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移植后亚临床心血管器官损害的性别差异:单中心队列研究。

Sex Differences in Subclinical Cardiovascular Organ Damage After Renal Transplantation: A Single-Center Cohort Study.

机构信息

Department of Pediatric Kidney, Liver and Metabolic Diseases, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany.

Department of Nephrology and Hypertension, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany.

出版信息

J Womens Health (Larchmt). 2021 Sep;30(9):1352-1361. doi: 10.1089/jwh.2020.8594. Epub 2020 Nov 18.

Abstract

Cardiovascular disease (CVD) is the leading cause of death after renal transplantation (RT). Sex-specific differences in CVD in the general population are well known. The aim of this study was to evaluate sex-specific differences in prevalence and course of subclinical cardiovascular (CV) organ damage in RT recipients during the first year after RT. In a prospective longitudinal study, we enrolled 121 patients (male 64%, age 51 ± 15 years). CV risk factors, left ventricular mass index (LVMI), and pulse wave velocity (PWV) were assessed at time of RT and 1 year later. Women showed less prediagnosed CVD and better blood pressure (BP) control, and were less likely to be treated with calcium channel blockers (CCBs). Despite similar transplant function, LVMI increased in women and decreased in men ( = 0.027). In multivariable analysis, changes in LVMI were independently associated with female sex and systolic BP. Importantly, women receiving CCBs showed a decrease in LVMI and PWV. Our findings indicate a sex-specific association between RT and changes in LVMI. CCBs seem to have a positive impact on CV risk after RT, especially in women. Further studies on the effect of sex and CCB use in RT recipients are warranted.

摘要

心血管疾病(CVD)是肾移植(RT)后的主要死亡原因。在普通人群中,CVD 的性别特异性差异是众所周知的。本研究旨在评估 RT 后 1 年内,RT 受者亚临床心血管(CV)器官损伤的患病率和病程是否存在性别差异。在一项前瞻性纵向研究中,我们纳入了 121 名患者(男性占 64%,年龄 51±15 岁)。在 RT 时和 1 年后评估 CV 危险因素、左心室质量指数(LVMI)和脉搏波速度(PWV)。女性表现出较少的预先诊断的 CVD 和更好的血压(BP)控制,并且不太可能使用钙通道阻滞剂(CCB)治疗。尽管移植功能相似,但女性的 LVMI 增加,男性的 LVMI 减少( = 0.027)。多变量分析显示,LVMI 的变化与女性性别和收缩压独立相关。重要的是,接受 CCB 治疗的女性 LVMI 和 PWV 下降。我们的研究结果表明,RT 与 LVMI 的变化之间存在性别特异性关联。CCB 似乎对 RT 后的 CV 风险有积极影响,尤其是在女性中。有必要进一步研究 RT 受者中性别和 CCB 使用的影响。

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