在接受环孢素A治疗的肾移植受者中，补充叶酸未能影响血管功能和颈动脉内膜中层厚度。

Folate supplementation fails to affect vascular function and carotid artery intima media thickness in cyclosporin A-treated renal transplant recipients.

作者信息

Austen S K, Fassett R G, Geraghty D P, Coombes J S

机构信息

School of Human Movement Studies, University of Queensland, St. Lucia, Qld, Australia.

出版信息

Clin Nephrol. 2006 Nov;66(5):373-9. doi: 10.5414/cnp66373.

DOI:10.5414/cnp66373

PMID:17140167

Abstract

BACKGROUND

Cyclosporin A (CsA)-treated renal transplant recipients (RTR) exhibit relative hyperhomocystinemia and vascular dysfunction. Folate supplementation lowers homocysteine and has been shown to improve vascular function in healthy subjects and patients with coronary artery disease. The aim of this study was to assess the effects of 3 months of folate supplementation (5 mg/day) on vascular function and structure in RTR.

METHODS

A double-blind, placebo-controlled crossover study was conducted in 10 CsA-treated RTR. Vascular structure was measured as carotid artery intima media thickness (IMT) and function was assessed as changes in brachial artery diameter during reactive hyperemia (RH) and in response to glyceryl trinitrate (GTN). Function data were analyzed as absolute and percent change from baseline and area under the diameter/time curve. Blood samples were collected before and after supplementation and analyzed for total plasma homocysteine, folate, vitamin B12 and asymmetric dimethyl arginine (ADMA) in addition to regular measures of hemoglobin, hematocrit, mean corpuscular volume (MCV) and serum creatinine.

RESULTS

Folate supplementation significantly increased plasma folate by 687% (p < 0.005) and decreased homocysteine by 37% (p < 0.05) with no changes (p > 0.05) in vitamin B12 or ADMA. There were no significant (p > 0.05) changes in vascular structure or function during the placebo or the folate supplementation phases; IMT; placebo pre mean +/- SD, 0.52 +/- 0.12, post 0.50 +/- 0.11; folate pre 0.55 +/- 0.17, post 0.49 +/- 0.20 mm, 5% change in brachial artery diameter (RH, placebo pre 10 +/- 8, post 6 +/- 5; folate pre 9 +/- 7, post 7 +/- 5; GTN, placebo pre 18 +/- 10, post 17 +/- 9, folate pre 16 +/- 9, post-supplementation 18 +/- 8).

CONCLUSION

Three months of folate supplementation decreases plasma homocysteine but has no effect on endothelial function or carotid artery IMT in RTR.

摘要

背景

接受环孢素A（CsA）治疗的肾移植受者（RTR）表现出相对高同型半胱氨酸血症和血管功能障碍。补充叶酸可降低同型半胱氨酸水平，并已证明可改善健康受试者和冠心病患者的血管功能。本研究的目的是评估3个月补充叶酸（5毫克/天）对RTR血管功能和结构的影响。

方法

对10名接受CsA治疗的RTR进行了一项双盲、安慰剂对照的交叉研究。血管结构通过颈动脉内膜中层厚度（IMT）进行测量，功能通过反应性充血（RH）期间肱动脉直径的变化以及对硝酸甘油（GTN）的反应进行评估。功能数据以相对于基线的绝对变化和百分比变化以及直径/时间曲线下面积进行分析。在补充前后采集血样，除了常规测量血红蛋白、血细胞比容、平均红细胞体积（MCV）和血清肌酐外，还分析血浆总同型半胱氨酸、叶酸、维生素B12和不对称二甲基精氨酸（ADMA）。

结果

补充叶酸使血浆叶酸显著增加687%（p < 0.005），同型半胱氨酸降低37%（p < 0.05），而维生素B12或ADMA无变化（p > 0.05）。在安慰剂或补充叶酸阶段，血管结构或功能无显著（p > 0.05）变化；IMT；安慰剂前平均值±标准差，0.52±0.12，后0.50±0.11；叶酸前0.55±0.17，后0.49±0.20毫米，肱动脉直径变化5%（RH，安慰剂前10±8，后6±5；叶酸前9±7，后7±5；GTN，安慰剂前18±10，后17±9，叶酸前16±9，补充后18±8）。