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内脂素与慢性肾脏病患者的脂质失调、内皮功能障碍和动脉粥样硬化有关。

Visfatin is related to lipid dysregulation, endothelial dysfunction and atherosclerosis in patients with chronic kidney disease.

机构信息

Institute of Nephrology of Chongqing and Department of Nephrology, Xinqiao Hospital, The Third Military Medical University, Chongqing, PR China.

出版信息

J Nephrol. 2011 Mar-Apr;24(2):177-84. doi: 10.5301/jn.2010.3488.

Abstract

BACKGROUND AND AIMS

This study aimed to test the hypothesis that visfatin is associated with atherosclerosis in patients with chronic kidney disease (CKD).

METHODS

In the study, we measured serum triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol levels and the following blood markers of endothelial function and inflammation: endothelin-1 (ET-1), nitric oxide (NO), thrombomodulin and high-sensitivity C-reactive protein (hsCRP) in 117 patients with CKD stage 4 or 5 and in 50 normal controls. Flow-mediated dilatation (FMD) was assessed by high-resolution brachial ultrasonography, and carotid intima-media thickness (IMT) was determined by vascular ultrasound. Plasma visfatin concentrations were measured by ELISA.

RESULTS

Compared with healthy controls, endothelial dysfunction was observed in all CKD patients. Visfatin levels were strongly correlated with hsCRP levels, serum triglyceride levels and LDL cholesterol levels, and negatively correlated with HDL cholesterol, estimated glomerular filtration rate (eGFR) and FMD levels in the CKD patients (p<0.05, for all). Moreover, carotid IMT was found to be significantly related to visfatin levels (p<0.05).

CONCLUSION

Overall, the study showed that in CKD patients, higher visfatin levels are associated with decreased GFR, increased serum triglyceride and LDL cholesterol levels and impaired endothelial function. Moreover, visfatin levels also correlated with hsCRP levels and carotid IMT, suggesting that visfatin may play an important role in uremia-related atherosclerosis.

摘要

背景与目的

本研究旨在检验内脂素与慢性肾脏病(CKD)患者动脉粥样硬化相关的假说。

方法

在这项研究中,我们测量了 117 例 CKD 4 或 5 期患者和 50 名正常对照者的血清甘油三酯、总胆固醇、高密度脂蛋白(HDL)胆固醇、低密度脂蛋白(LDL)胆固醇水平,以及内皮功能和炎症的以下血液标志物:内皮素-1(ET-1)、一氧化氮(NO)、血栓调节蛋白和高敏 C 反应蛋白(hsCRP)。通过高分辨率肱动脉超声评估血流介导的扩张(FMD),通过血管超声测定颈动脉内膜中层厚度(IMT)。通过 ELISA 测定血浆内脂素浓度。

结果

与健康对照组相比,所有 CKD 患者均存在内皮功能障碍。内脂素水平与 hsCRP 水平、血清甘油三酯水平和 LDL 胆固醇水平呈强相关,与 CKD 患者的 HDL 胆固醇、估计肾小球滤过率(eGFR)和 FMD 水平呈负相关(p<0.05,均为)。此外,颈动脉 IMT 与内脂素水平显著相关(p<0.05)。

结论

总体而言,该研究表明,在 CKD 患者中,较高的内脂素水平与 GFR 降低、血清甘油三酯和 LDL 胆固醇水平升高以及内皮功能受损有关。此外,内脂素水平还与 hsCRP 水平和颈动脉 IMT 相关,表明内脂素可能在尿毒症相关动脉粥样硬化中发挥重要作用。

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