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Pregnancy-associate...
Pregnancy-associated plasma protein A and mortality in hemodialysis
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- Nilsson, Erik (author)
- Orebro Univ, Sch Med Sci, Dept Internal Med, Orebro, Sweden;Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Renal Med & Baxter Novum, Stockholm, Sweden
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- Rudholm Feldreich, Tobias (author)
- Högskolan Dalarna,Medicinsk vetenskap,Uppsala universitet,Kardiovaskulär epidemiologi,Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden
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- Stenvinkel, Peter (author)
- Karolinska Institutet
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- Ärnlöv, Johan, 1970- (author)
- Karolinska Institutet,Högskolan Dalarna,Medicinsk vetenskap,Karolinska institutet,Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Huddinge, Sweden;Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden
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(creator_code:org_t)
- 2018-06-07
- 2018
- English.
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In: European Journal of Clinical Investigation. - : Wiley. - 0014-2972 .- 1365-2362. ; 48:8
- Related links:
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https://doi.org/10.1...
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Abstract
Subject headings
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- BACKGROUND: Elevated pregnancy-associated plasma protein A (PAPP-A) levels are associated with increased risk of death in ischemic heart disease as well as in hemodialysis patients. Previous research indicates that the prognostic value of PAPP-A may be stronger in patients with concomitant diabetes mellitus or signs of inflammation. We studied the association between PAPP-A and outcomes in prevalent hemodialysis patients and hypothesized that diabetes mellitus and inflammation status act as effect modifiers.MATERIALS AND METHODS: Circulating PAPP-A levels were quantified using ELISA. Cox proportional hazards- and quantile regression models were used for associations between PAPP-A and mortality. PAPP-A levels were log-transformed for Normality.RESULTS: During 60 months follow-up, 37 (40%) of the 92 participants died. Higher PAPP-A was associated with increased risk of mortality in unadjusted analysis (HR per SD = 1.4, 95% CI = 1 - 1.9, p = 0.03) and when adjusted for confounders and cardiovascular risk factors (HR = 1.8, 95% CI = 1.18-2.73, p = 0.006). An interaction between PAPP-A levels and diabetes mellitus on mortality was found (HR for the multiplicative interaction term = 2.74 95% CI = 1.02-7.37, p = 0.05). In a quantile regression adjusted for age and sex, one SD increase of PAPP-A was associated with 22 months shorter estimated time until 25% of the patients died (95% CI -35 to -9.1 months).CONCLUSIONS: Increased PAPP-A levels are associated with higher all-cause mortality in prevalent hemodialysis patients with concomitant diabetes mellitus.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Keyword
- Pregnancy-associated plasma protein A
- cardiovascular disease
- hemodialysis
- Health and Welfare
- Hälsa och välfärd
Publication and Content Type
- ref (subject category)
- art (subject category)
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