Biomarkers in the progression of nephropathy in type 2DM

2 型糖尿病肾病进展中的生物标志物

基本信息

批准号：
7478355
负责人：
JULIE LIN
金额：
$ 8.58万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-08-01 至 2010-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7478355
关键词：
Affect Age Albumins Albuminuria Biological Assay Biological Markers Biology Blood Body mass index C-reactive protein Characteristics Cholesterol Chronic Disease Chronic Kidney Failure Clinical Investigator Collection Creatinine Cross-Sectional Studies Data Diabetes Mellitus Diffuse Disease regression Dyslipidemias End stage renal failure Fibrinogen Functional disorder Funding Future Glomerular Filtration Rate Goals Grant High Density Lipoproteins Hypertension Hypertriglyceridemia Inflammation Inflammatory Insulin Resistance Investigation Kidney Kidney Diseases Kidney Failure Lipids Measurement Measures Microalbuminuria Monitor Non-Insulin-Dependent Diabetes Mellitus Nurses&apos Health Study Participant Pharmaceutical Preparations Plasma Play Prospective Studies Renal function Role Spottings Testing Time Tumor Necrosis Factor-alpha Tumor Necrosis Factors United States Urine Woman Work cigarette smoking cohort cost follow-up human TNF protein interest low density lipoprotein triglyceride urinary vascular endothelial dysfunction vascular inflammation

项目摘要

DESCRIPTION (provided by applicant): There is a growing recognition that dyslipidemia and elevated inflammatory biomarkers are associated with nephropathy as well as with the insulin-resistant state characteristic of type 2 diabetes. Most investigations, however, have examined these biomarkers and kidney function only in those with severe chronic kidney disease or end-stage renal disease in a cross-sectional manner. A few recent studies suggest that dyslipidemia and inflammation may contribute to subsequent glomerular filtration rate (GFR) decline, but only baseline biomarkers have been examined in this context. The effects of how alterations in lipids and inflammation over time affect kidney function over time are not known. This prospective study seeks to expand on currently funded work that focuses on identifying predictors of progressive nephropathy in type 2 diabetes, which is the leading cause of kidney failure in the world. The central hypothesis is that increasing or sustained high levels of dyslipidemia and inflammation over 11 years (1989 to 2000) will be independently associated with progressive nephropathy, as measured by estimated GFR decline and increased albuminuria over a subsequent eight years of follow-up (2000 to 2008), in 500 women with confirmed type 2 diabetes who are participating in the Nurses' Health Study (NHS). Biomarkers of interest in this investigation include total cholesterol, low-density lipoprotein, triglycerides, high-density lipoproteins, soluble tumor necrosis factor-(, fibrinogen, and C-reactive protein. Several of these biomarkers are significantly inversely associated with estimated GFR in preliminary cross-sectional studies in this NHS cohort. Multivariable regression will be used to adjust for important covariates such as age, duration of diabetes, body mass index, hypertension, cigarette smoking and other medication use, which may confound associations between biomarkers and progressive nephropathy in type 2 diabetes. Data on how these modifiable biomarkers are related to kidney function decline could have an important and beneficial impact on treatment and monitoring of nephropathy in type 2 diabetes in the near future.