Sabri Mohammad Reza, Tavana Esfandiar Najafi, Ahmadi Alireza, Gheissari Alaleh
Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Pediatrics, Isfahan Kidney Diseases Research Center, Isfahan Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2015 Dec 31;4:260. doi: 10.4103/2277-9175.172996. eCollection 2015.
It is well established that improvement of endothelial dysfunction (ED) could prevent or delay the occurrence of cardiovascular disease (CVD) and its related morbidity and mortality in patients with chronic kidney disease (CKD). In this study we investigated whether administration of vitamin C could be effective by improving brachial artery flow-mediated dilation (FMD) and intima media thickness (IMT), two surrogate markers of ED, in children with CKD or chronic renal failure (CRF).
In this analytic-experimental study children aged 3-18 years with a diagnosis of CRF and a group of healthy children were enrolled. Vitamin C (250 mg/day) administrated for the two studied groups for 1 month. Endothelial function was evaluated by FMD and IMT measurement using vascular Doppler ultrasonography, before and after trial.
In this study 18 patients with CRF and 19 normal children as the control group were studied. At baseline mean of IMT and FMD was not different in the two studied groups (P > 0.05). After vitamin C administration IMT decreased significantly in the two studied groups (P < 0.05). FMD increased in the two studied groups but the difference was significant in the control group (P < 0.05).
The findings of this interventional trial have demonstrated that vitamin C could have protective effect on ED of patients with CRF possibly in those with severe form of the disease but for obtaining more conclusive results larger sample size is needed.
众所周知,改善内皮功能障碍(ED)可预防或延缓慢性肾脏病(CKD)患者心血管疾病(CVD)的发生及其相关发病率和死亡率。在本研究中,我们调查了给予维生素C是否能通过改善肱动脉血流介导的血管舒张(FMD)和内膜中层厚度(IMT)(ED的两个替代指标)来对CKD或慢性肾衰竭(CRF)儿童产生效果。
在这项分析性实验研究中,纳入了3至18岁诊断为CRF的儿童以及一组健康儿童。两个研究组均给予维生素C(250毫克/天),持续1个月。在试验前后,使用血管多普勒超声通过测量FMD和IMT来评估内皮功能。
本研究纳入了18例CRF患者和19名正常儿童作为对照组。在基线时,两个研究组的IMT和FMD平均值无差异(P>0.05)。给予维生素C后,两个研究组的IMT均显著降低(P<0.05)。两个研究组的FMD均有所增加,但对照组的差异具有统计学意义(P<0.05)。
这项干预试验的结果表明,维生素C可能对CRF患者的ED具有保护作用,可能对病情严重的患者效果更明显,但为了获得更确凿的结果,需要更大的样本量。