估算的肌酐清除率对血清肌酐正常的高血压患者血浆同型半胱氨酸的影响。

The influence of estimated creatinine clearance on plasma homocysteine in hypertensive patients with normal serum creatinine.

作者信息

Lin Yen-Hung, Pao Kuan-Yin, Wu Vin-Cent, Lin Yu-Li, Chien Yu-Fen, Hung Chi-Sheng, Chen Yu-Jen, Liu Chung-Pin, Tsai I-Jung, Gau Churn-Shiouh, Wu Kwan-Dun, Hwang Juey-Jen

机构信息

Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.

出版信息

Clin Biochem. 2007 Feb;40(3-4):230-4. doi: 10.1016/j.clinbiochem.2006.11.010. Epub 2006 Dec 6.

DOI:10.1016/j.clinbiochem.2006.11.010

PMID:17222811

Abstract

OBJECTIVES

To examine the relation of estimated creatinine clearance (eCrCl) and plasma total homocysteine (tHcy) in hypertensive patients with a normal serum creatinine level.

DESIGN AND METHODS

A total of 137 hypertensive patients (mean age 66.6 years, 69 men) with serum creatinine level </=1.5 mg/dL gave 10-h fasting blood samples for measurement of tHcy, serum folic acid, and serum vitamin B(12).

RESULTS

95 patients fell into a chronic renal insufficiency (CRI) group (eCrCl< or =60 mL/min/1.73 m(2)) and 42 into a normal renal function (NRF) group (eCrCl>60 mL/min/1.73 m(2)). The CRI group was older (p<0.001), had higher tHcy (p<0.001), higher serum urea nitrogen (p<0.001), higher serum creatinine (p<0.001), lower eCrCl (p<0.001), and lower diastolic blood pressure (p=0.001). In univariate analysis, eCrCl had the strongest correlation with tHcy (r=-0.453, p<0.001). Significant correlations, ranging in decreasing order from r=-0.418, p<0.001 to r=-0.170, p=0.047, were also noted between tHcy and twelve other variables. In multivariate analysis, only eCrCl (p<0.001), usage of fibrate (p<0.001), serum level of vitamin B(12) (p=0.002), serum level of folic acid (p=0.009), and smoking (p=0.027) were independent predictors of tHcy.

CONCLUSION

eCrCl is a strong independent predictor of tHcy in hypertensive patients with normal serum creatinine.

摘要

目的

研究血清肌酐水平正常的高血压患者估算的肌酐清除率（eCrCl）与血浆总同型半胱氨酸（tHcy）之间的关系。

设计与方法

选取137例血清肌酐水平≤1.5mg/dL的高血压患者（平均年龄66.6岁，男性69例），采集10小时空腹血样，测定tHcy、血清叶酸和血清维生素B12。

结果

95例患者归入慢性肾功能不全（CRI）组（eCrCl≤60mL/min/1.73m²），42例归入肾功能正常（NRF）组（eCrCl＞60mL/min/1.73m²）。CRI组年龄更大（p＜0.001），tHcy更高（p＜0.001），血清尿素氮更高（p＜0.001），血清肌酐更高（p＜0.001），eCrCl更低（p＜0.001），舒张压更低（p = 0.001）。单因素分析中，eCrCl与tHcy的相关性最强（r = -0.453，p＜0.001）。tHcy与其他12个变量之间也存在显著相关性，r值从-0.418（p＜0.001）到-0.170（p = 0.047），按相关性递减顺序排列。多因素分析中，只有eCrCl（p＜0.001）、贝特类药物的使用（p＜0.001）、血清维生素B12水平（p = 0.002）、血清叶酸水平（p = 0.009）和吸烟（p = 0.027）是tHcy的独立预测因素。