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BioMed Research International
Volume 2013 (2013), Article ID 247649, 7 pages
http://dx.doi.org/10.1155/2013/247649
Research Article

What Is the Role of Apelin regarding Cardiovascular Risk and Progression of Renal Disease in Type 2 Diabetic Patients with Diabetic Nephropathy?

1Nephrology Department, Hospital Faro, Rua Leão Penedo, 8000-386 Faro, Portugal
2Pathology Clinic, Hospital Faro, 8000-836 Faro, Portugal
3Science of the Sea Department, University of Algarve, 8000-140 Faro, Portugal
4Cardiology Department, Hospital Faro, 8000-386 Faro, Portugal
5Pharmacology Department, Gnostic Laboratory, 8000-307 Faro, Portugal

Received 30 April 2013; Revised 5 August 2013; Accepted 8 August 2013

Academic Editor: Denis Feliers

Copyright © 2013 Ana Paula Silva et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aims. To evaluate the association of different apelin levels with cardiovascular mortality, hospitalization, renal function, and cardiovascular risk factors in type 2 diabetic patients with mild to moderate CKD. Methods. An observational, prospective study involving 150 patients divided into groups according to baseline apelin levels:  pg/mL, 2 = 98–328 pg/mL, and  pg/mL. Baseline characteristics were analyzed and compared. Multivariate Cox regression was used to find out predictors of cardiovascular mortality, and multivariate logistic regression was used to find out predictors of hospitalization and disease progression. Simple linear regressions and Pearson correlations were used to investigate correlations between apelin and renal disease and cardiovascular risk factors. Results. Patients’ survival at 83 months in groups 1, 2, and 3 was 39%, 40%, and 71.2%, respectively ( ). Apelin, age, and eGFR were independent predictors of mortality, and apelin, creatinine, eGFR, resistin, and visfatin were independent predictors of hospitalization. Apelin levels were negatively correlated with cardiovascular risk factors and positively correlated with eGFR. Patients with lower apelin levels were more likely to start a depurative technique. Conclusions. Apelin levels might have a significant clinical use as a marker/predictor of cardiovascular mortality and hospitalization or even as a therapeutic agent for CKD patients with cardiovascular disease.