Urinary kidney injury molecule 1 (KIM-1) and interleukin 18 (IL-18) as risk markers for heart failure in older adults: the Health, Aging, and Body Composition (Health ABC) Study

BACKGROUND

Kidney damage and reduced kidney function are potent risk factors for heart failure, but existing studies are limited to assessing albuminuria or estimated glomerular filtration rate (eGFR). We evaluated the associations of levels of urinary biomarkers of kidney tubular injury (interleukin 18 [IL-18] and kidney injury molecule 1 [KIM-1]) with future risk of heart failure.

STUDY DESIGN

Retrospective cohort study.

SETTING & PARTICIPANTS

2,917 participants without heart failure in the Health, Aging, and Body Composition (Health ABC) cohort.

PREDICTORS

Ratios of urine KIM-1, IL-18, and albumin to creatinine (KIM-1:Cr, IL-18:Cr, and ACR, respectively).

OUTCOMES

Incident heart failure over a median follow-up of 12 years.

RESULTS

Median values of each marker at baseline were 812 (IQR, 497-1,235)pg/mg for KIM-1:Cr, 31 (IQR, 19-56)pg/mg for IL-18:Cr, and 8 (IQR, 5-19) mg/g for ACR. 596 persons developed heart failure during follow-up. The top quartile of KIM-1:Cr was associated with risk of incident heart failure after adjustment for baseline eGFR, heart failure risk factors, and ACR (HR, 1.32; 95% CI, 1.02-1.70) in adjusted multivariate proportional hazards models. The top quartile of IL-18:Cr also was associated with heart failure in a model adjusted for risk factors and eGFR (HR, 1.35; 95% CI, 1.05-1.73), but was attenuated by adjustment for ACR (HR, 1.15; 95% CI, 0.89-1.48). The top quartile of ACR had a stronger adjusted association with heart failure (HR, 1.96; 95% CI, 1.53-2.51).

LIMITATIONS

Generalizability to other populations is uncertain.

CONCLUSIONS

Higher urine KIM-1 concentrations were associated independently with incident heart failure risk, although the associations of higher ACR were of stronger magnitude.

Association between IL-18, IFN-γ and TB susceptibility: a systematic review and meta-analysis

BACKGROUND

This study sought to evaluate the relationship between interleukin 18 (IL-18), interferon-gamma (IFN-γ), and susceptibility to tuberculosis (TB).

METHODS

We searched multiple databases, such as PubMed, Embase, Cochrane and China National Knowledge Database, for full-text articles on IL-18, IFN-γ, and TB. Bias risk tool in Review Manager 5.2 was used to evaluate the seven kinds of bias. We used Review Manager 5.2 to evaluate the effects of the results in the selected articles, analyzed the heterogeneity of the included articles to make a forest map, and undertook a sensitivity analysis and publication bias analysis.

RESULTS

Ultimately, 10 studies met the inclusion criteria, and were subjected to a data analysis. IL-18 was higher in the TB group than the health control (HC) group [mean difference (MD) =248.11, 95% confidence interval CI: 197.25, 298.98, P<0.0001; I2=63%]. The meta-analysis also showed that IFN-γ was higher in the TB group than the HC group (MD =38.74, 95% CI: 14.84, 62.64, P=0.001; I2=100%). Sensitivity analysis proved the robustness of this research and limited publication bias was observed in this study.

DISCUSSION

This study showed that IL-18 and IF-γ had a relationship with TB and might be used to help diagnose TB, which might be helpful in the clinical diagnosis about TB.