Bahadoran Zahra, Mirmiran Parvin, Tahmasebi Nejad Zhale, Ghasemi Asghar, Azizi Fereidoun
a Nutrition and Endocrine Research Center , Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran ;
b Department of Clinical Nutrition and Diet Therapy, Faculty of Nutrition Sciences and Food Technology , National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences , Tehran , Iran ;
Scand J Clin Lab Invest. 2016 Jul;76(4):304-8. doi: 10.3109/00365513.2016.1149880. Epub 2016 Mar 9.
Background and aim This study was conducted to investigate the association between serum nitric oxide metabolites (NOx) and the risk of chronic kidney disease (CKD). Methods We recruited 3462 and 2504 participants of the Tehran Lipid and Glucose Study (TLGS), for a cross-sectional and prospective analysis, respectively. Serum NOx concentrations were measured at baseline (2006-2008), and demographics, anthropometrics and biochemical variables were evaluated at baseline and again after 3 years (2009-2011). Estimated glomerular filtration rate (eGFR) and CKD were defined. Association between serum NOx and CKD in the cross-sectional phase and the predictability of NOx in CKD occurrence were assessed using multivariable logistic regression models with adjustment for confounders. Results Mean age of participants was 45.0 ± 15.9 years at baseline and 40.5% were male. The prevalence of CKD was 17.9% (13.4% in men, 21.0% in women) at baseline, at which point, marginally significant odds of CKD in the highest tertile of serum NOx in men (OR = 1.53, 95% CI = 0.96-2.45, p for trend = 0.047) and a significant odds of CKD in women (OR = 2.48, 95% CI = 1.76-3.49, p for trend = 0.001) were observed. After a 3-year follow-up, in women, risk of CKD was higher in the highest compared to the lowest NOx tertiles (OR = 1.86, 95% CI = 1.10-3.14, p for trend = 0.032) but no significant association was observed in men. Conclusion Serum NOx level was found to be an independent predictor of CKD in women; it could be a valuable surrogate for prediction of renal dysfunction in women and help to identify high-risk subjects.
背景与目的 本研究旨在探讨血清一氧化氮代谢产物（NOx）与慢性肾脏病（CKD）风险之间的关联。方法 我们分别招募了德黑兰脂质与血糖研究（TLGS）的3462名和2504名参与者，进行横断面分析和前瞻性分析。在基线期（2006 - 2008年）测量血清NOx浓度，并在基线期以及3年后（2009 - 2011年）评估人口统计学、人体测量学和生化变量。定义估算肾小球滤过率（eGFR）和CKD。使用多变量逻辑回归模型并对混杂因素进行调整，评估横断面阶段血清NOx与CKD之间的关联以及NOx对CKD发生的预测能力。结果 参与者在基线期的平均年龄为45.0±15.9岁，男性占40.5%。基线期CKD的患病率为17.9%（男性为13.4%，女性为21.0%），此时，男性血清NOx最高三分位数组的CKD优势比边缘显著（OR = 1.53，95%CI = 0.96 - 2.45，趋势p值 = 0.047），女性的CKD优势比显著（OR = 2.48，95%CI = 1.76 - 3.49，趋势p值 = 0.001）。经过3年随访，在女性中，与最低NOx三分位数组相比，最高三分位数组的CKD风险更高（OR = 1.86，95%CI = 1.10 - 3.14，趋势p值 = 0.032），但在男性中未观察到显著关联。结论 在女性中，血清NOx水平被发现是CKD的独立预测因素；它可能是预测女性肾功能障碍的有价值替代指标，并有助于识别高危人群。
