Satyesh K Sinha1,2, Susanne B Nicholas3, Jung Hye Sung4, Adolfo Correa5, Tripathi B Rajavashisth6,2,7, Keith C Norris2, Jae Eun Lee4. 1. Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA satyeshsinha@cdrewu.edu sunicholas@mednet.ucla.edu. 2. Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA. 3. Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA satyeshsinha@cdrewu.edu sunicholas@mednet.ucla.edu. 4. Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS. 5. Departments of Medicine and Pediatrics, University of Mississippi Medical Center, Jackson, MS. 6. Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA. 7. Molecular Biology Unit, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Abstract
OBJECTIVE: African Americans (AA) suffer disproportionately from diabetic nephropathy (DN). C-reactive protein (CRP) has been associated with prevalent DN, but its association with incident DN in AA is unknown. We examined hs-CRP and incident DN in AA. RESEARCH DESIGN AND METHODS: We conducted a longitudinal analysis of data from exams 1, 2, and 3 in 4,043 eligible Jackson Heart Study (JHS) participants. Participants with DN or without hs-CRP at exam 1 were excluded. Incident DN was defined as urinary albumin-to-creatinine ratio (ACR) >30 mg/g or self-reported dialysis/transplantation and type 2 diabetes mellitus (DM) or HbA1c >6.5% by exam 2 or 3 among participants free of DN at exam 1. Kaplan-Meier curves examined DN event-free survival probability by hs-CRP. With Cox proportional hazards regression we estimated hazard ratios (HRs) and 95% CI for DN by hs-CRP tertiles, adjusting for demographics and clinical and laboratory data. RESULTS: During 7.8 years of median follow-up time, participants who developed DN had significantly higher baseline hs-CRP, age, fasting glucose, triglycerides, ACR, systolic blood pressure, waist circumference, and duration of DM (P < 0.05). The overall incident rate of DN was 7.9%. The mean time to incident DN was shorter for participants with hs-CRP in the high tertile (>4.24 mg/L) than in the low tertile (<1.46 mg/L); P < 0.001. Participants with high hs-CRP had higher incidence of DN (HR 2.34, 95% CI 1.04-5.24) versus the reference group. CONCLUSIONS: Inflammation, as measured by hs-CRP levels, may be associated with incident DN in AA. Further studies are warranted to replicate and elucidate the basis for this association.
OBJECTIVE: African Americans (AA) suffer disproportionately from diabetic nephropathy (DN). C-reactive protein (CRP) has been associated with prevalent DN, but its association with incident DN in AA is unknown. We examined hs-CRP and incident DN in AA. RESEARCH DESIGN AND METHODS: We conducted a longitudinal analysis of data from exams 1, 2, and 3 in 4,043 eligible Jackson Heart Study (JHS) participants. Participants with DN or without hs-CRP at exam 1 were excluded. Incident DN was defined as urinary albumin-to-creatinine ratio (ACR) >30 mg/g or self-reported dialysis/transplantation and type 2 diabetes mellitus (DM) or HbA1c >6.5% by exam 2 or 3 among participants free of DN at exam 1. Kaplan-Meier curves examined DN event-free survival probability by hs-CRP. With Cox proportional hazards regression we estimated hazard ratios (HRs) and 95% CI for DN by hs-CRP tertiles, adjusting for demographics and clinical and laboratory data. RESULTS: During 7.8 years of median follow-up time, participants who developed DN had significantly higher baseline hs-CRP, age, fasting glucose, triglycerides, ACR, systolic blood pressure, waist circumference, and duration of DM (P < 0.05). The overall incident rate of DN was 7.9%. The mean time to incident DN was shorter for participants with hs-CRP in the high tertile (>4.24 mg/L) than in the low tertile (<1.46 mg/L); P < 0.001. Participants with high hs-CRP had higher incidence of DN (HR 2.34, 95% CI 1.04-5.24) versus the reference group. CONCLUSIONS: Inflammation, as measured by hs-CRP levels, may be associated with incident DN in AA. Further studies are warranted to replicate and elucidate the basis for this association.
Authors: Michelle E Tarver-Carr; Neil R Powe; Mark S Eberhardt; Thomas A LaVeist; Raynard S Kington; Josef Coresh; Frederick L Brancati Journal: J Am Soc Nephrol Date: 2002-09 Impact factor: 10.121
Authors: Kimberly Harding; Tesfaye B Mersha; Fern A Webb; Joseph A Vassalotti; Susanne B Nicholas Journal: Am J Nephrol Date: 2017-08-05 Impact factor: 3.754
Authors: Subodh Verma; Shu-Hong Li; Mitesh V Badiwala; Richard D Weisel; Paul W M Fedak; Ren-Ke Li; Bikramjit Dhillon; Donald A G Mickle Journal: Circulation Date: 2002-04-23 Impact factor: 29.690
Authors: Toshiharu Ninomiya; Vlado Perkovic; Bastiaan E de Galan; Sophia Zoungas; Avinesh Pillai; Meg Jardine; Anushka Patel; Alan Cass; Bruce Neal; Neil Poulter; Carl-Erik Mogensen; Mark Cooper; Michel Marre; Bryan Williams; Pavel Hamet; Giuseppe Mancia; Mark Woodward; Stephen Macmahon; John Chalmers Journal: J Am Soc Nephrol Date: 2009-05-14 Impact factor: 10.121
Authors: Ervin R Fox; Emelia J Benjamin; Daniel F Sarpong; Harsha Nagarajarao; Jason K Taylor; Michael W Steffes; Abdullah K Salahudeen; Michael F Flessner; Ermeg L Akylbekova; Caroline S Fox; Robert J Garrison; Herman A Taylor Journal: BMC Nephrol Date: 2010-01-15 Impact factor: 2.388
Authors: Katherine R Tuttle; George L Bakris; Rudolf W Bilous; Jane L Chiang; Ian H de Boer; Jordi Goldstein-Fuchs; Irl B Hirsch; Kamyar Kalantar-Zadeh; Andrew S Narva; Sankar D Navaneethan; Joshua J Neumiller; Uptal D Patel; Robert E Ratner; Adam T Whaley-Connell; Mark E Molitch Journal: Diabetes Care Date: 2014-10 Impact factor: 19.112
Authors: Minyoung Lee; Ho Seon Park; Min Yeong Choi; Hak Zoo Kim; Sung Jin Moon; Ji Yoon Ha; ARim Choi; Young Woo Park; Jong Suk Park; Eui-Cheol Shin; Chul Woo Ahn; Shinae Kang Journal: J Clin Med Date: 2020-05-08 Impact factor: 4.241