Department of Medicine, Division of Nephrology, University of California San Francisco, San Francisco, CA, USA.
Nephrol Dial Transplant. 2011 Jun;26(6):1903-8. doi: 10.1093/ndt/gfq648. Epub 2010 Nov 15.
Pentraxin-3 (PTX3), an inflammatory marker thought to be related to vascular inflammation, is elevated in advanced chronic kidney disease (CKD). Whether PTX3 is associated with mild to moderate kidney dysfunction is unknown.
We tested associations of proteins in the pentraxin family [PTX3, C-reactive protein (CRP) and serum amyloid protein (SAP)] with estimated glomerular filtration rate by cystatin C (eGFRcys) and microalbuminuria among 2824 participants in the Multi-Ethnic Study of Atherosclerosis. Associations were tested using multivariable linear regression with adjustment for demographics (age, gender, annual income), comorbidities (diabetes, hypertension, smoking, body mass index, low-density lipoprotein, high-density lipoprotein, triglycerides, ACE inhibitor and statin use) and systemic inflammation [interleukin-6 (IL-6)].
Among the 2824 participants, mean age was 62 years and mean eGFRcys was 94 mL/min/1.73 m(2); 25% were white, 25% Chinese, 25% African-American and 25% Hispanic. Among all participants after full adjustment, higher PTX3 was associated with lower eGFRcys independently of IL-6 (β - 3.0 mL/min/1.73 m(2) per unit increase in lnPTX3, P < 0.001). In contrast, CRP and SAP were associated with eGFRcys in demographic adjusted models, but these associations were attenuated after adjustment for comorbidities and IL-6 (lnCRP β - 0.06, P = 0.9; lnSAP β - 0.35, P = 0.7). There was a significant interaction with race/ethnicity (P < 0.001) in the association of PTX3 and eGFRcys. After adjustment for demographics, comorbidities and IL-6, this association was significant in blacks (β - 5.7 mL/min/1.73 m(2) per unit increase in lnPTX3, P = 0.002) but not in Hispanics (β - 2.4, P = 0.1), Chinese (β - 0.91, P = 0.5) or whites (β - 0.26, P = 0.9). PTX3 and CRP, but not SAP, had correlations with microalbuminuria in unadjusted models (Spearman coefficients PTX3 0.05, P = 0.005; CRP 0.07, P < 0.001; SAP 0.013, P = 0.5), but these were attenuated after full adjustment.
Endovascular inflammation may be an important mechanism associated with early kidney dysfunction, particularly among blacks. This mechanism appears to be independent of IL-6-regulated pathways.
Pentraxin-3（PTX3）是一种炎症标志物，被认为与血管炎症有关，在晚期慢性肾脏病（CKD）中升高。PTX3 是否与轻度至中度肾功能障碍有关尚不清楚。
我们在动脉粥样硬化多民族研究 2824 名参与者中，用多元线性回归检验了 pentraxin 家族[PTX3、C 反应蛋白（CRP）和血清淀粉样蛋白（SAP）]蛋白与胱抑素 C 估计肾小球滤过率（eGFRcys）和微量白蛋白尿的相关性，调整了人口统计学（年龄、性别、年收入）、合并症（糖尿病、高血压、吸烟、体重指数、低密度脂蛋白、高密度脂蛋白、甘油三酯、ACE 抑制剂和他汀类药物的使用）和全身炎症[白细胞介素-6（IL-6）]。
在 2824 名参与者中，平均年龄为 62 岁，平均 eGFRcys 为 94 mL/min/1.73 m2；25%为白人，25%为中国人，25%为非裔美国人，25%为西班牙裔。在所有经过充分调整的参与者中，PTX3 水平升高与 eGFRcys 降低独立相关，而与 IL-6 无关（lnPTX3 每增加一个单位，eGFRcys 降低 3.0 mL/min/1.73 m2，P<0.001）。相比之下，CRP 和 SAP 在人口统计学调整模型中与 eGFRcys 相关，但这些相关性在调整合并症和 IL-6 后减弱（lnCRPβ-0.06，P=0.9；lnSAPβ-0.35，P=0.7）。种族/民族之间存在显著的交互作用（P<0.001）。在调整人口统计学、合并症和 IL-6 后，lnPTX3 每增加一个单位，黑人的相关性显著（β-5.7 mL/min/1.73 m2，P=0.002），而西班牙裔（β-2.4，P=0.1）、中国人（β-0.91，P=0.5）或白人（β-0.26，P=0.9）则不显著。PTX3 和 CRP，但不是 SAP，在未调整模型中与微量白蛋白尿相关（Spearman 系数 PTX3 0.05，P=0.005；CRP 0.07，P<0.001；SAP 0.013，P=0.5），但这些相关性在充分调整后减弱。
血管内炎症可能是与早期肾功能障碍相关的一个重要机制，尤其是在黑人中。这种机制似乎独立于 IL-6 调节途径。
