Soluble CD40 ligand is elevated in type 1 diabetic nephropathy but not predictive of mortality, cardiovascular events or kidney function

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  • Maria Stenkil Lajer, Institut for Klinisk Medicin, Denmark
  • Inge Tarnow, LUKKET: 2012 Intern Medicin og Klinisk Patologi, Denmark
  • Alan D Michelson
  • ,
  • Anders Jorsal
  • Andrew L Frelinger
  • ,
  • Hans-Henrik Parving, Institut for Klinisk Medicin, Denmark
  • Peter Rossing, Ph.d.-studienævnet for Medicin, Denmark
  • Lise Tarnow, Denmark
Soluble CD40 ligand (sCD40L) derived from platelets mediates atherothrombosis, leading to proinflammatory and proatherosclerotic responses. We investigated the predictive value of plasma sCD40L for all-cause mortality, cardiovascular mortality and morbidity, progression towards end-stage renal disease (ESRD) and rate of decline in glomerular filtration rate (GFR) in patients with type 1 diabetes (T1DM) and nephropathy. The study was a prospective, observational follow-up study of 443 T1DM patients with diabetic nephropathy (274 men; age 42.1 ± 10.5 years [mean ± SD], duration of diabetes 28.3 ± 8.9 years, GFR 76 ± 33 ml/min/1.73 m2) and a control group of 421 patients with longstanding type 1 diabetes and persistent normoalbuminuria (232 men; age 45.4 ± 11.5 years, duration of diabetes 27.7 ± 10.1 years) at baseline. sCD40L was measured by ELISA. Plasma sCD40L levels were higher in patients with diabetic nephropathy compared to normoalbuminuric patients (median (range) 1.54 (0.02-13.38) vs. 1.30 (0.04-20.65) µg/L, respectively p = 0.004). The patients were followed for 8.1 (0.0-12.9) years (median (range)). Among normoalbuminuric patients, sCD40L levels did not predict all-cause mortality (p = 0.33) or combined fatal and non-fatal cardiovascular disease (CVD) (p = 0.27). Similarly, among patients with diabetic nephropathy, the covariate adjusted sCD40L levels did not predict all-cause mortality (p = 0.86) or risk of fatal and non-fatal CVD (p = 0.08). Furthermore, high levels of sCD40L did not predict development of ESRD (p = 0.85) nor rate of decline in GFR (p = 0.69). Plasma sCD40L is elevated in T1DM nephropathy but is not a predictor of all-cause mortality, cardiovascular mortality and morbidity or deterioration of kidney function
Original languageEnglish
JournalPlatelets
Volume21
Issue7
Pages (from-to)525-32
Number of pages8
ISSN0953-7104
DOIs
Publication statusPublished - 2010

    Research areas

  • Adult, CD40 Ligand, Cardiovascular Diseases, Case-Control Studies, Denmark, Diabetes Mellitus, Type 1, Diabetic Nephropathies, Disease Progression, Female, Glomerular Filtration Rate, Humans, Kidney, Kidney Failure, Chronic, Kidney Function Tests, Male, Predictive Value of Tests, Prospective Studies, Risk Factors, Survival Rate

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