Wong Foo Nian, Tan Jin Ai Mary Anne, Keng Tee Chau, Ng Kok Peng, Chua Kek Heng, Kuppusamy Umah Rani
Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Clin Chim Acta. 2016 Jan 30;453:56-61. doi: 10.1016/j.cca.2015.12.002. Epub 2015 Dec 3.
This study aimed to investigate the relationship between soluble RAGE and estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease (CKD) after controlling for the potential confounding factors such as medication usage and enzymatic antioxidants.
A total of 222 CKD patients whose eGFR is less than 60ml/min/1.73m(2) and 111 non-CKD individuals were recruited. The study subjects were classified based on their diabetes status. The plasma glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities as well as plasma soluble RAGE level were measured.
The plasma GPx and SOD activities were significantly lower and the plasma soluble RAGE level was significantly higher in the CKD patients than in the non-CKD individuals, regardless of the diabetes status. Soluble RAGE was significantly correlated with eGFR in both diabetic CKD (D-CKD) and non-diabetic CKD (ND-CKD) patients. The association between soluble RAGE and eGFR remained largely unaffected by the confounding factors in D-CKD patients. However, the confounding effect of enzymatic antioxidants in the relationship between eGFR and soluble RAGE was observed in ND-CKD patients.
The increased plasma level of soluble RAGE is a better indicator of renal function decline in diabetic CKD patients instead of non-diabetic CKD patients.
本研究旨在探究在控制诸如药物使用和酶促抗氧化剂等潜在混杂因素后,慢性肾脏病(CKD)患者中可溶性晚期糖基化终末产物受体(RAGE)与估计肾小球滤过率(eGFR)之间的关系。
共招募了222例eGFR低于60ml/min/1.73m²的CKD患者和111例非CKD个体。研究对象根据糖尿病状态进行分类。测量血浆谷胱甘肽过氧化物酶(GPx)和超氧化物歧化酶(SOD)活性以及血浆可溶性RAGE水平。
无论糖尿病状态如何,CKD患者的血浆GPx和SOD活性均显著低于非CKD个体,而血浆可溶性RAGE水平则显著高于非CKD个体。可溶性RAGE在糖尿病CKD(D-CKD)和非糖尿病CKD(ND-CKD)患者中均与eGFR显著相关。在D-CKD患者中,可溶性RAGE与eGFR之间的关联在很大程度上不受混杂因素的影响。然而,在ND-CKD患者中观察到酶促抗氧化剂在eGFR与可溶性RAGE关系中的混杂作用。
血浆可溶性RAGE水平升高是糖尿病CKD患者而非非糖尿病CKD患者肾功能下降的更好指标。