Renal-related biomarkers and long-term mortality in the US subjects with different coronary risks
Journal
Atherosclerosis
Journal Volume
216
Journal Issue
1
Pages
226-236
Date Issued
2011
Author(s)
Abstract
Objective: The objective was to evaluate the association of a panel of renal biomarkers with long-term mortalities. Methods: Participants in the Third National Health and Nutrition Examination Survey (NHANES III) aged 35 years and above were included and Framingham risk scores were calculated. Renal-related biomarkers, including creatinine-based estimated glomerular filtration rate (eGFR), cystatin C, uric acid, C-reactive protein (CRP), fibrinogen, urinary cadmium, albuminuria, homocysteine, and vitamin D were tested by Cox-regression model for their association with all-cause, cardiovascular (CV), and non-CV mortality obtained from the 2006 NHANES III-linked follow-up data, stratified by sex and Framingham risk. Results: In the 4873 men and 5372 women, 36.3%, 28.1%, and 35.6% of men and 67.2%, 25.8%, and 7.0% of women were classified into low-, intermediate-, and high coronary risk groups. With an average follow-up of 13.2 years, a total of 3632 deaths and 1657 CV deaths were recorded. Albuminuria was associated with all-cause mortality in both sexes across coronary risk groups. Creatinine-based eGFR provided additional differential capacity only in the women with intermediate-to-high coronary risk. Cystatin C was associated with all-cause mortality in the men with intermediate-to-high coronary risk and with CV mortality in the women with low coronary risk. Urinary cadmium was positively related to non-CV mortality. High vitamin D was protective against cardiovascular mortality in a limited category of men and women. Conclusions: Albuminuria is associated with long-term all-cause mortalities independent of Framingham risks. Adding the panel of renal biomarkers provides limited advantages for predicting risk when compared to FRS alone. ? 2011 Elsevier Ireland Ltd.
Subjects
Biological markers; Kidney function tests; Nutrition surveys; Risk assessment
SDGs
Other Subjects
biological marker; C reactive protein; cadmium; creatinine; cystatin C; fibrinogen; homocysteine; uric acid; vitamin D; adult; aged; albuminuria; article; coronary risk; female; follow up; glomerulus filtration rate; hazard ratio; health survey; human; male; mortality; priority journal; scoring system; United States; urine level; Adult; Aged; Albuminuria; Biological Markers; Chi-Square Distribution; Coronary Disease; Female; Glomerular Filtration Rate; Humans; Kidney; Kidney Diseases; Male; Middle Aged; Nutrition Surveys; Prognosis; Proportional Hazards Models; Risk Assessment; Risk Factors; Survival Analysis; Time Factors; United States
Type
journal article