1 research outputs found
Supplementary Material for: Association of Serum Amyloid A with Kidney Outcomes and All-Cause Mortality in American Indians with Type 2 Diabetes
<p><b><i>Background:</i></b> Serum amyloid A (SAA) induces inflammation
and apoptosis in kidney cells and is found to be causing the pathologic
changes that are associated with diabetic kidney disease (DKD). Higher
serum SAA concentrations were previously associated with increased risk
of end-stage renal disease (ESRD) and death in persons with type 2
diabetes and advanced DKD. We explored the prognostic value of SAA in
American Indians with type 2 diabetes without DKD or with early DKD. <b><i>Methods:</i></b>
SAA concentration was measured in serum samples obtained at the start
of follow-up. Multivariate proportional hazards models were employed to
examine the magnitude of the risk of ESRD or death across tertiles of
SAA concentration after adjustment for traditional risk factors. The C
statistic was used to assess the additional predictive value of SAA
relative to traditional risk factors. <b><i>Results:</i></b> Of 256
participants (mean ± SD glomerular filtration rate [iothalamate] = 148 ±
45 mL/min, and median [interquartile range] urine albumin/creatinine =
39 [14-221] mg/g), 76 developed ESRD and 125 died during a median
follow-up period of 15.2 and 15.7 years, respectively. After
multivariable proportional hazards regression, participants in the 2
highest SAA tertiles together exhibited a 53% lower risk of ESRD (hazard
ratio [HR] 0.47, 95% CI 0.29-0.78), and a 30% lower risk of death (HR
0.70, 95% CI 0.48-1.02), compared with participants in the lowest SAA
tertile, although the lower risk of death was not statistically
significant. Addition of SAA to the ESRD model increased the C statistic
from 0.814 to 0.815 (<i>p </i>= 0.005). <b><i>Conclusions:</i></b> Higher circulating SAA concentration is associated with a reduced risk of ESRD in American Indians with type 2 diabetes.</p