Serum Fractalkine (CX3CL1) and Cardiovascular Outcomes and Diabetes: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study. Academic Article uri icon

Overview

MeSH

  • Aged
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mortality
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors

MeSH Major

  • Cardiovascular Diseases
  • Chemokine CX3CL1
  • Diabetes Mellitus
  • Metabolic Syndrome X
  • Myocardial Infarction
  • Renal Insufficiency, Chronic

abstract

  • Cardiometabolic disease is a major cause of morbidity and mortality in persons with chronic kidney disease (CKD). Fractalkine (CX3CL1) is a potential mediator of both atherosclerosis and metabolic disease. Studies of the relationship of CX3CL1 with risk of cardiovascular disease (CVD) events and metabolic traits are lacking, particularly in the high-risk setting of CKD. Cross-sectional and longitudinal observational analysis. Adults with CKD from 7 US sites participating in the Chronic Renal Insufficiency Cohort (CRIC) Study. Quartiles of plasma CX3CL1 levels at baseline. Baseline estimated glomerular filtration rate from a creatinine and cystatin C-based equation, prevalent and incident CVD, diabetes, metabolic syndrome and its criteria, homeostatic model assessment of insulin resistance, hemoglobin A1c level, myocardial infarction, all-cause mortality, and the composite outcome of myocardial infarction/all-cause mortality. Among 3,687 participants, baseline CX3CL1 levels were associated positively with several CVD risk factors and metabolic traits, lower estimated glomerular filtration rate, and higher levels of inflammatory cytokines, as well as prevalent CVD (OR, 1.09; 95% CI, 1.01-1.19; P=0.03). Higher CX3CL1 level also was associated with prevalent diabetes (OR, 1.26; 95% CI, 1.16-1.38; P<0.001) in adjusted models. During a mean follow-up of 6 years, there were 352 deaths, 176 myocardial infarctions, and 484 composite outcomes. In fully adjusted models, 1-SD higher CX3CL1 level increased the hazard for all-cause mortality (1.11; 95% CI, 1.00-1.22; P=0.02) and the composite outcome (1.09; 95% CI, 1.00-1.19; P=0.04). Study design did not allow evaluation of changes over time, correlation with progression of phenotypes, or determination of causality of effect. Circulating CX3CL1 level may contribute to both atherosclerotic CVD and diabetes in a CKD cohort. Further studies are required to establish mechanisms through which CX3CL1 affects the pathogenesis of atherosclerosis and diabetes. Copyright © 2015 National Kidney Foundation, Inc. All rights reserved.

publication date

  • August 2015

has subject area

  • Aged
  • Cardiovascular Diseases
  • Chemokine CX3CL1
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus
  • Female
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Metabolic Syndrome X
  • Middle Aged
  • Mortality
  • Myocardial Infarction
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Insufficiency, Chronic
  • Risk Factors

Research

keywords

  • Journal Article
  • Observational Study

Identity

Language

  • eng

PubMed Central ID

  • PMC4516570

Digital Object Identifier (DOI)

  • 10.1053/j.ajkd.2015.01.021

PubMed ID

  • 25795074

Additional Document Info

start page

  • 266

end page

  • 273

volume

  • 66

number

  • 2