Paripović Aleksandra, Stajić Nataša, Putnik Jovana, Gazikalović Ana, Bogdanović Radovan, Vladislav Vukomanović
Nephrology department, Institute for Mother and Child Health, Radoja Dakića 4, 11070 New Belgrade, Serbia.
Nephrology department, Institute for Mother and Child Health, Radoja Dakića 4, 11070 New Belgrade, Serbia; School of medicine, University of Belgrade, Belgrade, Serbia.
Nephrol Ther. 2020 Dec;16(7):420-423. doi: 10.1016/j.nephro.2020.09.004. Epub 2020 Nov 6.
Aim of the study was to determine if carotid intima media thickness in children with idiopathic nephrotic syndrome is greater than in healthy subjects, and to assess whether carotid intima media thickness in children with nephrotic syndrome is associated with clinical (including disease duration, cumulative dose of steroids, number of relapses) and biochemical parameters.
A cross-sectional study included 40 patients with nephrotic syndrome (mean age 11.7±4.7 years). Steroid dependent nephrotic syndrome was established in 32 patients (80%), while 8 (20%) had steroid resistant nephrotic syndrome. Control group consisted of 20 age and gender matched healthy children. Blood pressure based on 24-h ambulatory blood pressure monitoring (ABPM), carotid intima media thickness, fasting glucose, insulin, HbA1c, lipid concentrations were measured in all children.
A significant difference was detected in carotid intima media thickness values (P=0.036). Children with nephrotic syndrome had significantly greater carotid intima media thickness compared with healthy children (0.42±0.06 and 0.38±0.03mm). Carotid intima-media thickness was positively associated with duration of nephrotic syndrome (r=0.45; P=0.004), body mass index (r=0.48; P=0.002), daytime systolic blood pressure (r=0.46; P=0.003) and night-time systolic blood pressure (r=0.52; P=0.001). Multiple linear regression showed that duration of nephrotic syndrome was the only independent predictor of carotid intima media thickness in children with nephrotic syndrome (R=0.244; β=0.327; P=0.037).
The findings of the present study suggest subclinical vascular damage in patients with nephrotic syndrome. Duration of nephrotic syndrome was the only independent predictor of carotid intima media thickness.
本研究旨在确定特发性肾病综合征患儿的颈动脉内膜中层厚度是否大于健康受试者，并评估肾病综合征患儿的颈动脉内膜中层厚度是否与临床（包括病程、类固醇累积剂量、复发次数）和生化参数相关。
一项横断面研究纳入了40例肾病综合征患者（平均年龄11.7±4.7岁）。32例患者（80%）为激素依赖型肾病综合征，8例（20%）为激素抵抗型肾病综合征。对照组由20名年龄和性别匹配的健康儿童组成。对所有儿童进行基于24小时动态血压监测（ABPM）的血压、颈动脉内膜中层厚度、空腹血糖、胰岛素、糖化血红蛋白、血脂浓度的测量。
颈动脉内膜中层厚度值存在显著差异（P=0.036）。与健康儿童相比，肾病综合征患儿的颈动脉内膜中层厚度显著更大（分别为0.42±0.06和0.38±0.03mm）。颈动脉内膜中层厚度与肾病综合征病程（r=0.45；P=0.004）、体重指数（r=0.48；P=0.002）、日间收缩压（r=0.46；P=0.003）和夜间收缩压（r=0.52；P=0.001）呈正相关。多元线性回归显示，肾病综合征病程是肾病综合征患儿颈动脉内膜中层厚度的唯一独立预测因素（R=0.244；β=0.327；P=0.037）。
本研究结果提示肾病综合征患者存在亚临床血管损伤。肾病综合征病程是颈动脉内膜中层厚度的唯一独立预测因素。
