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Abstract: TH-PO476

Syndecan-4 Is Associated with eGFR and the Incidence of Myocardial Infarction in a General Population: The Tromsø Study

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Solbu, Marit D., University Hospital of North Norway, Tromsø, Norway
  • Reine, Trine M, Univrsity of Oslo, Oslo, Norway
  • Kolset, Svein O, University of Oslo, Oslo, Norway
  • Jenssen, Trond G., Oslo University Hospital, Oslo, Norway
Background

Cardiovascular disease (CVD) is a common cause of morbidity and mortality. A link between chronic kidney disease (CKD) and CVD exists, but mechanisms are poorly understood. The endothelial glycocalyx is essential in maintaining vascular integrity. Disruption and shedding of the glycocalyx may be a common pathway in CVD and CKD. Syndecans are components of the glycocalyx. Increased serum levels of syndecan-4 is a marker of glycocalyx change or damage. We studied the cross-sectional association between syndecan-4 and kidney function, and the longitudinal association of these markers with myocardial infarction.

Methods

We used a case-cohort design and included participants from the Tromsø 5 Study (2001-02). Syndecan-4 was measured in frozen serum specimens with ELISA-assays. Baseline variables also included age, sex, cardiovascular risk factors, estimated GFR (eGFR) and urinary albumin-creatinine ratio (ACR). We used Spearman correlation, linear regression, and in Cox regression models we applied Borgan II weights.

Results

Among the 1496 men and women included, 328 experienced a fatal or non-fatal myocardial infarction between inclusion and the end of 2007. In the subcohort (n=831), mean age was 63.8 (±10.0) years, and 60.3% were women. Mean syndecan-4 was 18.7 (±5.6) ng/mL, mean eGFR was 87.7 (±13.7) ml/min/1.73 m2 and median ACR (IQR) was 0.43 (0.30, 0.77) mg/mmol. In the entire cohort, syndecan-4 was significantly correlated with eGFR (r=0.15; p<0.001), but only borderline significantly with ACR (r=0.05; p=0.045). In multiple linear regression analyses adjusted for age, sex, systolic blood pressure and waist circimference, syndecan-4 was positively associated with eGFR, but not significantly associated with ACR. Adjusted for the same variables plus smoking, glycosylated hemoglobin A1c, eGFR and ACR, syndecan-4 was an independent predictor of myocardial infarction (per 1 ng/mL: HR 1.24 (1.01, 1.52; P=0.04)), but eGFR and ACR were not.

Conclusion

In a general population serum syndecan-4 was positively associated with baseline eGFR and an independent predictor of myocardial infarction. Whether this association partly may be mediated through kidney function, remains to be studied.

Funding

  • Government Support - Non-U.S.