Hirawa Nobuhito, Uehara Yoshio, Yamakado Minoru, Toya Yoshiyuki, Gomi Tomoko, Ikeda Toshio, Eguchi Yutaka, Takagi Masao, Oda Hiroshi, Seiki Kousuke, Urade Yoshihiro, Umemura Satoshi
Department of Medicine 2, Yokohama City University, Japan.
Hypertension. 2002 Feb;39(2 Pt 2):449-54. doi: 10.1161/hy0202.102835.
Lipocalin-type prostaglandin D synthase (L-PGDS) reportedly well predicts cardiovascular injuries in humans. However, little is known about the implications of L-PGDS in hypertension. In the present study, we investigated the alterations of serum and urinary L-PGDS in hypertensive patients with or without renal dysfunction. A total of 111 patients with hypertension (EHT; 65 with normoalbuminuria, 23 with microalbuminuria, 12 with macroalbuminuria, 11 with renal failure) and 102 normotensive, nomoalbuminuric subjects (NT) were studied. L-PGDS was measured by enzyme-linked immunosorbent assay, and L-PGDS in the kidney was localized using immunohistochemical methods. Blood pressure was higher in EHT groups than in the NT group (P<0.0001). There were no differences in age, gender, BMI, TC, TG, and HbA1c levels among the groups. Serum creatinine and urinary albumin levels were higher in the group with renal failure. Serum levels of L-PGDS were increased in EHT with normoalbuminuria, as compared with NT (0.88 +/- 0.05 versus 0.65 +/- 0.02 microg/mL; P<0.001). Serum levels of L-PGDS increased with the renal function worsened and positively correlated with serum creatinine, particularly in patients with renal impairments (r=0.76, P<0.0001). Similarly, the urinary L-PGDS excretions in EHT with normoalbuminuria were higher than that in NT (2.31 +/- 0.29 versus 1.16 +/- 0.14 mg/gCr, P<0.001), whereas there were no differences in urinary albumin excretion between the 2 groups. Moreover, urinary L-PGDS excretion increased dramatically with an increase in albuminuria or proteinuria. L-PGDS was stained in the tubules and the interstitium of the kidney in nephrosclerosis. In conclusion, patients with hypertension exhibited a higher level of L-PGDS in serum and urine, and this became increasingly obvious along with advance in renal dysfunction. These data suggest that L-PGDS metabolism is related to blood pressure and kidney injuries associated with hypertension.
据报道,脂质运载蛋白型前列腺素D合成酶(L-PGDS)能很好地预测人类心血管损伤。然而,关于L-PGDS在高血压中的意义却知之甚少。在本研究中,我们调查了有无肾功能不全的高血压患者血清和尿液中L-PGDS的变化。共研究了111例高血压患者(原发性高血压;65例正常白蛋白尿、23例微量白蛋白尿、12例大量白蛋白尿、11例肾衰竭)和102例血压正常、无白蛋白尿的受试者(正常对照组)。采用酶联免疫吸附测定法检测L-PGDS,并使用免疫组织化学方法对肾脏中的L-PGDS进行定位。原发性高血压组的血压高于正常对照组(P<0.0001)。各组之间在年龄、性别、体重指数、总胆固醇、甘油三酯和糖化血红蛋白水平方面无差异。肾衰竭组的血清肌酐和尿白蛋白水平较高。与正常对照组相比,原发性高血压伴正常白蛋白尿患者的血清L-PGDS水平升高(0.88±0.05对0.65±0.02μg/mL;P<0.001)。血清L-PGDS水平随肾功能恶化而升高,并与血清肌酐呈正相关,尤其是在肾功能损害患者中(r=0.76,P<0.0001)。同样,原发性高血压伴正常白蛋白尿患者的尿L-PGDS排泄量高于正常对照组(2.31±0.29对1.16±0.14mg/g肌酐,P<0.001),而两组之间的尿白蛋白排泄量无差异。此外,尿L-PGDS排泄量随着白蛋白尿或蛋白尿的增加而显著增加。在肾硬化患者的肾小管和肾间质中L-PGDS呈染色阳性。总之,高血压患者血清和尿液中的L-PGDS水平较高,并且随着肾功能不全的进展变得越来越明显。这些数据表明,L-PGDS代谢与血压以及高血压相关的肾损伤有关。