据描述，终末期肾病 (ESKD) 和 1 型糖尿病 (T1D) 中午夜皮质醇 (MC) 升高。在 T1D 和 ESKD 中发现细胞因子可溶性肿瘤坏死因子 (TNF) 样弱凋亡诱导剂 (sTWEAK) 的循环水平较低，并且与后者的心血管 (CV) 事件相关。我们的目的是研究同步胰肾移植 (SPKT) 受者的 MC 和 sTWEAK，以及这些标记物与 CV 危险因素和移植结果的关联。这是一项回顾性队列研究，包括 2008 年至 2008 年期间接受首次 SPKT 的 T1D 受试者。 2020 年。基线时的 MC 和 sTWEAK 与 SPKT 后 1 年的 CV 危险因素和演变相关。我们纳入了 29 名受试者（58.6% 为女性，平均年龄 43.5±7.5 岁，糖尿病病程 31.9±9.4 年）。尽管高血压患病率相似，但收缩压 (SBP) 随 MC 四分位数直接升高 (p<0.05)。 1 年时，MC 较低四分位数的患者不再强化抗高血压治疗（p<<0.05）。在皮质醇较高的四分位数中，糖尿病神经病变的患病率逐渐下降（趋势 p= 0.005）。低 MC 与肾移植功能延迟相关（p 趋势 = 0.044），高 sTWEAK 与肾移植排斥相关（p 趋势 = 0.018）。在多变量分析中，MC（标准化-β 0.505，p = 0.004）和年龄（标准化-β - 0.460，p = 0.040）与SBP独立相关，并且MC与糖尿病神经病变的存在独立相关（OR 0.633，95） % CI 0.425-0.944，p = 0.025），根据混杂因素进行调整。在这项探索性研究中，较低的 MC 与较低的基线 SBP、移植后 1 年后抗高血压治疗的改善以及 SPKT 受者中较高的糖尿病神经病变患病率相关。 © 2023。作者。

An increased midnight cortisol (MC) has been described in end-stage kidney disease (ESKD) and type 1 diabetes (T1D). Lower circulating levels of the cytokine soluble tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) have been found in T1D and ESKD and associated with cardiovascular (CV) events in the latter. We aimed to study MC and sTWEAK in simultaneous pancreas-kidney transplant (SPKT) recipients, and the association of these markers with CV risk factors and transplant outcomes.This was a retrospective cohort study including subjects with T1D who received a first SPKT between 2008 and 2020. MC and sTWEAK at baseline were correlated with CV risk factors and evolution 1 year after SPKT.We included 29 subjects (58.6% women, mean age 43.5 ± 7.5 years, diabetes duration 31.9 ± 9.4 years). Systolic blood pressure (SBP) increased directly with MC quartiles, despite similar hypertension prevalence (p < 0.05). At 1 year, antihypertensive treatment was deintensified in those in lower MC quartiles (p < 0.05). Diabetic neuropathy prevalence decreased progressively in higher cortisol quartiles (p for trend = 0.005). Low MC was associated with delayed kidney graft function (p for trend = 0.044), and high sTWEAK with kidney graft rejection (p for trend = 0.018). In multivariate analyses, MC (standardized-β 0.505, p = 0.004) and age (standardized-β - 0.460, p = 0.040) were independently correlated with SBP, and MC was independently associated with the presence of diabetic neuropathy (OR 0.633, 95% CI 0.425-0.944, p = 0.025), adjusted for confounders.In this exploratory study, lower MC was associated with a lower baseline SBP, an improvement of antihypertensive treatment 1 year after transplant, and a higher diabetic neuropathy prevalence in SPKT recipients.© 2023. The Author(s).