Association of Serum Concentration of TNFR1 With All-Cause Mortality in Patients With Type 2 Diabetes and Chronic Kidney Disease: Follow-up of the SURDIAGENE Cohort
Open Access
- 10 April 2014
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 37 (5), 1425-1431
- https://doi.org/10.2337/dc13-2580
Abstract
Renal dysfunction is a key risk factor for all-cause mortality in patients with type 2 diabetes (T2D). Circulating tumor necrosis factor receptor 1 (TNFR1) was recently suggested as a strong biomarker for end-stage renal failure in T2D. However, its relevance regarding all-cause death has yet to be conclusively established. We aimed to assess the prognostic value of serum TNFR1 concentration for all-cause death in T2D and diabetic kidney disease (DKD) from the SURDIAGENE (Survie, Diabete de type 2 et Genetique) study. A total of 522 T2D patients with DKD (estimated glomerular filtration rate [eGFR] 30 mg/mmol) were followed for a median duration of 48 months, and 196 deaths occurred. Incidence rate (95% CI) for death increased as quartiles of TNFR1 concentration increased (first quartile: 4.7% patient-years [3.0–6.3%]; second quartile: 7.7% [5.4–10.0%]; third quartile: 9.3% [6.7–11.9%]; fourth quartile: 15.9% [12.2–19.5%]). In multivariate analysis taking age, diabetes duration, HbA1c, uACR, and eGFR into account, compared with the first quartile, patients from the fourth quartile had an adjusted hazard ratio for death of 2.98 (95% CI 1.70–5.23). The integrated discrimination improvement index was statistically significant when adding TNFR1 concentration to the UK Prospective Diabetes Study outcome equation (P = 0.031). TNFR1 is a strong prognostic factor for all-cause mortality in T2D with renal dysfunction, and its clinical utility is suggested in addition to established risk factors for all-cause mortality.Keywords
This publication has 20 references indexed in Scilit:
- Risk of ESRD and All Cause Mortality in Type 2 Diabetes According to Circulating Levels of FGF-23 and TNFR1PLOS ONE, 2013
- Kidney Disease and Increased Mortality Risk in Type 2 DiabetesJournal of the American Society of Nephrology, 2013
- Circulating TNF Receptors 1 and 2 Predict Stage 3 CKD in Type 1 DiabetesJournal of the American Society of Nephrology, 2012
- Circulating TNF Receptors 1 and 2 Predict ESRD in Type 2 DiabetesJournal of the American Society of Nephrology, 2012
- Inflammation in the pathogenesis of microvascular complications in diabetesFrontiers in Endocrinology, 2012
- Inflammatory molecules and pathways in the pathogenesis of diabetic nephropathyNature Reviews Nephrology, 2011
- Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific DeathThe New England Journal of Medicine, 2011
- In the absence of renal disease, 20 year mortality risk in type 1 diabetes is comparable to that of the general population: a report from the Pittsburgh Epidemiology of Diabetes Complications StudyDiabetologia, 2010
- Serum Concentrations of Markers of TNFα and Fas-Mediated Pathways and Renal Function in Nonproteinuric Patients with Type 1 DiabetesClinical Journal of the American Society of Nephrology, 2009
- The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes MellitusThe New England Journal of Medicine, 1993