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血液透析患者中可溶性CXC配体16与心脏损伤标志物的相互作用

Interaction of Soluble CXC Ligand 16 and Cardiac Injury Markers in Hemodialysis Patients.

作者信息

Liu Wenjin, Wang Lulu, Wei Yongyue, Li Xiurong, Gao Chaoqing, Zhou Jianmei, Wang Liang, Sun Zhuxing, Chu Hong, Bai Youwei, Yang Junwei

机构信息

Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Am J Nephrol. 2017;46(1):64-70. doi: 10.1159/000478031. Epub 2017 Jun 21.

Abstract

BACKGROUND

Recent data suggest that there is a pathogenic role for CXC ligand 16 (CXCL16) in cardiovascular diseases. Little is known about circulating CXCL16 in patients with kidney dysfunction. We explored the relationships of plasma CXCL16 with cardiac injury markers in a group of dialysis patients.

METHODS

Plasma CXCL16 and C-reactive protein (CRP) were measured in 366 patients who were on maintenance hemodialysis. Cardiac injury was evaluated via measurements of the circulating B-type natriuretic peptide (BNP), N-terminal prohormone of brain natriuretic peptide (NT proBNP), Troponin I (TnI), and Troponin T (TnT). Sixty healthy subjects who were frequency matched with the patients on the basis of age and gender were recruited as healthy controls.

RESULTS

The mean age of the patients was 52.5 ± 12.1 years and 56.3% were male. Circulating CXCL16 was significantly higher in the patients than in the controls (patients vs.

CONTROLS

477.3 (367.0-647.1) pg/mL vs. 229.5 (203.8-254.5) pg/mL; p < 0.001). The log-transformed (log-) CXCL16 level was correlated with all 4 cardiac markers (log-BNP, log-NTproBNP, log-TnI, and log-TnT) with high levels of significance (all p < 0.001), even after extensive controls for the covariates. In contrast, CRP was correlated only with BNP (marginally) and NT proBNP and was not correlated with troponins.

CONCLUSION

We showed, for the first time, highly significant relationships of circulating CXCL16 level with cardiac injury markers in dialysis patients. Our data suggest that circulating CXCL16 is possibly involved in the pathological process of cardiovascular damage in dialysis patients and may serve as a therapeutic target for cardiac protection in these patients.

摘要

背景

近期数据表明,CXC配体16(CXCL16)在心血管疾病中具有致病作用。关于肾功能不全患者循环CXCL16的情况知之甚少。我们在一组透析患者中探讨了血浆CXCL16与心脏损伤标志物之间的关系。

方法

对366例维持性血液透析患者测定血浆CXCL16和C反应蛋白(CRP)。通过检测循环B型利钠肽(BNP)、脑钠肽N端前体(NT proBNP)、肌钙蛋白I(TnI)和肌钙蛋白T(TnT)评估心脏损伤。招募60名在年龄和性别上与患者频率匹配的健康受试者作为健康对照。

结果

患者的平均年龄为52.5±12.1岁,56.3%为男性。患者的循环CXCL16显著高于对照组(患者与对照组:477.3(367.0 - 647.1)pg/mL对229.5(203.8 - 254.5)pg/mL;p < 0.001)。即使在对协变量进行广泛控制后,对数转换(log-)的CXCL16水平与所有4种心脏标志物(log-BNP、log-NTproBNP、log-TnI和log-TnT)仍具有高度显著的相关性(所有p < 0.001)。相比之下,CRP仅与BNP(微弱)和NT proBNP相关,与肌钙蛋白无关。

结论

我们首次表明,透析患者循环CXCL16水平与心脏损伤标志物之间存在高度显著的关系。我们的数据表明,循环CXCL16可能参与透析患者心血管损伤的病理过程,并可能成为这些患者心脏保护的治疗靶点。

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