Soluble tumor necrosis factor receptor type 1 predicts cardiorenal outcomes and better associated with distinct cardiovascular or renal outcomes than precedential renal or cardiovascular events in type 2 diabetes mellitus

Li-Hsin Chang; Chia-Huei Chu; Chin-Chou Huang; Liang-Yu Lin

doi:10.1177/20420188231207345

Soluble tumor necrosis factor receptor type 1 predicts cardiorenal outcomes and better associated with distinct cardiovascular or renal outcomes than precedential renal or cardiovascular events in type 2 diabetes mellitus

Ther Adv Endocrinol Metab. 2023 Oct 29:14:20420188231207345. doi: 10.1177/20420188231207345. eCollection 2023.

Authors

Li-Hsin Chang¹, Chia-Huei Chu^{2

3}, Chin-Chou Huang⁴, Liang-Yu Lin^{5

6}

Affiliations

¹ Division of Endocrinology and Metabolism, Department of Medicine, Yeezen General Hospital, Taoyuan.
² Department of Otorhinolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, Taipei.
³ Department of Audiology and Speech Language Pathology, Mackay Medical College, New Taipei City.
⁴ Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei.
⁵ Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217.
⁶ Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei.

Abstract

Background: Inflammations are the crucial pathogenesis of chronic complications of type 2 diabetes mellitus (T2DM).

Objectives: The timeline of cardiovascular and renal complications of T2DM and whether soluble tumor necrosis factor receptor type 1 (sTNFR1) levels predict cardiorenal outcomes were still elusive.

Design: Prospectively observational study.

Methods: Chinese patients with T2DM were enrolled. Cardiorenal composite events defined by either cardiovascular composite events (all-cause mortality, acute coronary syndrome, or non-fatal stroke) or renal composite events (a decline of >30% of renal function or worsening status of albuminuria) were followed. Associations of sTNFR1 levels and cardiovascular, renal, and cardiorenal composite events were analyzed in regression models presented by hazard ratio (HR) and 95% confidence interval (95% CI).

Results: Among 370 subjects, 42 cardiovascular and 86 renal composite events occurred. Higher sTNFR1 levels were related to higher frequency and risks of cardiovascular composite events (HR 1.07, 95% CI 1.01-1.13, p = 0.009) and renal composite events (HR 1.05, 95% CI 1.02-1.09, p < 0.001). Occurrences of cardiovascular composite events were not predicted by precedential renal composite events. sTNFR1 levels were proved to be associated with risks of cardiorenal composite events in Cox regression sequential models (adjusted HR 1.04, 95% CI 1.00-1.08, p = 0.03). The results were consistent in all subgroup analyses.

Conclusion: Levels of sTNFR1 were associated with cardiorenal complications of T2DM and the predictabilities of TNFR1 levels were better than precedential cardiovascular or renal events.

Keywords: macrovascular complications; microvascular complications; soluble tumor necrosis factor receptor type 1; type 2 diabetes mellitus.