Supplementary Material for: Association of Monocyte Chemoattractant Protein-1 with Death and Atherosclerotic Events in Chronic Kidney Disease

Background: Monocyte chemoattractant protein-1 ­(MCP-1), a marker of inflammation and monocyte recruitment to atherosclerotic plaques, is associated with cardiovascular (CV) outcomes in patients with acute coronary syndrome. Although plasma levels are elevated in chronic kidney disease (CKD), associations with reduced kidney function or outcomes in CKD have not been explored. Methods: In this population-based, probability-sampled, longitudinal cohort of 3,257 participants, including 286 (8.8%) patients with CKD, we studied the association of plasma MCP-1 with estimated glomerular filtration rate (eGFR), albuminuria, death, and intermediate and hard CV outcomes in CKD and non-CKD individuals. Cox proportional hazards regression assessed associations of baseline MCP-1 with all-cause death and atherosclerotic events. Results: MCP-1 was higher in CKD than non-CKD participants (p r = –0.23, p p Conclusions: Although plasma MCP-1 increased with decreased eGFR, it remained an independent risk factor for death in CKD. MCP-1 did not correlate with intermediate CV outcomes, implicating pathways other than atherosclerosis in the association of MCP-1 with death in CKD.

背景：单核细胞趋化蛋白-1（Monocyte chemoattractant protein-1，MCP-1）是一种炎症标志物，可介导单核细胞招募至动脉粥样硬化斑块，与急性冠状动脉综合征患者的心血管（cardiovascular，CV）不良结局密切相关。尽管慢性肾脏病（chronic kidney disease，CKD）患者的血浆MCP-1水平升高，但目前尚未明确其与肾功能减退或慢性肾脏病患者不良结局的关联。
方法：本研究针对一项基于人群、采用概率抽样的纵向队列展开分析，该队列共纳入3257名参与者，其中286名（8.8%）为慢性肾脏病患者。我们分析了血浆MCP-1水平与估算肾小球滤过率（estimated glomerular filtration rate，eGFR）、白蛋白尿、死亡结局，以及慢性肾脏病与非慢性肾脏病人群的中间型与硬终点心血管不良结局的关联。采用Cox比例风险回归模型评估基线MCP-1水平与全因死亡及动脉粥样硬化事件的相关性。
结果：慢性肾脏病参与者的血浆MCP-1水平高于非慢性肾脏病参与者（相关系数r=-0.23，P值信息不完整）。
结论：尽管血浆MCP-1水平随估算肾小球滤过率降低而升高，但MCP-1仍是慢性肾脏病患者死亡的独立危险因素。MCP-1与中间型心血管结局无显著相关性，这提示在慢性肾脏病患者中，MCP-1与死亡的关联并非通过动脉粥样硬化通路介导。