Papagianni Aikaterini, Kokolina Elisavet, Kalovoulos Michalis, Vainas Andreas, Dimitriadis Chrisostomos, Memmos Dimitrios
University Department of Nephrology, Hippokration General Hospital, 50 Papanastasiou Str, 54642 Thessaloniki, Greece.
Nephrol Dial Transplant. 2004 May;19(5):1258-63. doi: 10.1093/ndt/gfh078. Epub 2004 Feb 19.
Recent evidence suggests that endothelial cell adhesion molecules may participate in the initiation and progression of atherosclerotic vascular damage. The aim of the present report was to investigate serum intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin concentrations and their probable association with atherosclerotic disease in patients on continuous ambulatory peritoneal dialysis (CAPD).
Sixty-three CAPD patients and 40 age- and sex-matched apparently healthy normotensive controls participated in the study. Atherosclerotic disease in both groups was assessed by measuring the intima-media thickness (IMT) and plaque score of the common carotid arteries using an ultrasound scanner.
Compared with controls, CAPD patients had significantly increased IMT and plaque score values (P<0.001 and P<0.0001, respectively), as well as serum ICAM-1, VCAM-1 and E-selectin concentrations (P<0.0001, P<0.0001 and P<0.05, respectively). In univariate analyses, IMT values were significantly correlated with age, systolic blood pressure (BP), logCRP, fibrinogen, albumin and ICAM-1 levels (P = 0.001, P = 0.04, P = 0.01, P = 0.04, P = 0.02 and P = 0.002, respectively). Multivariate analysis showed that ICAM-1 levels were a strong independent correlate of IMT (P = 0.005). Serum albumin also remained independently associated with IMT values (P = 0.03). Plaque score values were significantly correlated with age, systolic BP and fibrinogen (P = 0.002, P = 0.04 and P = 0.01, respectively). Multivariate analysis showed that fibrinogen concentrations were a significant independent contributor to plaque score values (P = 0.002). Adhesion molecule concentrations did not show any relation with plaque score either on univariate or multivariate analyses.
In CAPD patients, carotid atherosclerosis is associated with markers of inflammation, malnutrition and circulating levels of adhesion molecule ICAM-1. Hypoalbuminaemia and ICAM-1 appear independently related with atherogenesis but the mechanisms supporting these associations remain to be identified.
最近有证据表明，内皮细胞黏附分子可能参与动脉粥样硬化性血管损伤的起始和进展。本报告的目的是研究持续性非卧床腹膜透析（CAPD）患者血清细胞间黏附分子-1（ICAM-1）、血管细胞黏附分子-1（VCAM-1）和E-选择素的浓度及其与动脉粥样硬化疾病的可能关联。
63例CAPD患者和40例年龄和性别匹配的明显健康的血压正常对照者参与了本研究。通过使用超声扫描仪测量颈总动脉的内膜中层厚度（IMT）和斑块评分来评估两组的动脉粥样硬化疾病。
与对照组相比，CAPD患者的IMT和斑块评分值显著升高（分别为P<0.001和P<0.0001），血清ICAM-1、VCAM-1和E-选择素浓度也显著升高（分别为P<0.0001、P<0.0001和P<0.05）。在单因素分析中，IMT值与年龄、收缩压（BP）、logCRP、纤维蛋白原、白蛋白和ICAM-1水平显著相关（分别为P = 0.001、P = 0.04、P = 0.01、P = 0.04、P = 0.02和P = 0.002）。多因素分析显示，ICAM-1水平是IMT的强独立相关因素（P = 0.005）。血清白蛋白也与IMT值独立相关（P = 0.03）。斑块评分值与年龄、收缩压和纤维蛋白原显著相关（分别为P = 0.002、P = 0.04和P = 0.01）。多因素分析显示，纤维蛋白原浓度是斑块评分值的重要独立影响因素（P = 0.002）。在单因素或多因素分析中，黏附分子浓度与斑块评分均无任何关系。
在CAPD患者中，颈动脉粥样硬化与炎症、营养不良标志物以及黏附分子ICAM-1的循环水平有关。低白蛋白血症和ICAM-1似乎与动脉粥样硬化独立相关，但支持这些关联的机制仍有待确定。
