Mallamaci Francesca, Cutrupi Sebastiano, Pizzini Patrizia, Tripepi Giovanni, Zoccali Carmine
CNR-IBIM, Institute of Biomedicine, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension and Division of Nephrology, Dialysis and Transplantation, Reggio Calabria, Italy.
Am J Hypertens. 2006 May;19(5):505-10. doi: 10.1016/j.amjhyper.2005.10.019.
Urotensin II (UTN), a cyclic undecapeptide widely distributed in various organs and tissues, is found in high concentration in atheromatous lesions. Because UTN accumulates in patients with chronic renal failure, the association between plasma UTN and biomarkers of atherosclerosis and endothelial activation needs to be better understood.
We tested by a robust statistical approach (Holm method) the association between plasma UTN and biomarkers of atherosclerosis and endothelial activation in a population of 191 patients undergoing chronic hemodialysis.
Plasma UTN was significantly higher in patients with end-stage renal disease (median: 6.5 ng/mL) than in healthy subjects (median: 3.1 ng/mL) (P < .001), and in both patients and control subjects it was independent of age and sex. Interestingly, UTN was inversely related to fibrinogen (r = -0.50, P < .004), intracellular adhesion molecule-1 (r = -0.24, P < .004) and with NO synthesis inhibitor asymmetric dimethyl-arginine (r = -0.40, P < .004). These links were paralleled by direct correlations with albumin (r = 0.21, P < .006) and with transforming growth factor-beta1 (TGFbeta1) (r = 0.36, P < .004). Of note, on multiple regression analysis, these associations remained highly significant also after data adjustment for potential confounders.
The inverse links between UTN with biomarkers of atherosclerosis and endothelial activation suggest that downregulation of UTN may be a counter-regulatory response aimed at mitigating cardiovascular damage or that UTN itself is a protective factor.
尾加压素 II（UTN）是一种广泛分布于各种器官和组织中的环状十一肽，在动脉粥样硬化病变中浓度较高。由于UTN在慢性肾衰竭患者体内蓄积，血浆UTN与动脉粥样硬化和内皮激活生物标志物之间的关联需要进一步深入了解。
我们采用稳健的统计方法（霍尔姆法），对191例接受慢性血液透析的患者群体中血浆UTN与动脉粥样硬化和内皮激活生物标志物之间的关联进行了检测。
终末期肾病患者的血浆UTN水平（中位数：6.5 ng/mL）显著高于健康受试者（中位数：3.1 ng/mL）（P <.001），且在患者和对照受试者中，其水平均与年龄和性别无关。有趣的是，UTN与纤维蛋白原（r = -0.50，P <.004）、细胞间黏附分子-1（r = -0.24，P <.004）以及一氧化氮合成抑制剂不对称二甲基精氨酸（r = -0.40，P <.004）呈负相关。这些关联与UTN与白蛋白（r = 0.21，P <.006）和转化生长因子-β1（TGFβ1）（r = 0.36，P <.004）的直接相关性相平行。值得注意的是，在多因素回归分析中，在对潜在混杂因素进行数据调整后，这些关联仍然高度显著。
UTN与动脉粥样硬化和内皮激活生物标志物之间的负相关表明，UTN的下调可能是一种旨在减轻心血管损伤的反调节反应，或者UTN本身就是一种保护因子。
