4.7 Article

The pattern-recognition molecule H-ficolin in relation to diabetic kidney disease, mortality, and cardiovascular events in type 1 diabetes

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SCIENTIFIC REPORTS
卷 11, 期 1, 页码 -

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NATURE RESEARCH
DOI: 10.1038/s41598-021-88352-y

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资金

  1. Danish Diabetes Association
  2. Danish Council for Independent Research
  3. Health Research Fund of Central Denmark Region
  4. Folkhalsan Research Foundation
  5. Academy of Finland [316664, 299200]
  6. Wilhelm and Else Stockmann Foundation
  7. Novo Nordisk Foundation [OC0013659]
  8. Paivikki and Sakari Sohlberg Foundation
  9. Medical Society of Finland
  10. Finnish Diabetes Research Foundation
  11. Finnish Foundation for Cardiovascular Research
  12. Karl Walter and Jarl Walter Perklen Foundation
  13. Dorothea Olivia
  14. HUH state research funding (EVO governmental grant) [TYH2018207]
  15. Liv och Halsa Society
  16. Novo Nordisk Fonden [NNF13OC0003820, NNF17SA0031230] Funding Source: researchfish

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The study found that H-ficolin predicts diabetes-related mortality but has no association with all-cause mortality or cardiovascular events. Additionally, H-ficolin is related to the progression of DKD, but not independently in fully adjusted models.
H-ficolin recognizes patterns on microorganisms and stressed cells and can activate the lectin pathway of the complement system. We aimed to assess H-ficolin in relation to the progression of diabetic kidney disease (DKD), all-cause mortality, diabetes-related mortality, and cardiovascular events. Event rates per 10-unit H-ficolin-increase were compared in an observational follow-up of 2,410 individuals with type 1 diabetes from the FinnDiane Study. DKD progression occurred in 400 individuals. The unadjusted hazard ratio (HR) for progression was 1.29 (1.18-1.40) and 1.16 (1.05-1.29) after adjustment for diabetes duration, sex, HbA(1c), systolic blood pressure, and smoking status. After adding triglycerides to the model, the HR decreased to 1.07 (0.97-1.18). In all, 486 individuals died, including 268 deaths of cardiovascular causes and 192 deaths of complications to diabetes. HRs for all-cause mortality and cardiovascular mortality were 1.13 (1.04-1.22) and 1.05 (0.93-1.17), respectively, in unadjusted analyses. These estimates lost statistical significance in adjusted models. However, the unadjusted HR for diabetes-related mortality was 1.19 (1.05-1.35) and 1.18 (1.02-1.37) with the most stringent adjustment level. Our results, therefore, indicate that H-ficolin predicts diabetes-related mortality, but neither all-cause mortality nor fatal/non-fatal cardiovascular events. Furthermore, H-ficolin is associated with DKD progression, however, not independently of the fully adjusted model.

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