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老年心力衰竭住院患者视黄醇结合蛋白 4、N 端脑利钠肽前体与肾功能的血浆水平。

Plasma Level of Retinol-Binding Protein 4, N-Terminal proBNP and Renal Function in Older Patients Hospitalized for Heart Failure.

机构信息

Pathophysiology Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.

Department of Cardiology, District Hospital in Zakopane, Zakopane, Poland.

出版信息

Cardiorenal Med. 2018;8(3):237-248. doi: 10.1159/000489403. Epub 2018 Jul 4.

Abstract

BACKGROUND/AIM: Elevated plasma concentration of retinol-binding protein 4 (RBP4) has recently emerged as a potential new risk factor for cardiovascular diseases, including hypertension (HT) and coronary artery disease (CAD). Limited data suggest that RBP4 promotes inflammatory damage to cardiomyocytes and participates in the development of heart failure (HF). This study aimed to analyze the relationship between concentrations of plasma RBP4 and serum N-terminal proBNP (NT-proBNP), a powerful biomarker of left ventricle dysfunction, in the older Polish population.

METHODS

The study sample consisted of 2,826 (1,487 men) participants of the PolSenior study, aged 65 years and older, including a subgroup hospitalized for HF (n = 282). In all subjects, plasma concentrations of RBP4, interleukin-6 (IL-6), serum level of NT-proBNP, and hs-CRP were measured. Additionally, BMI, estimated glomerular filtration rate (eGFR), and HOMA-IR were calculated. The prevalence of HT, CAD, atrial fibrillation (AF), and medication were considered as potential confounders.

RESULTS

Similar RBP4 levels were found in subjects with NT-proBNP < 125 and ≥125 ng/mL, with and without AF, and in the subgroups hospitalized for HF with and without AF. Regression analysis revealed no association between log10(NT-proBNP) and log10(RBP4). Plasma levels of RBP4 were increased by HT occurrence and diuretic therapy, while diminished with regard to female gender, age, eGFR values, AF, and IL-6 levels.

CONCLUSION

Our results show that RBP4 is affected by GFR but cannot be considered as an independent biomarker of heart muscle dysfunction.

摘要

背景/目的:最近,血浆视黄醇结合蛋白 4(RBP4)浓度升高已成为心血管疾病(包括高血压(HT)和冠状动脉疾病(CAD))的一个潜在新危险因素。有限的数据表明,RBP4 促进心肌细胞的炎症损伤,并参与心力衰竭(HF)的发展。本研究旨在分析波兰老年人群血浆 RBP4 浓度与血清 N 末端脑钠肽前体(NT-proBNP)之间的关系,后者是左心室功能障碍的有力生物标志物。

方法

该研究样本包括 2826 名(1487 名男性)年龄在 65 岁及以上的 PolSenior 研究参与者,包括因 HF 住院的亚组(n=282)。在所有受试者中,测量了血浆 RBP4、白细胞介素 6(IL-6)、血清 NT-proBNP 水平和 hs-CRP。此外,还计算了 BMI、估计肾小球滤过率(eGFR)和 HOMA-IR。HT、CAD、心房颤动(AF)和药物治疗的患病率被认为是潜在的混杂因素。

结果

在 NT-proBNP<125 和≥125ng/mL、有或无 AF 以及有或无 AF 住院的 HF 亚组中,发现 RBP4 水平相似。回归分析显示 log10(NT-proBNP)与 log10(RBP4)之间没有关联。RBP4 血浆水平随着 HT 发生和利尿剂治疗而增加,而随着女性性别、年龄、eGFR 值、AF 和 IL-6 水平降低而降低。

结论

我们的结果表明,RBP4 受 GFR 影响,但不能被视为心肌功能障碍的独立生物标志物。

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