Department of Cardiology, Kagawa Prefectural Central Hospital, Kagawa, Japan.
Cardiovasc Diabetol. 2012 Mar 21;11:26. doi: 10.1186/1475-2840-11-26.
Chronic kidney disease (CKD) is associated with cardiovascular events. Adipocyte fatty acid-binding protein (A-FABP) plays an important role in atherosclerosis. We investigated whether plasma A-FABP is involved in renal function in patients with stable angina pectoris.
A total of 221 patients with significant coronary artery stenosis were enrolled after coronary angiography. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2. The severity of coronary stenosis was assessed using a modified Gensini score and coronary angiography. Serum A-FABP levels were determined by enzyme-linked immunosorbent assay.
Serum A-FABP levels were significantly correlated with both eGFR (r = -0.41, p < 0.01) and the severity of coronary artery stenosis (r = 0.16, p = 0.02), and these relationships remained significant after adjusting for confounding factors. The prevalence of CKD and multi-vessel disease was significantly higher among patients with serum A-FABP levels above the median value of 20.3 ng/ml than among patients with serum A-FABP levels below the median value (57% vs. 27%, p < 0.01 and 64% vs. 48%, p = 0.02, respectively). Multivariate analysis revealed that the presence of three-vessel disease in comparison with single-vessel disease was independently associated with the higher A-FABP (per doubling) (odds ratio; 2.26, 95% confidential interval; 1.28-3.98, p < 0.01) and tended to be associated with the lower eGFR (p = 0.06).
Serum A-FABP may have a significant role in the interplay between renal dysfunction and coronary atherosclerosis.
慢性肾脏病(CKD)与心血管事件有关。脂肪细胞脂肪酸结合蛋白(A-FABP)在动脉粥样硬化中发挥重要作用。我们研究了稳定型心绞痛患者的血浆 A-FABP 是否与肾功能有关。
冠状动脉造影后共纳入 221 例有明显冠状动脉狭窄的患者。CKD 的定义为估算肾小球滤过率(eGFR)<60ml/min/1.73m2。冠状动脉狭窄的严重程度采用改良 Gensini 评分和冠状动脉造影进行评估。通过酶联免疫吸附试验测定血清 A-FABP 水平。
血清 A-FABP 水平与 eGFR(r=-0.41,p<0.01)和冠状动脉狭窄严重程度(r=0.16,p=0.02)均呈显著相关,且在调整混杂因素后仍具有显著相关性。血清 A-FABP 水平高于中位数 20.3ng/ml 的患者 CKD 和多支血管疾病的患病率明显高于血清 A-FABP 水平低于中位数的患者(57%比 27%,p<0.01;64%比 48%,p=0.02)。多变量分析显示,与单支血管疾病相比,三支血管疾病的存在与较高的 A-FABP(每倍增)独立相关(优势比;2.26,95%置信区间;1.28-3.98,p<0.01),且与较低的 eGFR 呈正相关趋势(p=0.06)。
血清 A-FABP 可能在肾功能不全和冠状动脉粥样硬化之间的相互作用中发挥重要作用。