Abstract 18415: Beta-trace Protein and Beta-2-microglobulin are Independent Predictors of All-cause and Cardiovascular Mortality in US Adults

Abstract

Background: Beta-trace protein (BTP) and beta-2-microglobulin (B2M) are novel markers of renal dysfunction associated with cardiovascular disease. We evaluated their relationship with all-cause and cardiovascular mortality in a representative sample of US adults.

Methods: 6,642 participants aged 20 or above were included in the Third National Health and Nutrition Examination Survey. They were recruited from 1988 to 1994 and followed up through 2006. Multivariate Cox regression analysis was used, with adjustment for age, race/ethnicity, sex, education, smoking, physical activity, BMI, diabetes, hypertension, hypertriglyceridemia, low HDL, serum uric acid, C-reactive protein, vitamin D, total cholesterol, blood urea nitrogen, hemoglobin, white blood cell count and eGFR.

Results: The mean (95% CI) serum BTP and B2M levels were 0.581 mg/L (0.571-0.592) and 1.93 mg/L (1.89-1.97) respectively. Within an average 12.1 years follow-up, 2,540 all-cause and 1,157 cardiovascular deaths occurred. The multivariate adjusted hazard ratios comparing the lowest BTP quartile with the highest quartile were 1.43 (95% CI: 1.11-1.83; P-trend=0.007) for all-cause mortality, and 1.53 (95% CI: 1.11-2.11; P-trend<0.001) for cardiovascular mortality. The multivariate adjusted hazard ratios comparing the lowest with the highest B2M quartile were 2.30 (95% CI: 1.68-3.15; P-trend<0.001) for all-cause mortality, and 1.91 (95% CI: 1.03-3.55; P-trend=0.006) for cardiovascular mortality. Similar results were obtained when BTP and B2M were analyzed as continuous variables, in the subgroup with eGFR≥60 (n=4,066), or with further adjustment of LDL in the subgroup with LDL measurements (n=3,099).

Conclusion: We have identified serum BTP and B2M as novel and significant predictors of all-cause and cardiovascular mortality in the general population.