Department of Nephrology, Herlev Hospital, Herlev, Denmark.
Scand J Clin Lab Invest. 2012 Jul;72(4):304-12. doi: 10.3109/00365513.2012.682164. Epub 2012 May 6.
Arterial stiffness contributes to the increased cardiovascular risk in patients with chronic kidney disease (CKD). Reproducible and easily obtainable indices of arterial stiffness are needed in order to monitor therapeutic strategies. The ambulatory arterial stiffness index (AASI) has been proposed as such a marker. The present study investigated the day-to-day reproducibility of AASI in CKD stage 2-5 and its relationship with other markers of arterial stiffness as well as with kidney function.
Eighty-three patients (29% female, median age 62 years) were studied by 24 h ambulatory blood pressure monitoring (ABPM), aortic pulse wave velocity (aPWV), augmentation index (AIx) and estimated glomerular filtration rate (eGFR) at a median interval of 7 days. Individual AASIs were calculated from 24 h ABPMs as 1 minus the regression slope of diastolic blood pressure over systolic blood pressure.
Mean AASI, aPWV, AIx and 24 h pulse pressure (PP) were similar on repeated measurements. The intraclass correlation coefficients were between 72% and 78% for AASI calculated by three different methods, 87% for aPWV, 88% for AIx, and 96% for 24 h PP. The correlation coefficients between AASI and aPWV were from 0.48 to 0.53; with AIx it was between 0.19 and 0.34. After adjustment for covariates none of the arterial stiffness indices were significantly correlated to eGFR.
In patients with CKD stage 2-5 AASI had a moderate, but acceptable reproducibility. The correlation between AASI and aPWV was good whilst the correlation between AASI and AIx was considerably lower. There was no significant correlation between AASI and eGFR.
动脉僵硬是导致慢性肾脏病（CKD）患者心血管风险增加的因素。为了监测治疗策略，需要有可重复且易于获得的动脉僵硬指数。动态动脉僵硬指数（AASI）已被提出作为此类标志物。本研究旨在探讨 CKD 2-5 期患者 AASI 的日内可重复性及其与其他动脉僵硬标志物以及肾功能的关系。
对 83 例患者（29%为女性，中位年龄 62 岁）进行了 24 小时动态血压监测（ABPM）、主动脉脉搏波速度（aPWV）、增强指数（AIx）和估算肾小球滤过率（eGFR）检测，两次检测的时间间隔中位数为 7 天。通过 24 小时 ABPM 计算个体 AASI，方法为舒张压与收缩压回归斜率的倒数。
重复测量时，AASI、aPWV、AIx 和 24 小时脉压（PP）的平均值相似。AASI 计算的三种不同方法的组内相关系数为 72%至 78%，aPWV 为 87%，AIx 为 88%，24 小时 PP 为 96%。AASI 与 aPWV 之间的相关系数为 0.48 至 0.53；与 AIx 之间的相关系数为 0.19 至 0.34。在调整协变量后，没有一个动脉僵硬指数与 eGFR 有显著相关性。
在 CKD 2-5 期患者中，AASI 的重复性中等，但可接受。AASI 与 aPWV 之间的相关性良好，而 AASI 与 AIx 之间的相关性要低得多。AASI 与 eGFR 之间无显著相关性。
