Lin Mao-Shin, Li Hung-Yuan, Wei Jung-Nan, Lin Cheng-Hsin, Smith David J, Vainio Jani, Shih Shyang-Rong, Chen Ying-Hui, Lin Lung-Chun, Kao Hsien-Li, Chuang Lee-Ming, Chen Ming-Fong
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Clin Biochem. 2008 Nov;41(16-17):1362-7. doi: 10.1016/j.clinbiochem.2008.06.019. Epub 2008 Jul 9.
An increased level of serum vascular adhesion protein-1 (VAP-1) has been found in patients with diabetes mellitus and vascular disorders. This study examined whether serum VAP-1 levels are associated with chronic kidney disease (CKD).
We included 262 subjects aged 30 and above with fasting plasma glucose level <7 mmol/L checked within 1 year. First morning urine specimens were collected. Microalbuminuria was defined if urinary albumin-to-creatinine ratio > or =30 microg/mg creatinine. The glomerular filtration rate (GFR) was estimated. CKD stages were defined according to the suggestions of the National Kidney Foundation. Serum VAP-1 levels were analyzed by immunofluorometric assay.
Serum VAP-1 levels were positively associated with the urinary albumin-to-creatinine ratio (r=0.29, p<0.0001) and negatively associated with estimated GFR (r=-0.24, p=0.0001). Subjects with CKD stage 2 (N=51) and stage 3 (N=91) had significantly higher levels of serum VAP-1 than those without CKD (p=0.0003 and p=0.035, adjusted for age and gender, respectively). A high serum VAP-1 level was associated with the presence of CKD (OR 1.63 for 1 SD increase of VAP-1, p=0.018), adjusting for age, sex, and smoking. Ordered logit models revealed that high serum VAP-1 levels correlated with advanced stages of CKD.
Serum levels of VAP-1 are associated with the severity of kidney damage or stages of kidney disease. The true mechanism which links the serum VAP-1 and CKD remains to be elucidated in further studies.
糖尿病和血管疾病患者血清血管黏附蛋白-1(VAP-1)水平升高。本研究旨在探讨血清VAP-1水平是否与慢性肾脏病(CKD)相关。
我们纳入了262名年龄在30岁及以上、1年内空腹血糖水平<7 mmol/L的受试者。收集首次晨尿标本。尿白蛋白与肌酐比值>或=30 μg/mg肌酐定义为微量白蛋白尿。估算肾小球滤过率(GFR)。根据美国国家肾脏基金会的建议定义CKD分期。采用免疫荧光分析法分析血清VAP-1水平。
血清VAP-1水平与尿白蛋白与肌酐比值呈正相关(r=0.29,p<0.0001),与估算GFR呈负相关(r=-0.24,p=0.0001)。CKD 2期(N=51)和3期(N=91)的受试者血清VAP-1水平显著高于无CKD者(分别调整年龄和性别后,p=0.0003和p=0.035)。调整年龄、性别和吸烟因素后,血清VAP-1水平升高与CKD的存在相关(VAP-1每增加1个标准差,OR为1.63,p=0.018)。有序logit模型显示,血清VAP-1水平升高与CKD晚期相关。
血清VAP-1水平与肾损伤严重程度或肾脏疾病分期相关。血清VAP-1与CKD之间的真正机制仍有待进一步研究阐明。