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亲环素A与老年患者的外周动脉疾病和慢性肾脏病相关:天辽老人(TOP)研究

Cyclophilin A is associated with peripheral artery disease and chronic kidney disease in geriatrics: The Tianliao Old People (TOP) study.

作者信息

Liu Meng-Chuan, Lee Yen-Wei, Lee Po-Tseng, Chang Chin-Sung, Tai Yun-Lin, Yu Jia-Rong, Su Xiao-Ting, Hsu Ling-Wei, Lin Sheng-Hsiang, Wu Chi-Hsing, Liu Ping-Yen

机构信息

School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

1] Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan [2] Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Sci Rep. 2015 Apr 24;5:9937. doi: 10.1038/srep09937.

Abstract

Cyclophilin A (CyPA), secreted by vascular smooth muscle cells in response to oxidative stress, is important in the pathogenesis of progressive peripheral arterial occlusion disease (PAOD), which is common among chronic kidney disease. We explored the prevalence of PAOD in Taiwan's elderly (≥ 65 years old) population and its association with CyPA and renal function. Residents of Tianliao District, a rural community in southern Taiwan, were surveyed. An ankle-brachial index (ABI) < 0.91 was defined as PAOD. Chronic kidney disease (CKD) was defined based on eGFR levels < 60 mL/min/1.73 m(2). Serum CyPA was measured. Of the 473 participants, 68 (14.4%) had PAOD. Multiple logistic regression analysis showed PAOD was significantly associated with lower eGFR, lower BMI, higher glycated hemoglobin and higher pulse pressure. Serum CyPA levels in participants with PAOD were significantly higher than those with normal ABI values (47.3 ± 0.4 vs. 25.5 ± 0.2 ng/mL, p < 0.001). Moreover, eGFR inversely correlated with serum CyPA level (p < 0.05) in participants with CKD, but not in participants with normal renal function. In conclusion, with a prevalence of PAOD as high as 14.4% in an elderly community, CyPA might be the link between PAOD and advanced impaired renal function.

摘要

亲环素A(CyPA)由血管平滑肌细胞在氧化应激反应时分泌,在进行性外周动脉闭塞性疾病(PAOD)的发病机制中起重要作用,PAOD在慢性肾脏病中很常见。我们探讨了台湾老年(≥65岁)人群中PAOD的患病率及其与CyPA和肾功能的关系。对台湾南部一个农村社区田寮区的居民进行了调查。踝臂指数(ABI)<0.91被定义为PAOD。慢性肾脏病(CKD)根据估算肾小球滤过率(eGFR)水平<60 mL/min/1.73 m²来定义。检测血清CyPA。在473名参与者中,68名(14.4%)患有PAOD。多因素logistic回归分析显示,PAOD与较低的eGFR、较低的体重指数、较高的糖化血红蛋白和较高的脉压显著相关。PAOD参与者的血清CyPA水平显著高于ABI值正常者(47.3±0.4 vs. 25.5±0.2 ng/mL,p<0.001)。此外,在CKD参与者中,eGFR与血清CyPA水平呈负相关(p<0.05),而在肾功能正常的参与者中则无此相关性。总之,在一个老年社区中PAOD患病率高达14.4%,CyPA可能是PAOD与晚期肾功能损害之间的联系纽带。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6d2/4408976/8d224ed9486a/srep09937-f1.jpg

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