Education and Research Center of Clinical Pharmacy, Osaka University of Pharmaceutical Sciences, Osaka, Japan.
Iida Regional Public Health Center, Nagano, Japan.
J Clin Hypertens (Greenwich). 2020 Aug;22(8):1458-1465. doi: 10.1111/jch.13959. Epub 2020 Aug 9.
Hypertension and chronic kidney disease (CKD) are serious interrelated public health problems. Despite the monitoring and control of high blood pressure, symptoms of CKD are not usually apparent in its early stages. Previously, we reported the utility of urinary vanin-1 as an early biomarker of kidney injury in spontaneously hypertensive rats, but it remains unknown whether urinary vanin-1 is associated with CKD in humans. In this study, we estimated associations between urinary vanin-1 and parameters of kidney function in a cross-sectional study of hypertensive patients. We measured concentrations of vanin-1 using spot urine from 147 adult hypertensive patients (mean age, 72.8 years; 39.5% women). Patients were divided into 2 groups based on the median of the estimated glomerular filtration rate (eGFR). The group with eGFR < 60 mL/min per 1.73 m showed significantly higher levels of urinary vanin-1 than those with eGFR ≥ 60 mL/min per 1.73 m. On univariate analysis, urinary vanin-1 as well as neutrophil gelatinase-associated lipocalin (NGAL) showed significant negative correlations with eGFR; however, multivariate analysis revealed that urinary vanin-1, but not NGAL, significantly correlated with eGFR. In addition, urinary vanin-1 had a significant positive correlation with the urinary protein-to-creatinine ratio (UPCR) (r = 0.21; P = .021) and albumin-to-creatinine ratio (UACR) (r = 0.61; P < .01). In conclusion, urinary vanin-1 is associated with lower eGFR and higher UPCR and UACR, and might be a potential marker of decreased kidney function in hypertensive patients. Further studies are needed to confirm these findings.
高血压和慢性肾脏病（CKD）是严重的相互关联的公共卫生问题。尽管监测和控制血压，但 CKD 的症状在早期通常不明显。此前，我们报告了尿 vanin-1 作为自发性高血压大鼠肾脏损伤早期生物标志物的效用，但尚不清楚尿 vanin-1是否与人类 CKD 有关。在这项横断面研究中，我们评估了高血压患者尿 vanin-1与肾功能参数之间的关系。我们使用 147 名成年高血压患者的随机尿样测量了 vanin-1 的浓度（平均年龄 72.8 岁；39.5%为女性）。根据估算肾小球滤过率（eGFR）的中位数将患者分为 2 组。eGFR < 60 mL/min/1.73 m 组的尿 vanin-1 水平明显高于 eGFR ≥ 60 mL/min/1.73 m 组。单变量分析显示，尿 vanin-1 和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）与 eGFR 呈显著负相关；然而，多变量分析显示，尿 vanin-1 与 eGFR 显著相关，而 NGAL 则不相关。此外，尿 vanin-1 与尿蛋白与肌酐比值（UPCR）（r = 0.21；P =.021）和白蛋白与肌酐比值（UACR）（r = 0.61；P <.01）呈显著正相关。总之，尿 vanin-1 与较低的 eGFR 和较高的 UPCR 和 UACR 相关，可能是高血压患者肾功能下降的潜在标志物。需要进一步的研究来证实这些发现。
