Pawlak Krystyna, Mysliwiec Michal, Pawlak Dariusz
Department of Monitored Pharmacotherapy, Bialystok, Poland.
Department of Nephrology and Clinical Transplantation, Bialystok, Poland.
Clin Biochem. 2015 Apr;48(6):425-30. doi: 10.1016/j.clinbiochem.2015.01.006. Epub 2015 Jan 22.
Endocan is a new marker of endothelial cell activation that mediates adhesion of leukocytes into endothelium. Soluble intercellular (sICAM-1) and vascular cellular (sVCAM-1) adhesion molecules play an important role in the prevalence of cardiovascular disease (CVD) in chronic kidney disease (CKD) patients. The aim of this study is to investigate whether endocan could affect the concentrations of sICAM-1 and sVCAM-1 in CKD patients, particularly in those with CVD.
We evaluated plasma endocan, sICAM-1, sVCAM-1 and the markers of inflammation: high sensitivity C-reactive protein (hs CRP), interleukin-6, tumor necrosis factor-α (TNF-α) and their interrelationships in 53 CKD patients (both with and without CVD) and 29 healthy controls.
Endocan, sICAM-1, sVCAM-1 and inflammatory markers were significantly higher in CKD patients than in controls, and patients with CVD had levels significantly higher (except interleukin-6 and TNF-α) than those without CVD. The presence of CVD, ferritin, TNF-α and SBP were the independent predictors of endocan levels in the whole CKD group. In this group, the weak relationship was between endocan and sICAM-1 and sVCAM-1, but age was the only independent predictor of these adhesion molecules. The strong association between endocan and sICAM-1 and sVCAM-1 was exclusively observed in subgroup with CVD, and the low % of lymphocytes followed by increased endocan was identified as the independent variables significantly associated with these soluble molecule levels.
This study shows that plasma endocan is significantly increased and independently associated with sICAM-1 and sVCAM-1 levels in CKD patients with cardiovascular complications.
内皮糖蛋白是内皮细胞活化的一种新标志物，可介导白细胞黏附于内皮。可溶性细胞间黏附分子-1（sICAM-1）和血管细胞黏附分子（sVCAM-1）在慢性肾脏病（CKD）患者心血管疾病（CVD）的发生中起重要作用。本研究旨在探讨内皮糖蛋白是否会影响CKD患者，尤其是合并CVD患者的sICAM-1和sVCAM-1浓度。
我们评估了53例CKD患者（包括合并和未合并CVD者）及29例健康对照者的血浆内皮糖蛋白、sICAM-1、sVCAM-1以及炎症标志物：高敏C反应蛋白（hs CRP）、白细胞介素-6、肿瘤坏死因子-α（TNF-α）及其相互关系。
CKD患者的内皮糖蛋白、sICAM-1、sVCAM-1和炎症标志物显著高于对照组，合并CVD的患者（白细胞介素-6和TNF-α除外）的水平显著高于未合并CVD者。CVD的存在、铁蛋白、TNF-α和收缩压是整个CKD组内皮糖蛋白水平的独立预测因素。在该组中，内皮糖蛋白与sICAM-1和sVCAM-1之间存在弱相关性，但年龄是这些黏附分子的唯一独立预测因素。仅在合并CVD的亚组中观察到内皮糖蛋白与sICAM-1和sVCAM-1之间存在强相关性，淋巴细胞比例降低后内皮糖蛋白升高被确定为与这些可溶性分子水平显著相关的独立变量。
本研究表明，在合并心血管并发症的CKD患者中，血浆内皮糖蛋白显著升高，且与sICAM-1和sVCAM-1水平独立相关。
