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吸烟减轻高血压患者肾功能恶化可能是由同型半胱氨酸升高介导的。

Cigarette smoking reduced renal function deterioration in hypertensive patients may be mediated by elevated homocysteine.

作者信息

Huang Feifei, Chen Jie, Liu Xun, Han Feng, Cai Qingqing, Peng Guicheng, Zhang Kun, Chen Weiqing, Wang Jingfeng, Huang Hui

机构信息

Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.

Laboratory of RNA and Major Diseases of Brain and Heart, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.

出版信息

Oncotarget. 2016 Dec 27;7(52):86000-86010. doi: 10.18632/oncotarget.13308.

Abstract

Elevated homocysteine (HCY) and smoking are both important risk factors for hypertensive patients. However, whether they have crossing effect on renal function deterioration of hypertensive patients and what is the underlying mechanism are unclear. In the present study, 3033 participants diagnosed as essential hypertension with estimated glomerular filtration rate (eGFR)> 30 ml/min/1.73 m2 from southern China were enrolled in this cross-sectional study. We collected the demographic and clinical data. In addition, the mediation effects were analyzed. The results showed that, comparing with non-smokers, smokers had significant higher levels of HCY (13.10 (11.20-16.87) vs. 11.00 (8.90-13.40) umol/L, P < 0.001) and lower eGFR (79.71 (66.83-91.05) vs. 82.89 (69.80-95.85) ml/min/1.73m2, P < 0.001). HCY levels and smoking were independently associated with decreased eGFR. Meanwhile, eGFR levels were significantly negatively correlated with HCY (P < 0.001), and this correlation might be stronger in current smokers. Current smoker consuming over 20 cigarettes per day would accelerate early renal function deterioration (OR = 1.859, P = 0.019). The mediation effects analysis further showed that the association between smoking and renal function deterioration was mediated by HCY. And elevated HCY was accounted for 56.94% of the estimated causal effect of smoking on renal function deterioration in hypertensive patients. Our findings indicated that cigarette smoking was associated with renal function deterioration in hypertensive patients, and the association between cigarette smoking and renal function deterioration was probably mediated by elevated HCY. Therefore, HCY-lowering therapy may be beneficial for renal function deterioration in hypertensive smoking patients.

摘要

同型半胱氨酸(HCY)升高和吸烟都是高血压患者的重要危险因素。然而,它们对高血压患者肾功能恶化是否具有交叉影响以及潜在机制尚不清楚。在本研究中,来自中国南方的3033名被诊断为原发性高血压且估算肾小球滤过率(eGFR)>30 ml/min/1.73 m²的参与者被纳入这项横断面研究。我们收集了人口统计学和临床数据。此外,还分析了中介效应。结果显示,与不吸烟者相比,吸烟者的HCY水平显著更高(13.10(11.20 - 16.87)对11.00(8.90 - 13.40)μmol/L,P < 0.001),而eGFR更低(79.71(66.83 - 91.05)对82.89(69.80 - 95.85)ml/min/1.73m²,P < 0.001)。HCY水平和吸烟与eGFR降低独立相关。同时,eGFR水平与HCY显著负相关(P < 0.001),并且这种相关性在当前吸烟者中可能更强。每天吸烟超过20支的当前吸烟者会加速早期肾功能恶化(OR = 1.859,P = 0.019)。中介效应分析进一步表明,吸烟与肾功能恶化之间的关联是由HCY介导的。升高的HCY占高血压患者吸烟对肾功能恶化估计因果效应的56.94%。我们的研究结果表明,吸烟与高血压患者的肾功能恶化相关,吸烟与肾功能恶化之间的关联可能由升高的HCY介导。因此,降低HCY治疗可能有益于高血压吸烟患者的肾功能恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7a4/5349892/71f0f5fe74dc/oncotarget-07-86000-g001.jpg

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