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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/30915


    標題: Serum Vascular Adhesion Protein-1 Predicts End-Stage Renal Disease in Patients with Type 2 Diabetes
    作者: Li, Hung-Yuan
    Lin, Hung-An
    Nien, Feng-Jung
    Wu, Vin-Cent
    Jiang, Yi-Der
    Chang, Tien-Jyun
    Kao, Hsien-Li
    Lin, Mao-Shin
    Wei, Jung-Nan
    Lin, Cheng-Hsin
    Shih, Shyang-Rong
    Hung, Chi-Sheng
    Chuang, Lee-Ming
    貢獻者: Natl Taiwan Univ Hosp, Dept Internal Med
    Minist Hlth & Welf, Lo Sheng Sanat & Hosp
    Natl Taiwan Univ Hosp, Yun Lin Branch, Dept Internal Med
    Natl Taiwan Univ, Coll Med, Grad Inst Clin Med
    Chia Nan Univ Pharm & Sci
    Taipei Med Univ, Wan Fang Hosp, Dept Surg, Div Cardiovasc Surg
    Natl Taiwan Univ, Sch Publ Hlth, Grad Inst Prevent Med
    關鍵字: sensitive amine oxidase
    chronic kidney-disease
    risk-factors
    complications
    mortality
    inflammation
    dialysis
    markers
    people
    taiwan
    日期: 2016-02
    上傳時間: 2018-01-18 11:37:51 (UTC+8)
    出版者: Public Library Science
    摘要: Background Diabetes is the leading cause of end-stage renal disease (ESRD) worldwide. Vascular adhesion protein-1 (VAP-1) participates in inflammation and catalyzes the deamination of primary amines into aldehydes, hydrogen peroxide, and ammonia, both of which are involved in the pathogenesis of diabetic complications. We have shown that serum VAP-1 is higher in patients with diabetes and in patients with chronic kidney disease (CKD), and can predict cardiovascular mortality in subjects with diabetes. In this study, we investigated if serum VAP-1 can predict ESRD in diabetic subjects. Methods In this prospective cohort study, a total of 604 type 2 diabetic subjects were enrolled between 1996 to 2003 at National Taiwan University Hospital, Taiwan, and were followed for a median of 12.36 years. The development of ESRD was ascertained by linking our database with the nationally comprehensive Taiwan Society Nephrology registry. Serum VAP-1 concentrations at enrollment were measured by time-resolved immunofluorometric assay. Results Subjects with serum VAP-1 in the highest tertile had the highest incidence of ESRD (p<0.001). Every 1-SD increase in serum VAP-1 was associated with a hazard ratio of 1.55 (95% CI 1.12-2.14, p<0.01) for the risk of ESRD, adjusted for smoking, history of cardiovascular disease, body mass index, hypertension, HbA1c, duration of diabetes, total cholesterol, use of statins, ankle-brachial index, estimated GFR, and proteinuria. We developed a risk score comprising serum VAP-1, HbA1c, estimated GFR, and proteinuria, which could predict ESRD with good performance (area under the ROC curve = 0.9406, 95% CI 0.8871-0.9941, sensitivity = 77.3%, and specificity = 92.8%). We also developed an algorithm based on the stage of CKD and a risk score including serum VAP-1, which can stratify these subjects into 3 categories with an ESRD risk of 0.101%/year, 0.131%/year, and 2.427%/year, respectively. Conclusions In conclusion, serum VAP-1 can predict ESRD and is a useful biomarker to improve risk stratification in type 2 diabetic subjects.
    Appears in Collections:[職業安全衛生系(含防災所)] 期刊論文

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