Suthanthiran Manikkam, Gerber Linda M, Schwartz Joseph E, Sharma Vijay K, Medeiros Mara, Marion Rosemerie, Pickering Thomas G, August Phyllis
Department of Medicine, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY 10065, USA.
Kidney Int. 2009 Jul;76(1):72-80. doi: 10.1038/ki.2009.66. Epub 2009 Mar 11.
Transforming growth factor-beta1 (TGF-beta1) is known to induce progression of experimental renal disease. Here we determined whether there is an association between serum levels of TGF-beta1 and the risk factors for progression of clinically relevant renal disorders in 186 black and 147 white adults, none of whom had kidney disease or diabetes. Serum TGF-beta1 protein levels were positively and significantly associated with plasma renin activity along with the systolic and diastolic blood pressure in blacks but not whites after controlling for age, gender, and body mass index. These TGF-beta1 protein levels were also significantly associated with body mass index and metabolic syndrome and more predictive of microalbuminuria in blacks than in whites. The differential association between TGF-beta1 and renal disease risk factors in blacks and whites suggests an explanation for the excess burden of end-stage renal disease in the black population, but this requires validation in an independent cohort. Whether these findings show that it is the circulating levels of TGF-beta1 that contribute to renal disease progression or the findings reflect other unmeasured factors, further longitudinal studies are needed.
已知转化生长因子-β1(TGF-β1)可促使实验性肾脏疾病进展。在此,我们确定了186名黑人成年人和147名白人成年人血清TGF-β1水平与临床相关肾脏疾病进展风险因素之间是否存在关联,这些人都没有肾脏疾病或糖尿病。在控制年龄、性别和体重指数后,黑人的血清TGF-β1蛋白水平与血浆肾素活性以及收缩压和舒张压呈显著正相关,而白人则不然。这些TGF-β1蛋白水平也与体重指数和代谢综合征显著相关,并且在预测黑人微量白蛋白尿方面比白人更具预测性。黑人与白人中TGF-β1与肾脏疾病风险因素之间的差异关联为黑人人群终末期肾病负担过重提供了解释,但这需要在独立队列中进行验证。这些发现究竟表明是循环中的TGF-β1水平导致了肾脏疾病进展,还是这些发现反映了其他未测量的因素,仍需要进一步的纵向研究。