Trefoil factor 3 (TFF3) has been studied in processes leading to atherosclerosis. Data are scarce in manifest disease and missing in peripheral artery disease (PAD). This study aims to elucidate TFF3 with disease stages, degrees of atherosclerosis, and outcomes. TFF3 was measured in serum in 364 PAD patients without critical limb ischemia and mild to moderate chronic kidney disease (CKD). Mortality data were retrieved from the Austrian central death registry (median observation 9.6 years). Survival analyses were performed using Cox regression and the Kaplan–Meier method. A negative association between ankle-brachial index and TFF3 ( P < .001) was observed, while levels were similar in asymptomatic and symptomatic PAD. TFF3 increased with history of cardiovascular and cerebrovascular disease ( P < .001). TTF3 was associated with the estimated glomerular filtration rate (R = −0.617, P < .001) and urinary albumin-creatinine ratio (R = 0.229, P < .001). One SD increase in TFF3 showed a worsening in all-cause mortality (hazard ratio 1.68, CI 1.37–2.05) which persisted after multiple adjustment for cardiovascular risk, inflammatory, and angiogenetic markers (hazard ratio 1.35, CI 1.01–1.81). This study is the first to link TFF3 with both disease markers and outcomes in PAD. TFF3 demonstrated associations with renal function, PAD severity measured by ankle-brachial index, and additional atherosclerotic burden in PAD.

中文翻译：

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血清三叶因子 3 可预测外周动脉疾病的生存率

三叶因子 3 (TFF3) 已在导致动脉粥样硬化的过程中进行了研究。明显疾病的数据稀缺，外周动脉疾病（PAD）的数据缺失。本研究旨在阐明 TFF3 与疾病阶段、动脉粥样硬化程度和结果的关系。对 364 名没有严重肢体缺血和轻度至中度慢性肾病 (CKD) 的 PAD 患者的血清中的 TFF3 进行了测量。死亡率数据取自奥地利中央死亡登记处（中位观察时间 9.6 年）。使用 Cox 回归和 Kaplan-Meier 方法进行生存分析。观察到踝肱指数和 TFF3 之间呈负相关 (P < .001)，而无症状和有症状 PAD 的水平相似。TFF3随着心脑血管疾病史的增加而增加(P<0.001)。TTF3 与估计肾小球滤过率 (R = -0.617, P < .001) 和尿白蛋白肌酐比值 (R = 0.229, P < .001) 相关。TFF3 每增加一个 SD，表明全因死亡率恶化（风险比 1.68，CI 1.37-2.05），在对心血管风险、炎症和血管生成标志物进行多重调整后，这种情况持续存在（风险比 1.35，CI 1.01-1.81）。这项研究首次将 TFF3 与 PAD 的疾病标志物和结果联系起来。TFF3 与肾功能、通过踝臂指数测量的 PAD 严重程度以及 PAD 中的额外动脉粥样硬化负担相关。