Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Hypertens Res. 2014 May;37(5):472-7. doi: 10.1038/hr.2013.154. Epub 2013 Dec 5.
Recently, cardio-renal interactions have been considered to be important and it has been demonstrated that mild renal dysfunction is associated with left ventricular hypertrophy (LVH). However, the correlation between LVH and subclinical renal damage is unclear. We investigated this association by assessing pretransplant biopsies from living kidney donors with normal renal function. We retrospectively categorized 238 living kidney donors into tertiles according to the percentage of global glomerulosclerosis (%GGS) observed in pretransplant biopsies (low, 0-3.45% (n=80); moderate, 3.46-11.76% (n=78); high, ⩾11.77% (n=80)) to analyze trends in their left ventricular mass index (LVMI) measured by echocardiography and baseline factors. LVH was defined as LVMI >110 g m(-2) in female and >125 g m(-2) in male subjects. We used a logistic regression model to evaluate any correlations between %GGS and LVH. LVMI increased significantly with increasing tertiles of %GGS, as did the prevalence of left ventricular remodeling and LVH. According to multivariate logistic regression analysis, subjects with high %GGS tertiles had a sevenfold greater risk of LVH than did those with low tertiles, even after adjusting for age, sex, systolic blood pressure, history of diabetes mellitus, total serum cholesterol and glomerular filtration rate (GFR) measured by a radioisotopic technique. There is an association between GGS and LVH in subjects with normal renal function. This association is significant after adjustment for age, sex, blood pressure, GFR and other atherogenic factors.
最近,人们认为心肾交互作用很重要,并且已经证明轻度肾功能障碍与左心室肥厚(LVH)有关。然而,LVH 与亚临床肾脏损害之间的相关性尚不清楚。我们通过评估肾功能正常的活体肾供体的移植前活检来研究这种相关性。我们根据移植前活检中肾小球硬化的百分比(%GGS)将 238 名活体肾供体分为三分位数(低,0-3.45%(n=80);中,3.46-11.76%(n=78);高,≥11.77%(n=80)),以分析超声心动图测量的左心室质量指数(LVMI)和基线因素的趋势。LVH 定义为女性 LVMI >110 g/m2 和男性 LVMI >125 g/m2。我们使用逻辑回归模型来评估%GGS 与 LVH 之间的任何相关性。LVMI 随着%GGS 三分位数的增加而显著增加,左心室重构和 LVH 的患病率也随之增加。根据多变量逻辑回归分析,与低三分位数相比,高三分位数的患者发生 LVH 的风险高 7 倍,即使在调整年龄、性别、收缩压、糖尿病史、总血清胆固醇和放射性同位素技术测量的肾小球滤过率(GFR)后也是如此。在肾功能正常的患者中,GGS 与 LVH 之间存在关联。这种关联在调整年龄、性别、血压、GFR 和其他致动脉粥样硬化因素后仍然显著。