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- Title
Comprehensive assessment of cardiovascular-kidney--metabolic (CKM) syndrome: Novel tools for assessment of cardiovascular risk and kidney outcomes in long-term kidney transplant patients.
- Authors
Batko, Krzysztof; Sączek, Anna; Banaszkiewicz, Małgorzata; Małyszko, Jolanta; Koc-Żórawska, Ewa; Żórawski, Marcin; Niezabitowska, Karolina; Siek, Katarzyna; Bętkowska-Prokop, Alina; Małyszko, Jacek A.; Krzanowski, Marcin; Krzanowska, Katarzyna
- Abstract
Background: Cardiovascular (CV)-kidney-metabolic (CKM) syndrome, a newly defined entity, offers a framework for assessing CV risk. Emerging evidence suggests that histone deacetylase sir-tuin-1 (SIRT1) and adipokine chemerin hold promise as CKM markers. Aims: This study aimed to explore the relationship between CKM stage, clinical parameters, and both novel and established markers of CV and renal risk. Methods: A cohort of 102 patients with long-term, stable kidney transplant (KTx) (>24 months) and median (interquartile range) follow-up of 83 (42-85) months was recruited alongside 32 healthy controls. Patients were classified into modified CKM stages following the American Heart Association guidance. Serum high-sensitivity interleukin-6 (hsIL-6), chemerin, and SIRT1 were measured using commercial immunoassay kits. The incidence of CV events (CVE), CV mortality, and permanent transfer to dialysis therapy were primary endpoints. Results: CKM stage was associated with higher risk of CVE/CV death (HR 95% CI, 3.79 [1.16-12.42]; P = 0.03) and allograft loss (HR 95% CI, 2.05 [1.17-3.57]; P = 0.01). Elevated sirtuin-1 was associated with significantly lower risk of CV event/death (HR 95% CI, 0.11 [0.11-0.89]; P = 0.04), whereas high chemerin status was tied to dialysis risk (HR 95% CI, 5.77 [1.96-17.00]; P = 0.001) alone. In contrast to sirtuin-1, hsIL-6 and chemerin showed incremental changes across more advanced CKM stages, though statistically significant for hsIL-6 alone. In age-adjusted models for CV disease, independent associations with diabetes and total cholesterol were noted. Conclusions: Classifying patients based on modified CKM stages offers valuable prognostic insights for stable KTx recipients, particularly when assessing reno-cardiovascular risk. The investigated serum markers may serve as supplemental tools for refining risk stratification.
- Subjects
KIDNEY disease risk factors; KIDNEY transplantation; RISK assessment; PATIENTS; TRANSPLANTATION of organs, tissues, etc.; CHEMERIN; RESEARCH funding; CARDIOVASCULAR diseases risk factors; TREATMENT effectiveness; HEMODIALYSIS; DESCRIPTIVE statistics; METABOLIC syndrome; CONFIDENCE intervals; BIOMARKERS; INTERLEUKINS; DIABETES
- Publication
Polish Heart Journal / Kardiologia Polska, 2024, Vol 82, Issue 7/8, p760
- ISSN
0022-9032
- Publication type
Article
- DOI
10.33963/v.phj.101062