du.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Pregnancy-associated plasma protein A and mortality in hemodialysis
Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.ORCID iD: 0000-0002-6933-4637
2018 (English)In: European Journal of Clinical Investigation, ISSN 0014-2972, E-ISSN 1365-2362, article id e12959Article in journal (Refereed) Epub ahead of print
Abstract [en]

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. 

Place, publisher, year, edition, pages
2018. article id e12959
Keyword [en]
Pregnancy-associated plasma protein A, cardiovascular disease, hemodialysis
National Category
Clinical Medicine
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-27767DOI: 10.1111/eci.12959PubMedID: 29802620OAI: oai:DiVA.org:du-27767DiVA, id: diva2:1213729
Available from: 2018-06-05 Created: 2018-06-05 Last updated: 2018-06-05Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Authority records BETA

Ärnlöv, Johan

Search in DiVA

By author/editor
Ärnlöv, Johan
By organisation
Medical Science
In the same journal
European Journal of Clinical Investigation
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 2 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf