Zhu Shiming, Liu Yuying, Wang Liqi, Meng Qing H
Division of Cardiology, Department of Medicine, Clinical Medical College of Shandong University, Jinan Central Hospital, Jinan, People's Republic of China.
Nephrol Dial Transplant. 2008 Sep;23(9):2841-6. doi: 10.1093/ndt/gfn159. Epub 2008 Apr 5.
Evidence suggests that transforming growth factor-beta1 (TGF-beta(1)) is associated with target organ damage in hypertension. This study aimed to investigate the relationship between TGF-beta(1) levels and kidney damage and renoprotective effects of angiotensin-converting enzyme inhibitor and/or angiotensin II type 1 receptor blocker in patients with essential hypertension (EH).
A total of 156 patients with EH were enrolled and grouped according to albumin-to-creatinine ratio (ACR). Of these, 90 patients with EH underwent a 12-week antihypertensive trial with administration of benazepril, valsartan or both. Serum TGF-beta(1), plasma angiotensin (Ang) II and urinary albumin were quantified by immunoassays.
Serum TGF-beta1, plasma Ang II and ACR were highly elevated in patients with EH (P < 0.01). There was a positive correlation between serum TGF-beta1 levels and ACR (r = 0.53, P < 0.01). Significant decreases in TGF beta1 and ACR were obtained in all groups at the end of 12-week antihypertensive therapy compared to the baseline values, with the combined group to a greater extent (P < 0.01). Plasma Ang II levels were significantly decreased in the benazepril group but increased in the valsartan group (P < 0.05) while no significant change was observed in the combined group.
TGF-beta(1) is highly elevated and strongly associated with urinary albumin excretion in patients with EH. Treatment with benazepril or valsartan attenuates serum TGF-beta(1) levels and microalbuminuria with the combined therapy receiving the greater effect. TGF-beta(1) could be a potential surrogate marker in monitoring the development and progression of kidney damage in EH.
有证据表明，转化生长因子β1（TGF-β1）与高血压患者的靶器官损害有关。本研究旨在探讨原发性高血压（EH）患者中TGF-β1水平与肾脏损害之间的关系，以及血管紧张素转换酶抑制剂和/或血管紧张素II 1型受体阻滞剂的肾脏保护作用。
共纳入156例EH患者，并根据白蛋白与肌酐比值（ACR）进行分组。其中，90例EH患者接受了为期12周的降压试验，给予苯那普利、缬沙坦或两者联合使用。通过免疫测定法定量血清TGF-β1、血浆血管紧张素（Ang）II和尿白蛋白。
EH患者血清TGF-β1、血浆Ang II和ACR均显著升高（P < 0.01）。血清TGF-β1水平与ACR呈正相关（r = 0.53，P < 0.01）。与基线值相比，所有组在12周降压治疗结束时TGF-β1和ACR均显著降低，联合治疗组降低幅度更大（P < 0.01）。苯那普利组血浆Ang II水平显著降低，而缬沙坦组升高（P < 0.05），联合治疗组未观察到显著变化。
EH患者中TGF-β1显著升高，且与尿白蛋白排泄密切相关。苯那普利或缬沙坦治疗可降低血清TGF-β1水平和微量白蛋白尿，联合治疗效果更佳。TGF-β1可能是监测EH患者肾脏损害发生和进展的潜在替代标志物。
