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估算肾小球滤过率与新诊断的高血压患者的动脉僵硬度和 N 末端脑利钠肽前体均相关。

Estimated glomerular filtration rate is associated with both arterial stiffness and N-terminal pro-brain natriuretic peptide in newly diagnosed hypertensive patients.

机构信息

Department of Cardiology, Adana Numune Training and Research Hospital , Adana , Turkey and.

出版信息

Clin Exp Hypertens. 2014;36(6):374-9. doi: 10.3109/10641963.2013.827703. Epub 2014 Jan 16.

Abstract

Even a slight decrease in the glomerular filtration rate (GFR) is an independent risk factor for cardiovascular disease. Arterial stiffness, left ventricular hypertrophy and N-terminal pro-brain natriuretic peptide (NT-proBNP) are independent risk factors for cardiovascular disease, which are particularly common in end-stage renal disease. We aimed to evaluate the association between GFR with arterial stiffness, left ventricle mass (LVM) and NT-proBNP in hypertensive subjects with normal to mildly impaired renal function. The study population consisted of 285 newly diagnosed hypertensive patients (mean age; 49.9 ± 11.8 years). GFR was estimated (eGFR) by the Modification of Diet in Renal Disease formula. Pulse wave velocity (PWV) and augmentation index (AIx), which reflects arterial stiffness, were calculated using the single-point method via the Mobil-O-Graph® ARCsolver algorithm. LVM was obtained by echocardiography. Plasma NT-proBNP was measured by electrochemiluminescence. The patients were divided into two groups according to the median eGFR value (eGFRlow group <101 ml/min/1.73 m(2) and eGFRhigh group ≥ 101 ml/min/1.73 m(2)). LVM and NT-proBNP values were higher in eGFRlow group compared with eGFRhigh group (p<0.05). Pulse wave velocity and augmentation index values were higher in eGFRlow group compared with eGFRhigh group (p<0.05, for all). Multiple linear regression analysis showed that eGFR was independently associated with PWV (β=-0.422, p<0.001) and NT-proBNP (β=-0.404, p<0.001). Present study showed that eGFR was independently associated with PWV and NT-proBNP values. Importantly, these findings may explain, in part, the increase in cardiovascular risk in with slightly impaired renal function.

摘要

肾小球滤过率(GFR)的轻微下降也是心血管疾病的独立危险因素。动脉僵硬度、左心室肥厚和 N 端脑利钠肽前体(NT-proBNP)是心血管疾病的独立危险因素,在终末期肾病中尤为常见。我们旨在评估肾小球滤过率与动脉僵硬度、左心室质量(LVM)和高血压患者中 NT-proBNP 之间的关系,这些患者的肾功能正常至轻度受损。研究人群包括 285 名新诊断的高血压患者(平均年龄:49.9±11.8 岁)。通过肾脏病饮食改良公式(MDRD)估计肾小球滤过率(eGFR)。使用 Mobil-O-Graph® ARCsolver 算法的单点法计算脉搏波速度(PWV)和增强指数(AIx),这反映了动脉僵硬度。通过超声心动图获得 LVM。通过电化学发光法测量血浆 NT-proBNP。根据中位 eGFR 值(eGFRlow 组<101 ml/min/1.73 m²和 eGFRhigh 组≥101 ml/min/1.73 m²)将患者分为两组。与 eGFRhigh 组相比,eGFRlow 组的 LVM 和 NT-proBNP 值更高(p<0.05)。与 eGFRhigh 组相比,eGFRlow 组的 PWV 和 AIx 值更高(p<0.05,全部)。多元线性回归分析显示,eGFR 与 PWV(β=-0.422,p<0.001)和 NT-proBNP(β=-0.404,p<0.001)独立相关。本研究表明,eGFR 与 PWV 和 NT-proBNP 值独立相关。重要的是,这些发现部分解释了肾功能轻度受损患者心血管风险增加的原因。

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