Institute of Medical Sciences, Jan Kochanowski University in Kielce, Al. IX Wieków Kielc 19A, 25-317, Kielce, Poland.
Department of Family Medicine, Medical University of Lublin, Lublin, Poland.
BMC Nephrol. 2018 Dec 17;19(1):359. doi: 10.1186/s12882-018-1157-1.
Decreased heat shock protein 27 (HSP27) participates in many processes that are involved in cardiovascular (CV) disease. The objective of the study was to evaluate if HSP27 level was predictive of mortality as well as to evaluate factors associated with HSP27 level in a group of patients treated with HD.
Enrolled to the study were 202 HD patients. Clinical data, biochemical, echocardiographic, and carotid atherosclerosis parameters were evaluated. Patients were splited into groups on the basis of the cut-off lower and higher 50th percentile of serum HSP27 levels, and were followed-up for 28.68 ± 6.12 months.
No significant difference was observed between serum HSP27 levels in patients and controls. Low HSP27 patients were older, had higher left ventricular mass index, lower ejection fraction, higher prevalence of diabetes, myocardial infarction and carotid atherosclerosis, higher C-reactive protein level, and worse oxidant/antioxidant status. The multiple regression analysis identified that HSP27 levels were independently, negatively associated with serum oxidized LDL and the number of carotid plaques. Using the Kaplan-Meier analysis it was shown that the cumulative incidences of both CV and sudden cardiac death (SCD) mortality were higher in low HSP27 group in comparison with high serum HSP27 group. A multivariate Cox analysis showed that HSP27 level is an independent and strong predictor of CV as well as SCD mortality.
Low serum HSP27 level is independently associated with both CV and SCD mortality but not with all-cause mortality. Low serum HSP27 level is associated with carotid atherosclerosis and oxidative stress.
热休克蛋白 27（HSP27）水平降低与心血管疾病的许多过程有关。本研究旨在评估 HSP27 水平是否可预测死亡率，并评估一组接受 HD 治疗的患者中与 HSP27 水平相关的因素。
研究纳入了 202 名 HD 患者。评估了临床数据、生化、超声心动图和颈动脉粥样硬化参数。根据 HSP27 血清水平的下 50%和上 50%的截断值将患者分为两组，并进行了 28.68±6.12 个月的随访。
患者和对照组之间的血清 HSP27 水平无显著差异。低 HSP27 患者年龄较大，左心室质量指数较高，射血分数较低，糖尿病、心肌梗死和颈动脉粥样硬化的患病率较高，C 反应蛋白水平较高，氧化/抗氧化状态较差。多元回归分析表明，HSP27 水平与血清氧化型 LDL 和颈动脉斑块数量呈独立、负相关。Kaplan-Meier 分析表明，与高血清 HSP27 组相比，低 HSP27 组的心血管和心源性猝死（SCD）死亡率的累积发生率更高。多变量 Cox 分析表明，HSP27 水平是心血管和 SCD 死亡率的独立且强有力的预测因子。
低血清 HSP27 水平与心血管和 SCD 死亡率独立相关，但与全因死亡率无关。低血清 HSP27 水平与颈动脉粥样硬化和氧化应激有关。
