Nagano Makio, Fukami Kei, Yamagishi Sho-ichi, Ueda Seiji, Kaida Yusuke, Matsumoto Takafumi, Yoshimura Junko, Hazama Takuma, Takamiya Yoshimi, Kusumoto Takuo, Gohara Shojiro, Tanaka Hideharu, Adachi Hisashi, Okuda Seiya
Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
Am J Nephrol. 2009;29(2):109-15. doi: 10.1159/000151439. Epub 2008 Aug 14.
BACKGROUND/AIM: Matrix metalloproteinase-2 (MMP-2) has been implicated in chronic kidney disease (CKD) and cardiovascular disease. However, there is no knowledge about the correlations between serum levels of MMP-2, proteinuria and atherosclerosis in patients with CKD. We investigated whether serum MMP-2 levels were associated with proteinuria, intima media thickness (IMT), and the presence of carotid atherosclerotic plaque in CKD patients.
CKD patients without hemodialysis (n = 99) were enrolled. MMP-2 levels were measured by an ELISA system. IMT and carotid atherosclerotic plaque were evaluated by a high-resolution ultrasonography.
Multivariate analyses revealed that low-density lipoprotein (p < 0.001), MMP-2 (p = 0.001) and systolic blood pressure (p = 0.011) were independent correlates of proteinuria. Age- and serum creatinine-adjusted MMP-2 levels were significantly increased (p = 0.001) in proportion to the increasing levels of proteinuria. Further, age (p < 0.001), systolic blood pressure (p = 0.015) and MMP-2 levels (p = 0.042) were independent correlates of IMT. MMP-2 levels were significantly (p < 0.01) higher in patients with atherosclerotic plaque than those without it.
The present study demonstrated that serum levels of MMP-2 were one of the independent correlates of proteinuria and IMT in patients with CKD. Our results suggest that serum MMP-2 levels may be one of the risk factors for renal damage and atherosclerosis in CKD patients.
背景/目的:基质金属蛋白酶-2(MMP-2)与慢性肾脏病(CKD)及心血管疾病有关。然而,对于CKD患者血清MMP-2水平、蛋白尿与动脉粥样硬化之间的相关性尚无相关了解。我们调查了CKD患者血清MMP-2水平是否与蛋白尿、内膜中层厚度(IMT)及颈动脉粥样硬化斑块的存在相关。
纳入未进行血液透析的CKD患者(n = 99)。通过酶联免疫吸附测定系统测量MMP-2水平。采用高分辨率超声评估IMT及颈动脉粥样硬化斑块。
多因素分析显示,低密度脂蛋白(p < 0.001)、MMP-2(p = 0.001)及收缩压(p = 0.011)是蛋白尿的独立相关因素。经年龄和血清肌酐校正后的MMP-2水平随蛋白尿水平升高而显著升高(p = 0.001)。此外,年龄(p < 0.001)、收缩压(p = 0.015)及MMP-2水平(p = 0.042)是IMT的独立相关因素。有动脉粥样硬化斑块的患者MMP-2水平显著高于无斑块患者(p < 0.01)。
本研究表明,CKD患者血清MMP-2水平是蛋白尿及IMT的独立相关因素之一。我们的结果提示,血清MMP-2水平可能是CKD患者肾脏损害及动脉粥样硬化的危险因素之一。