Risk Management and Healthcare Policy (Nov 2020)
The Relationship Between Interleukin-4 Levels and Cardiovascular Events in Patients with Chronic Kidney Disease
Abstract
Ling Gu,1 Huogen Liu,1 Xianhong Liu,2 Xi Zeng,3 Zuchen Lei,1 Xin Wan1 1Department of Critical Care Medicine, Mindong Hospital of Fujian Medical University, Fuan, Fujian 355000, People’s Republic of China; 2Department of Nephrology, Mindong Hospital of Fujian Medical University, Fuan, Fujian 355000, People’s Republic of China; 3Department of Geriatrics, Mindong Hospital of Fujian Medical University, Fuan, Fujian 355000, People’s Republic of ChinaCorrespondence: Xin WanDepartment of Critical Care Medicine, Mindong Hospital of Fujian Medical University, No. 89 Heshan Road, Fuan City 355000, Fujian Province, People’s Republic of ChinaTel +86 15259367910Email [email protected]: Cardiovascular diseases (CVDs) are the main cause of death in patients with chronic kidney disease (CKD). Interleukin-4 (IL-4) is considered an inflammatory cytokine. However, few studies have investigated the association between serum IL-4 and cardiovascular events in CKD. This study investigated whether serum IL-4 levels were associated with an increased risk of cardiovascular (CV) events in patients with CKD.Patients and Methods: A total of 302 patients with stage 1– 5 CKD were followed up for a mean of 32 (range=4– 36) months for end points (CV events). Serum IL-4 levels were measured at baseline. The independent relationship between serum IL-4 and the risk of CV events was assessed with multivariate Cox regression analysis.Results: The average age of this cohort (N=302) was 65.4 years. A total of 69.9% of them were male. CV events numbered 41 (13.6%) during the follow-up period. The Kaplan–Meier analysis showed that the rate of CV events was higher in patients with CKD with IL-4 levels above the mean (126.2 pg/mL) than in those with IL-4 levels below the mean. The multivariate Cox proportional hazard analysis revealed that serum IL-4 (HR=1.650, 95% CI 1.266– 2.210, P< 0.001) was associated with CV events in these patients with CKD. Sensitivity analysis showed that the association between serum IL-4 and CV events was not affected by the use of anti-inflammatory medication. The significant association between higher IL-4 levels and increased risk of CV events existed in patients with CKD3-5 but not in patients with CKD1-2 by using the stratified analysis.Conclusion: Higher serum IL-4 levels were associated with an increased risk of CV events during follow-up. Elevated serum IL-4 levels may help clinicians predict early CV events in patients with CKD.Keywords: interleukin-4, chronic kidney disease, cardiovascular event, Cox regression, prognosis
