Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.
PLoS One. 2011;6(8):e23718. doi: 10.1371/journal.pone.0023718. Epub 2011 Aug 19.
Soluble endoglin, a TGF-β receptor, plays a key role in cardiovascular physiology. Whether circulating concentrations of soluble endoglin are elevated in CKD or underlie the high risk of cardiovascular death associated with chronic kidney disease (CKD) is unknown.
Individuals with and without CKD were recruited at a single center. Estimated glomerular filtration rate (eGFR) was estimated using the modified MDRD study equation and the serum creatinine at the time of recruitment, and patients were assigned to specific CKD stage according to usual guidelines. Serum endoglin concentration was measured by ELISA and univariate and multivariable regression was used to analyze the association between eGFR or CKD stage and the concentration of soluble endoglin.
Serum endoglin was measured in 216 patients including 118 with stage 3 or higher CKD and 9 individuals with end stage renal disease (ESRD). Serum endoglin concentration did not vary significantly with CKD stage (increase of 0.16 ng/mL per 1 stage increase in CKD, P = 0.09) or eGFR (decrease -0.06 ng/mL per 10 mL/min/1.73 m(2) increase in GFR, P = 0.12), and was not higher in individuals with ESRD than in individuals with preserved renal function (4.2±1.1 and 4.3±1.2 ng/mL, respectively). Endoglin concentration was also not significantly associated with urinary albumin excretion.
Renal function is not associated with the circulating concentration of soluble endoglin. Elevations in soluble endoglin concentration are unlikely to contribute to the progression of CKD or the predisposition of individuals with CKD to develop cardiovascular disease.
可溶性内皮糖蛋白（endoglin）是转化生长因子-β（TGF-β）受体的一种，在心血管生理学中起着关键作用。循环中可溶性内皮糖蛋白浓度是否在 CKD 中升高，或者是否是慢性肾脏病（CKD）患者心血管死亡风险高的原因尚不清楚。
在一个中心招募了有和没有 CKD 的个体。采用改良的 MDRD 研究方程和招募时的血清肌酐估算肾小球滤过率（eGFR），并根据常规指南将患者分配到特定的 CKD 分期。采用 ELISA 法测定血清内皮糖蛋白浓度，采用单变量和多变量回归分析 eGFR 或 CKD 分期与可溶性内皮糖蛋白浓度之间的关系。
共检测了 216 例患者的血清内皮糖蛋白，其中包括 118 例 3 期或更高 CKD 患者和 9 例终末期肾病（ESRD）患者。血清内皮糖蛋白浓度与 CKD 分期（CKD 每增加 1 期，内皮糖蛋白浓度增加 0.16ng/ml，P=0.09）或 eGFR（肾小球滤过率每增加 10ml/min/1.73m²，内皮糖蛋白浓度降低 0.06ng/ml，P=0.12）无显著差异，且 ESRD 患者的内皮糖蛋白浓度并不高于肾功能正常者（分别为 4.2±1.1 和 4.3±1.2ng/ml）。内皮糖蛋白浓度与尿白蛋白排泄量也无显著相关性。
肾功能与可溶性内皮糖蛋白的循环浓度无关。可溶性内皮糖蛋白浓度升高不太可能导致 CKD 进展或 CKD 患者易发生心血管疾病。
