Cargando…

Plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease

BACKGROUND: Cardiovascular disease (CVD) is a leading cause of death in patients with chronic kidney disease (CKD). Left ventricular hypertrophy (LVH) and left ventricular diastolic dysfunction (LVDD) are known as predictors of CVD in these patients. Neutrophil gelatinase-associated lipocalin (NGAL)...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Il Young, Kim, June Hyun, Kim, Min Jeong, Lee, Dong Won, Hwang, Cheol Gu, Han, Miyeun, Rhee, Harin, Song, Sang Heon, Seong, Eun Young, Lee, Soo Bong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191140/
https://www.ncbi.nlm.nih.gov/pubmed/30325973
http://dx.doi.org/10.1371/journal.pone.0205848
_version_ 1783363670922756096
author Kim, Il Young
Kim, June Hyun
Kim, Min Jeong
Lee, Dong Won
Hwang, Cheol Gu
Han, Miyeun
Rhee, Harin
Song, Sang Heon
Seong, Eun Young
Lee, Soo Bong
author_facet Kim, Il Young
Kim, June Hyun
Kim, Min Jeong
Lee, Dong Won
Hwang, Cheol Gu
Han, Miyeun
Rhee, Harin
Song, Sang Heon
Seong, Eun Young
Lee, Soo Bong
author_sort Kim, Il Young
collection PubMed
description BACKGROUND: Cardiovascular disease (CVD) is a leading cause of death in patients with chronic kidney disease (CKD). Left ventricular hypertrophy (LVH) and left ventricular diastolic dysfunction (LVDD) are known as predictors of CVD in these patients. Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury. Recently, elevated NGAL levels have been reported in patients with CVD. This study aimed to evaluate the association between plasma NGAL levels and LVH/LVDD in patients with CKD. METHODS: This study included 332 patients with pre-dialysis CKD (estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m(2)). Two-dimensional echocardiography was performed to measure the left ventricular mass index (LVMI). Tissue Doppler imaging was used to measure early mitral inflow velocity (E) and the peak early mitral annular velocity (E'). Diastolic function was estimated using E' and the ratio of E to E' (E/E'). The associations of echocardiographic index with clinical and laboratory variables (age, sex, diabetes, hypertension, eGFR, albumin, uric acid, calcium, phosphate, total cholesterol, hemoglobin, C-reactive protein, intact parathyroid hormone (PTH), the inferior vena cava collapse index (IVCCI) < 50%, and plasma NGAL) were investigated using univariate and multivariate analyses. RESULTS: In multivariate logistic regression analysis, plasma NGAL was an independent predictor of LVH (OR: 1.02, 95% CI: 1.01–1.02), P < 0.001). In addition, hypertension, intact PTH, and IVCCI < 50% were independent predictors of LVH. Plasma NGAL (OR: 1.02, 95% CI: 1.01–1.02, P < 0.001) was also an independent factor of LVDD. Furthermore, hypertension, intact PTH, and IVCCI < 50% were independent predictors of LVDD. Receiver operating characteristic curve analysis (area under the curve: 0.835, 95% CI: 0.792–0.879) showed the best cutoff value of plasma NGAL for identifying LVDD was ≥ 258 ng/ml with an associated sensitivity of 77.6% and a specificity of 87.6%. CONCLUSION: Plasma NGAL levels were independent predictors of LVH and LVDD in patients with pre-dialysis CKD, suggesting that plasma NGAL could be a biomarker for LVH and LVDD in these patients.
format Online
Article
Text
id pubmed-6191140
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-61911402018-10-25 Plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease Kim, Il Young Kim, June Hyun Kim, Min Jeong Lee, Dong Won Hwang, Cheol Gu Han, Miyeun Rhee, Harin Song, Sang Heon Seong, Eun Young Lee, Soo Bong PLoS One Research Article BACKGROUND: Cardiovascular disease (CVD) is a leading cause of death in patients with chronic kidney disease (CKD). Left ventricular hypertrophy (LVH) and left ventricular diastolic dysfunction (LVDD) are known as predictors of CVD in these patients. Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury. Recently, elevated NGAL levels have been reported in patients with CVD. This study aimed to evaluate the association between plasma NGAL levels and LVH/LVDD in patients with CKD. METHODS: This study included 332 patients with pre-dialysis CKD (estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m(2)). Two-dimensional echocardiography was performed to measure the left ventricular mass index (LVMI). Tissue Doppler imaging was used to measure early mitral inflow velocity (E) and the peak early mitral annular velocity (E'). Diastolic function was estimated using E' and the ratio of E to E' (E/E'). The associations of echocardiographic index with clinical and laboratory variables (age, sex, diabetes, hypertension, eGFR, albumin, uric acid, calcium, phosphate, total cholesterol, hemoglobin, C-reactive protein, intact parathyroid hormone (PTH), the inferior vena cava collapse index (IVCCI) < 50%, and plasma NGAL) were investigated using univariate and multivariate analyses. RESULTS: In multivariate logistic regression analysis, plasma NGAL was an independent predictor of LVH (OR: 1.02, 95% CI: 1.01–1.02), P < 0.001). In addition, hypertension, intact PTH, and IVCCI < 50% were independent predictors of LVH. Plasma NGAL (OR: 1.02, 95% CI: 1.01–1.02, P < 0.001) was also an independent factor of LVDD. Furthermore, hypertension, intact PTH, and IVCCI < 50% were independent predictors of LVDD. Receiver operating characteristic curve analysis (area under the curve: 0.835, 95% CI: 0.792–0.879) showed the best cutoff value of plasma NGAL for identifying LVDD was ≥ 258 ng/ml with an associated sensitivity of 77.6% and a specificity of 87.6%. CONCLUSION: Plasma NGAL levels were independent predictors of LVH and LVDD in patients with pre-dialysis CKD, suggesting that plasma NGAL could be a biomarker for LVH and LVDD in these patients. Public Library of Science 2018-10-16 /pmc/articles/PMC6191140/ /pubmed/30325973 http://dx.doi.org/10.1371/journal.pone.0205848 Text en © 2018 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kim, Il Young
Kim, June Hyun
Kim, Min Jeong
Lee, Dong Won
Hwang, Cheol Gu
Han, Miyeun
Rhee, Harin
Song, Sang Heon
Seong, Eun Young
Lee, Soo Bong
Plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease
title Plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease
title_full Plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease
title_fullStr Plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease
title_full_unstemmed Plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease
title_short Plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease
title_sort plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191140/
https://www.ncbi.nlm.nih.gov/pubmed/30325973
http://dx.doi.org/10.1371/journal.pone.0205848
work_keys_str_mv AT kimilyoung plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease
AT kimjunehyun plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease
AT kimminjeong plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease
AT leedongwon plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease
AT hwangcheolgu plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease
AT hanmiyeun plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease
AT rheeharin plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease
AT songsangheon plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease
AT seongeunyoung plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease
AT leesoobong plasmaneutrophilgelatinaseassociatedlipocalinisindependentlyassociatedwithleftventricularhypertrophyanddiastolicdysfunctioninpatientswithchronickidneydisease