■血浆神经紧张素/神经紧张素N(pro-NT/NMN)是神经紧张素的前体,与2型糖尿病和其他与肾脏疾病相关的合并症相关的三肽。pro-NT/NMN是否与慢性肾脏病(CKD)直接相关,以及这种联系是否因种族而异,不确定。我们评估了pro-NT/NMN水平是否与肾脏结局风险增加相关。
■前瞻性队列。
■风险因素种族差异的生物标志物中介参与者,来自中风研究中地理和种族差异的原因的嵌套队列,使用来自基线和第二次访问的可用存储的血清和尿液样本进行生物标志物测量。
■基线对数变换的pro-NT/NMN。
■意外CKD,进行性估计肾小球滤过率(eGFR)下降,偶发蛋白尿,中位随访时间9.4年内发生肾衰竭。
■Logistic回归。
■在3,914名参与者中,平均±SD年龄为64±8(SD)岁,48%是女性,51%是黑人。基线eGFR中位数为90(IQR,77-102)mL/min/1.73m2。pro-NT/NMN的SD越高,eGFR进行性下降的几率越高9%(OR,1.09;95%CI,1.00-1.20)。未观察到与CKD相关(OR,1.10;95%CI,0.96-1.27),偶发蛋白尿(OR,1.08;95%CI,0.96-1.22),或肾衰竭(OR,1.10;95%CI,0.83-1.46)。种族或性别的结果没有差异。
■pro-NT/NMN的单一测量和有限的泛化性。
■较高的pro-NT/NMN与进行性eGFR下降相关,但没有肾脏疾病发病率的其他表现。
神经降压素是小肠响应于进餐而分泌的肽。更高水平的神经降压素及其稳定前体,前神经紧张素/神经紧张素N(pro-NT/NMN),与心血管疾病和2型糖尿病有关,肾脏疾病发展的重要危险因素。pro-NT/NMN是否与肾脏结局直接相关的研究较少,并且在白人参与者的大部分同质队列中进行了研究。利用中风研究中地理和种族差异的原因,我们追踪了黑白参与者,并评估了出现肾脏结局的风险.我们发现pro-NT/NMN水平升高与肾功能下降有关。Pro-NT/NMN可以帮助可能从更密切监测肾功能中受益的个体。
UNASSIGNED: Plasma proneurotensin/neuromedin N (pro-NT/NMN) is a precursor of neurotensin, a tridecapeptide linked with type 2 diabetes mellitus and other comorbid conditions associated with kidney disease. Whether pro-NT/NMN is directly associated with incident chronic kidney disease (CKD), and whether that association differs by race, is uncertain. We evaluated whether pro-NT/NMN levels were associated with increased risk of kidney outcomes.
UNASSIGNED: Prospective cohort.
UNASSIGNED: Participants in Biomarker Mediators of Racial Disparities in Risk Factors, a nested cohort from the REasons for Geographic And Racial Differences in Stroke study, with available stored serum and urine samples from baseline and second visits for biomarker measurement.
UNASSIGNED: Baseline log-transformed pro-NT/NMN.
UNASSIGNED: Incident CKD, progressive estimated glomerular filtration rate (eGFR) decline, incident albuminuria, and incident kidney failure within median follow-up time of 9.4 years.
UNASSIGNED: Logistic regression.
UNASSIGNED: Among 3,914 participants, the mean ± SD age was 64 ± 8 (SD) years, 48% were women, and 51% were Black. Median baseline eGFR was 90 (IQR, 77-102) mL/min/1.73 m2. Each SD higher of pro-NT/NMN was associated with 9% higher odds of progressive eGFR decline (OR, 1.09; 95% CI, 1.00-1.20). There was no association observed with incident CKD (OR, 1.10; 95% CI, 0.96-1.27), incident albuminuria (OR, 1.08; 95% CI, 0.96-1.22), or incident kidney failure (OR, 1.10; 95% CI, 0.83-1.46). There were no differences in results by race or sex.
UNASSIGNED: Single measurement of pro-NT/NMN and limited generalizability.
UNASSIGNED: Higher pro-NT/NMN was associated with progressive eGFR decline but no other manifestations of kidney disease incidence.
Neurotensin is a peptide secreted by the small intestine in response to a meal. Higher levels of neurotensin and its stable precursor, proneurotensin/neuromedin N (pro-NT/NMN), have been associated with cardiovascular disease and type 2 diabetes mellitus, important risk factors for the development of kidney disease. Whether pro-NT/NMN is directly associated with kidney outcomes has been less studied and has been done so in largely homogenous cohorts of White participants. Using the REasons for Geographic And Racial Differences in Stroke study, we followed Black and White participants and evaluated the risk of developing kidney outcomes. We found that elevated levels of pro-NT/NMN were associated with kidney function decline. Pro-NT/NMN may help individuals who may benefit from closer monitoring of kidney function.