Abdel-Salam Manal, Ibrahim Soheir, Pessar Shaimaa Abdelmalik, Al-Morsy Eman
Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Saudi J Kidney Dis Transpl. 2017 May-Jun;28(3):483-490. doi: 10.4103/1319-2442.206442.
Hyperhomocysteinemia has attracted a lot of attention in renal patients, not only because of its close relationship with renal function but also because it has been implicated as an independent cardiovascular risk factor in these patients. An increased level of C-reactive protein (CRP) has been reported to be a strong predictor of cardiovascular mortality in hemodialysis (HD) patients. The aim of this study was to assess the association between homocysteine (Hcy) and highly sensitive CRP (hsCRP) in cardiovascular risk prediction in children with chronic kidney disease (CKD) on HD. This case-control study was conducted on 40 children with CKD on regular HD and 20 age- and sex-matched healthy children as controls. Their ages ranged from 4 to 18 years, and they were selected from the pediatric nephrology and HD unit at Al-Azhar University Hospital, during the period from May 2015 to April 2016. Complete blood count, serum ferritin, cholesterol, triglycerides, calcium, phosphorus, parathormone (PTH), Hcy, and hsCRP levels were measured in both groups. Measurements of anthropometry and blood pressure (BP) were performed. There was a significant increase in serum Hcy levels in cases than controls; it was 17.22 ± 9.66 pmol/L and 6.32 ± 1.47 pmol/L, respectively (P <0.01). Furthermore, there was a significant increase in hsCRP in patients than controls; 2.73 ± 2.65 and 0.9 ± 0.85, respectively (P <0.01). There was a significant positive correlation between hsCRP and Hcy with BP, cholesterol, triglyceride, PTH, and ferritin levels. Our data highlighted the important correlation between serum Hcy and hsCRP to detect high-risk patients for subsequent cardiovascular disease and utility of preventive strategies that attenuate inflammatory risk.
高同型半胱氨酸血症在肾病患者中已引起广泛关注，这不仅是因为它与肾功能密切相关，还因为它被认为是这些患者独立的心血管危险因素。据报道，血液透析（HD）患者中C反应蛋白（CRP）水平升高是心血管死亡率的有力预测指标。本研究的目的是评估慢性肾脏病（CKD）行HD治疗的儿童在心血管风险预测中同型半胱氨酸（Hcy）与超敏CRP（hsCRP）之间的关联。本病例对照研究选取了40例接受规律HD治疗的CKD儿童以及20例年龄和性别匹配的健康儿童作为对照。他们的年龄在4至18岁之间，于2015年5月至2016年4月期间从爱资哈尔大学医院儿科肾脏病和HD科室选取。两组均检测了全血细胞计数、血清铁蛋白、胆固醇、甘油三酯、钙、磷、甲状旁腺激素（PTH）、Hcy和hsCRP水平。进行了人体测量和血压（BP）测量。病例组血清Hcy水平显著高于对照组；分别为17.22±9.66 pmol/L和6.32±1.47 pmol/L（P<0.01）。此外，患者的hsCRP也显著高于对照组；分别为2.73±2.65和0.9±0.85（P<0.01）。hsCRP与Hcy与BP、胆固醇、甘油三酯、PTH和铁蛋白水平之间存在显著正相关。我们的数据突出了血清Hcy与hsCRP之间的重要关联，有助于检测后续心血管疾病的高危患者以及实施减轻炎症风险的预防策略。
