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Lookup NU author(s): Professor Kimon Stamatelopoulos
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025 The Author(s). European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.Background: Recent evidence suggests that Alzheimer's amyloid-beta (1-40) (Αβ1-40), an emerging biomarker of cardiovascular disease, may be involved in the heart-brain-renal axis. We aimed to comprehensively explore the association between circulating Aβ1-40 levels and renal function and its clinical relevance. Methods: Consecutively recruited subjects in the Athens Angiometabolic Registry with measured Aβ1-40 plasma levels (n = 811) were analysed. Αβ1-40 was measured by enzyme-linked immunosorbent assay and glomerular filtration rate (GFR) was calculated using the abbreviated four-variable Modification of Diet in Renal Disease (MDRD) formula. All-cause mortality was the main clinical endpoint across a median follow-up of 47 months. Results: Cross-sectionally, a bidirectional association between Αβ1-40 [adjusted odds ratio (adjOR) = 3.67 for highest tertile of Αβ1-40 and chronic kidney disease (CKD) stage ≥3, p <.001] and CKD stage ≥3 (adjOR = 3.52 for association with highest Aβ1-40 tertile, p <.001) was observed. Longitudinally, increased Αβ1-40 at baseline was associated with decline in renal function at follow-up (adjOR for CKD stage ≥3 = 2.26, p =.033). Similarly, longitudinal changes in Aβ1-40 were inversely associated with changes in GFR (OR =.77 per 1 SD increase in Aβ1-40, p =.006). Aβ1-40 was associated with all-cause mortality, independently of traditional risk factors (hazard ratio = 1.20 per 1 SD increase in Aβ1-40, p =.016). An indirect effect of GFR on the association between Aβ1-40 and mortality (p <.05) with an estimated indirect-to-total effect ratio of.334, but not of Αβ1-40 on GFR with mortality, was observed. Conclusions: In a population with a wide range of GFR, we found a bidirectional association between Αβ1-40 levels and renal function. The association of Αβ1-40 with all-cause mortality was partly mediated by lower GFR.
Author(s): Mavraganis G, Georgiopoulos G, Zervas G, Aivalioti E, Delialis D, Petropoulos I, Rachiotis N, Konstantaki C, Moustou C, Dimopoulou M-A, Sachse M, Tual-Chalot S, Sopova K, Psimmenou E, Stellos K, Stamatelopoulos K
Publication type: Article
Publication status: Published
Journal: European Journal of Clinical Investigation
Year: 2025
Volume: 55
Issue: 5
Print publication date: 01/05/2025
Online publication date: 24/02/2025
Acceptance date: 27/01/2025
Date deposited: 10/03/2025
ISSN (print): 0014-2972
ISSN (electronic): 1365-2362
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/eci.70006
DOI: 10.1111/eci.70006
Data Access Statement: Anonymized data can be requested after publication of the results of prespecified analyses from the corresponding authors to be shared subject to approval of institutional review boards.
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