Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
Department of Infection Control, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China.
J Clin Lab Anal. 2020 Aug;34(8):e23336. doi: 10.1002/jcla.23336. Epub 2020 Apr 16.
Chronic kidney disease (CKD) is associated with an increased cardiovascular disease (CVD) mortality risk. Elevation of cardiac biomarkers in patients with renal dysfunction is ambiguous in the diagnosis of CVD. The purpose of this study was to investigate the associations between estimated glomerular filtration rate (eGFR) and cardiac biomarkers, and the influence of renal dysfunction on the cardiac biomarkers.
We examined the cross-sectional associations of eGFR with cardiac troponin I (cTnI), creatine kinase (CK), CK-MB, lactic dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), and brain natriuretic peptide (BNP) in 812 adults and 215 child. Spearman correlation and logistic regression analysis were performed to evaluate the associations.
For adults, lower eGFR had significantly higher cTnI, CK-MB, LDH, HBDH, and BNP. There were negative correlations between eGFR and cTnI, CK-MB, LDH, HBDH, and BNP. After adjustment for potential confounders, as compared with eGFR ≥ 90 mL/min/1.73 m , eGFR < 60 mL/min/1.73 m remained associated with a 2.83 (1.08-7.41) [ratio (95% CI)] times higher cTnI and a 6.50 (2.32-18.22) [ratio (95% CI)] times higher HBDH. For child, lower eGFR had significant higher CK and CK-MB. There were negative correlations between eGFR and CK, and eGFR and CK-MB. After adjustment for potential confounders, as compared with eGFR ≥ 90 mL/min/1.73 m , eGFR < 90 mL/min/1.73 m revealed no significant higher CVD biomarkers.
Reduced eGFR is associated with elevated cTnI and HBDH among adults without clinically evident CVD, but not child.
慢性肾脏病（CKD）与心血管疾病（CVD）死亡率风险增加有关。肾功能障碍患者中心脏生物标志物的升高对 CVD 的诊断意义不明确。本研究旨在探讨估算肾小球滤过率（eGFR）与心脏生物标志物之间的关系，以及肾功能障碍对心脏生物标志物的影响。
我们检查了 812 名成年人和 215 名儿童的 eGFR 与心脏肌钙蛋白 I（cTnI）、肌酸激酶（CK）、CK-MB、乳酸脱氢酶（LDH）、羟丁酸脱氢酶（HBDH）和脑钠肽（BNP）的横断面相关性。采用 Spearman 相关和 logistic 回归分析评估相关性。
对于成年人，较低的 eGFR 与较高的 cTnI、CK-MB、LDH、HBDH 和 BNP 相关。eGFR 与 cTnI、CK-MB、LDH、HBDH 和 BNP 呈负相关。在调整潜在混杂因素后，与 eGFR≥90 mL/min/1.73 m 相比，eGFR＜60 mL/min/1.73 m 与 cTnI 升高 2.83（1.08-7.41）[比值（95%CI）]倍和 HBDH 升高 6.50（2.32-18.22）[比值（95%CI）]倍相关。对于儿童，较低的 eGFR 与较高的 CK 和 CK-MB 相关。eGFR 与 CK 和 eGFR 与 CK-MB 呈负相关。在调整潜在混杂因素后，与 eGFR≥90 mL/min/1.73 m 相比，eGFR＜90 mL/min/1.73 m 并未显示出较高的 CVD 生物标志物。
在没有临床明显 CVD 的成年人中，较低的 eGFR 与 cTnI 和 HBDH 升高有关，但在儿童中则不然。
