, P < 0.001) were independently associated with occurrence of MACCE. ROC curve analysis showed that NGAL (area under ROC (AUC) = 0.79, 95% CI: 0.75-0.84, P < 0.001) and sdlDL-C (AUC = 0.76, 95% CI: 0.72-0.80, P < 0.001) could predict the occurrence of MACCE (area under ROC. NGAL combined with sdlDL-C could predict the occurrence of MACCE well (AUC = 0.87, 95% CI: 0.84-0.90, P < 0.001). CONCLUSION The higher NGAL and sdLDL-C in T2DM patients aged ≥ 65 years were significantly and independently associated with the risk of MACCE, and showed higher clinical values than other lipid biomarkers or other chronic inflammation, so they were expected to be the most effective predictors of MACCE assessment.
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Berthelot L, Jamin A, Viglietti D, Chemouny JM, Ayari H, Pierre M, Housset P, Sauvaget V, Hurtado-Nedelec M, Vrtovsnik F, Daugas E, Monteiro RC, Pillebout E. Value of biomarkers for predicting immunoglobulin A vasculitis nephritis outcome in an adult prospective cohort. Nephrol Dial Transplant 2019; 33:1579-1590. [PMID: 29126311 DOI: 10.1093/ndt/gfx300] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 09/11/2017] [Indexed: 11/12/2022] Open
Abstract
Background Henoch-Schönlein purpura, more recently renamed immunoglobulin A vasculitis (IgAV), is a systemic vasculitis characterized by IgA deposits. The current markers used to assess IgAV inaccurately evaluate the risk of nephritis occurrence and its long-term outcomes. The current study assessed biomarkers of nephritis outcomes. Methods This French multicentre prospective study enrolled 85 adult patients at the time of disease onset. Patients were assessed for clinical and biological parameters and re-examined after 1 year. Immunoglobulins, cytokines, IgA glycosylation, IgA complexes and neutrophil gelatinase-associated lipocalin (NGAL) concentrations were assessed in blood and urine. Results We identified 60 patients with IgAV-related nephritis (IgAV-N) and 25 patients without nephritis (IgAV-woN). At the time of inclusion (Day 1), the serum levels of galactose-deficient IgA1 (Gd-IgA1) and urinary concentrations of IgA, IgG, IgM, NGAL, interleukin (IL)-1β, IL-6, IL-8, IL-10, IgA-IgG and IgA-sCD89 complexes were higher in the IgAV-N patients than in the IgAV-woN patients (P < 0.005 for all comparisons). After follow-up (1 year), 22 patients showed a poor outcome. Among the tested markers, urine IgA at disease onset adequately reclassified the risk of poor outcome over conventional clinical factors, including estimated glomerular filtration rate, proteinuria and age (continuous net reclassification improvement = 0.72, P = 0.001; integrated discrimination improvement = 0.13, P = 0.009) in IgAV patients. Conclusions Taken together, these results showed that serum Gd-IgA1 and urinary IgA, IgG, IgM, NGAL, IL-1β, IL-6, IL-8, IL-10, IgA-IgG and IgA-sCD89 complexes were associated with nephritis in IgAV patients. Urinary IgA level may improve patient risk stratification for poor outcome.
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Affiliation(s)
- Laureline Berthelot
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France
| | - Agnès Jamin
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France
| | - Denis Viglietti
- Department of Nephrology, Saint-Louis Hospital, AP-HP, Paris, France
| | - Jonathan M Chemouny
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France.,Department of Nephrology, Bichat Hospital, DHU Fire, AP-HP, Paris, France
| | - Hamza Ayari
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France
| | - Melissa Pierre
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France
| | - Pierre Housset
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France
| | - Virginia Sauvaget
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France
| | - Margarita Hurtado-Nedelec
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France.,Department of Immunology, Bichat Hospital, AP-HP, Paris, France
| | - François Vrtovsnik
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France.,Department of Nephrology, Bichat Hospital, DHU Fire, AP-HP, Paris, France
| | - Eric Daugas
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France.,Department of Nephrology, Bichat Hospital, DHU Fire, AP-HP, Paris, France
| | | | - Renato C Monteiro
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France.,Department of Immunology, Bichat Hospital, AP-HP, Paris, France
| | - Evangeline Pillebout
- INSERM 1149, Center of Research on Inflammation, Paris, France.,Inflamex, Laboratory of Excellence, Bichat Medical Faculty, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,CNRS ERL8252, Paris, France.,Department of Nephrology, Saint-Louis Hospital, AP-HP, Paris, France
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