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终末期肾病中白细胞介素-6与主动脉僵硬度的关联。

Association of interleukin-6 with aortic stiffness in end-stage renal disease.

作者信息

Desjardins Marie-Pier, Sidibé Aboubacar, Fortier Catherine, Mac-Way Fabrice, Marquis Karine, De Serres Sacha, Larivière Richard, Agharazii Mohsen

机构信息

CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Division of Nephrology, Faculty of Medicine, Université Laval, Québec City, Québec, Canada.

CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Division of Nephrology, Faculty of Medicine, Université Laval, Québec City, Québec, Canada.

出版信息

J Am Soc Hypertens. 2018 Jan;12(1):5-13. doi: 10.1016/j.jash.2017.09.013. Epub 2017 Oct 13.

Abstract

Cardiovascular disease (CVD) is the leading cause of mortality in patients with chronic kidney disease (CKD). Aortic stiffness, a nontraditional risk factor, is associated with high rate of mortality in CKD. Using a CKD animal model with medial vascular calcification, we previously reported increased mRNA expression of interleukin-6 (IL-6), tumor necrosis factor (TNF), and interleukin-1β (IL-1β) in calcified aorta. The aim of the study was to investigate the association between IL-6, TNF, IL-1β, and aortic stiffness in end-stage renal disease patients. In a cross-sectional study, we enrolled 351 patients on dialysis. Aortic stiffness was assessed by carotid-femoral pulse wave velocity (cf-PWV), while central pulse pressure and augmentation index were assessed using generalized transfer function applied to the radial artery pressure wave form. Plasma IL-6, TNF, and IL-1β were measured by enzyme-linked immunosorbent assay. IL-6 was associated with cf-PWV adjusted for mean blood pressure (MBP) (standardized β = 0.270; P < .001). In a multivariate adjusted model for age, diabetes, hypertension, CVD, and MBP, IL-6 was still associated with cf-PWV (standardized β = 0.096; P = .026). The impact of age, diabetes, and CVD on cf-PWV was partially mediated by IL-6 in a mediation analysis. However, there were no associations between TNF, IL-1β, and aortic stiffness. While IL-6 was associated with augmentation index (standardized β = 0.224; P < .001) and central pulse pressure (standardized β = 0.162; P = .001) when adjusted for MBP and heart rate, this relationship was not significant after adjusting for potential confounders.This study suggests a potential role of IL-6 for CKD-related aortic stiffness.

摘要

心血管疾病(CVD)是慢性肾脏病(CKD)患者死亡的主要原因。主动脉僵硬作为一种非传统风险因素,与CKD患者的高死亡率相关。我们之前利用一种伴有血管中层钙化的CKD动物模型,报道了钙化主动脉中白细胞介素-6(IL-6)、肿瘤坏死因子(TNF)和白细胞介素-1β(IL-1β)的mRNA表达增加。本研究的目的是调查终末期肾病患者中IL-6、TNF、IL-1β与主动脉僵硬之间的关联。在一项横断面研究中,我们纳入了351例接受透析的患者。通过颈股脉搏波速度(cf-PWV)评估主动脉僵硬程度,同时使用应用于桡动脉压力波形的广义传递函数评估中心脉压和增强指数。采用酶联免疫吸附测定法测量血浆IL-6、TNF和IL-1β。在校正平均血压(MBP)后,IL-6与cf-PWV相关(标准化β = 0.270;P <.001)。在针对年龄、糖尿病、高血压、CVD和MBP的多变量校正模型中,IL-6仍与cf-PWV相关(标准化β = 0.096;P = 0.026)。在一项中介分析中,年龄、糖尿病和CVD对cf-PWV的影响部分由IL-6介导。然而,TNF、IL-1β与主动脉僵硬之间无关联。在校正MBP和心率后,IL-6与增强指数(标准化β = 0.224;P <.001)和中心脉压(标准化β = 0.162;P = 0.001)相关,但在调整潜在混杂因素后,这种关系并不显著。本研究提示IL-6在CKD相关主动脉僵硬中可能发挥作用。

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