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Urinary neutrophil gelatinase-associated lipocalin (NGAL) is associated with mortality in a community-based cohort of older Swedish men
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
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2013 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 227, no 2, 408-413 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE

Neutrophil gelatinase-associated lipocalin (NGAL) indicates tubular kidney damage, neutrophil activation and possibly atherogenesis, however the prospective association between urinary NGAL (u-NGAL) and cardiovascular death in the community is not known.

METHODS

This study evaluates the association between urinary and serum NGAL and mortality in a Swedish population of 597 men aged 78 years. During the study (median follow-up 8.1 years) 261 men died, 90 of cardiovascular causes.

RESULTS

U-NGAL was associated with increased all-cause and cardiovascular mortality (HR 2.0 for quartile 4 vs. quartile 1, 95% CI 1.0-4.0, P < 0.05) in Cox regression models independently of cardiovascular risk factors, CRP and cystatin C estimated glomerular filtration rate (eGFRCysC) but not urinary Albumin (u-Alb). A combination of low eGFRCysC (≤60 mL/min), high u-Alb (≥3 mg/mmol Cr) and high u-NGAL (≥1.19 μg/mmol Cr) was associated with a 9-fold increased cardiovascular mortality (P < 0.001) and a 3-fold increased all-cause mortality (P < 0.001). Serum NGAL was associated with increased all-cause mortality risk independent of other cardiovascular risk factors (HR 1.4 for quartile 4 vs.1, 95% CI 1.0-1.9, P < 0.05) but not after adjustment with CRP, eGFRCysC or u-Alb.

CONCLUSION

This community study is the first to show that the tubular kidney biomarker u-NGAL associated with increased cardiovascular and all-cause mortality independent of cardiovascular risk factors and glomerular filtration. Additional research is needed to evaluate the utility of NGAL in clinical practice.

Place, publisher, year, edition, pages
2013. Vol. 227, no 2, 408-413 p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
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URN: urn:nbn:se:uu:diva-197358DOI: 10.1016/j.atherosclerosis.2013.01.009ISI: 000316603100034PubMedID: 23375682OAI: oai:DiVA.org:uu-197358DiVA: diva2:612764
Available from: 2013-03-25 Created: 2013-03-25 Last updated: 2017-12-06Bibliographically approved

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Helmersson-Karlqvist, JohannaLarsson, AndersCarlsson, Axel CVenge, PerSundström, JohanIngelsson, ErikLind, LarsÄrnlöv, Johan

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Helmersson-Karlqvist, JohannaLarsson, AndersCarlsson, Axel CVenge, PerSundström, JohanIngelsson, ErikLind, LarsÄrnlöv, Johan
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Biochemial structure and functionDepartment of Public Health and Caring SciencesDepartment of Medical SciencesGeriatrics
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Atherosclerosis
Public Health, Global Health, Social Medicine and Epidemiology

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