Saulnier PJ, et al. - This study investigated the impact of serum amyloid A (SAA) on the prognosis in American Indians with type 2 diabetes without diabetic kidney disease (DKD) or with early DKD. Findings demonstrated an association of higher circulating SAA concentration with an attenuated risk of end-stage renal disease (ESRD) in American Indians with type 2 diabetes.

Methods

• Serum samples were collected at the start of follow-up in order to measure SAA concentration.
• For assessing the magnitude of the risk of ESRD or death across tertiles of SAA concentration after adjustment for traditional risk factors, multivariate proportional hazards models were employed.  
• In addition, researchers used the C statistic to evaluate the additional predictive value of SAA relative to traditional risk factors.

Results

• Findings demonstrated that out of 256 participants (mean ± SD glomerular filtration rate [iothalamate] = 148 ± 45 mL/min, and median [interquartile range] urine albumin/creatinine = 39 [14-221] mg/g), 76 developed ESRD and 125 died during a median follow-up period of 15.2 and 15.7 years, respectively.
• Researchers observed that following multivariable proportional hazards regression, in comparison with the participants in the lowest SAA tertile, participants in the 2 highest SAA tertiles together exhibited a 53% lower risk of ESRD (hazard ratio [HR] 0.47, 95% CI 0.29-0.78), and a 30% lower risk of death (HR 0.70, 95% CI 0.48-1.02), although the lower risk of death was not statistically significant.
• Data also revealed that addition of SAA to the ESRD model increased the C statistic from 0.814 to 0.815 (p = 0.005).