儿童特发性肾病综合征患者的同型半胱氨酸代谢。

Homocysteine metabolism in children with idiopathic nephrotic syndrome.

机构信息

Division of Pediatric Nephrology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research associated Dr. Ram Manohar Lohia Hospital, New Delhi, India.

出版信息

Clin Transl Sci. 2014 Apr;7(2):132-6. doi: 10.1111/cts.12145. Epub 2014 Jan 23.

DOI:10.1111/cts.12145

PMID:24456587

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5350952/

Abstract

BACKGROUND

Homocysteine metabolism is altered in children with idiopathic nephrotic syndrome. Hyperhomocysteinemia is a risk factor of early atherosclerosis and glomerulosclerosis and may occur at time of first occurrence of idiopathic nephrotic syndrome.

METHODS

Thirty children with first episode of idiopathic nephrotic syndrome (FENS) aged 1-16 years along with 30 age- and sex-matched healthy controls were enrolled in this study. Homocysteine and cysteine were measured with HPLC; vitamin B12 and folic acid were measured with electro-chemilumiscence immunoassay. Primary outcome measure was plasma homocysteine level in children with FENS and in controls. Secondary outcome measures were (1) plasma and urine homocysteine and cysteine levels in children with FENS at 12 weeks and 1 year (remission) and (2) plasma and urine levels of vitamin B12 and folic acid in children with FENS, at 12 weeks and 1 year (remission).

RESULTS

Plasma homocysteine and cysteine levels were comparable to controls in children with FENS, at 12 weeks and 1-year remission. Plasma levels of vitamin B12 and folic acid were significantly decreased compared to controls in FENS due to increased urinary excretion, which normalize during remission at 12 weeks and 1 year. Urinary homocysteine and cysteine levels were significantly raised in FENS compared to controls and continued to be raised even at 12-week and 1-year remission.

CONCLUSION

Homocysteine metabolism is deranged in children with FENS. Renal effects of long-term raised urinary homocysteine levels need to be studied.

摘要

背景

同型半胱氨酸代谢在特发性肾病综合征患儿中发生改变。高同型半胱氨酸血症是早发动脉粥样硬化和肾小球硬化的危险因素，可能在特发性肾病综合征首次发作时发生。

方法

本研究纳入 30 例年龄为 1-16 岁的特发性肾病综合征初发患儿（FENS）和 30 例年龄和性别匹配的健康对照者。采用 HPLC 测定同型半胱氨酸和半胱氨酸，采用电化学发光免疫分析法测定维生素 B12 和叶酸。主要观察指标为 FENS 患儿和对照组的血浆同型半胱氨酸水平。次要观察指标为（1）FENS 患儿在 12 周和 1 年（缓解期）时的血浆和尿液同型半胱氨酸和半胱氨酸水平；（2）FENS 患儿在 12 周和 1 年（缓解期）时的血浆和尿液维生素 B12 和叶酸水平。

结果

在 12 周和 1 年缓解期时，FENS 患儿的血浆同型半胱氨酸和半胱氨酸水平与对照组相似。由于尿排泄增加，FENS 患儿的血浆维生素 B12 和叶酸水平与对照组相比显著降低，在 12 周和 1 年缓解期时恢复正常。与对照组相比，FENS 患儿的尿液同型半胱氨酸和半胱氨酸水平显著升高，即使在 12 周和 1 年缓解期时仍持续升高。