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10.1371/journal.pone.0196634

http://scihub22266oqcxt.onion/10.1371/journal.pone.0196634
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suck abstract from ncbi


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pmid29698460
      PLoS+One 2018 ; 13 (4 ): e0196634
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  • Growth differentiation factor-15 and fibroblast growth factor-23 are associated with mortality in type 2 diabetes - An observational follow-up study #MMPMID29698460
  • Frimodt-Møller M ; von Scholten BJ ; Reinhard H ; Jacobsen PK ; Hansen TW ; Persson FI ; Parving HH ; Rossing P
  • PLoS One 2018[]; 13 (4 ): e0196634 PMID29698460 show ga
  • OBJECTIVES: Two biomarkers, growth differentiation factor 15 (GDF-15) and fibroblast growth factor 23 (FGF-23)), reflecting different aspects of renal pathophysiology, were evaluated as determinants of decline in estimated glomerular filtration rate (eGFR), incident cardiovascular disease (CVD) and all-cause mortality in patients with type 2 diabetes (T2D) and microalbuminuria, but without clinical cardiac disease. MATERIALS AND METHODS: Prospective study including 200 T2D patients. The predefined endpoint of chronic kidney disease (CKD) progression: A decline in eGFR of >30% at any time point during follow-up. Hazard ratios (HR) are provided per 1 SD increment of log2-transformed values. RESULTS: Mean (± SD) age was 59 ± 9 years, eGFR 91.1 ± 18.3 ml/min/1.73m2 and median (IQR) UAER 103 (39-230) mg/24-h. During a median 6.1 years follow-up, 40 incident CVD events, 26 deaths and 42 patients reached the CKD endpoint after median 4.9 years. Higher GDF-15 was a determinant of decline in eGFR >30% and all-cause mortality in adjusted models (HR 1.7 (1.1-2.5); p = 0.018 and HR 1.9 (1.2-2.9); p = 0.003, respectively). Adding GDF-15 to traditional risk factors improved risk prediction of decline in renal function (relative integrated discrimination improvement (rIDI) = 30%; p = 0.037). Higher FGF-23 was associated with all-cause mortality in adjusted models (HR 1.6 (1.1-2.2); p = 0.011) with a rIDI of 30% (p = 0.024). CONCLUSIONS: In patients with T2D and microalbuminuria, higher GDF-15 and FGF-23 were independently associated with all-cause mortality and higher GDF-15 improved risk prediction of decline in kidney function and higher FGF-23 of all-cause mortality, beyond traditional risk factors, but not independently of GDF-15.
  • |Aged [MESH]
  • |Albuminuria/complications/diagnosis [MESH]
  • |Cardiovascular Diseases/diagnosis/epidemiology/etiology [MESH]
  • |Cause of Death [MESH]
  • |Diabetes Mellitus, Type 2/complications/*mortality/pathology [MESH]
  • |Female [MESH]
  • |Fibroblast Growth Factor-23 [MESH]
  • |Fibroblast Growth Factors/*blood [MESH]
  • |Follow-Up Studies [MESH]
  • |Glomerular Filtration Rate [MESH]
  • |Growth Differentiation Factor 15/*blood [MESH]
  • |Humans [MESH]
  • |Incidence [MESH]
  • |Kaplan-Meier Estimate [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Proportional Hazards Models [MESH]
  • |Renal Insufficiency, Chronic/diagnosis/etiology [MESH]


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