Ekinci İskender, Buyukkaba Mitat, Cinar Ahmet, Tunc Muhammed, Cebeci Egemen, Gursu Meltem, Kazancioglu Rumeyza
Department of Internal Medicine, SBU Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, TUR.
Department of Internal Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR.
Cureus. 2021 Feb 25;13(2):e13561. doi: 10.7759/cureus.13561.
Introduction In this study, we aimed to determine the endothelial dysfunction (ED) and atherosclerosis in patients with autosomal dominant polycystic kidney disease (ADPKD). Materials and methods This study was conducted with 83 subjects (26 male, mean age: 46±11 years) consisted of three groups including ADPKD, hypertension (HT) and healthy control groups. The groups were evaluated in terms of serum endocan and asymmetric dimethylarginine (ADMA) levels, flow-mediated dilatation (FMD), nitroglycerin-mediated dilation (NMD) and carotid intima-media thickness (CIMT). Results Serum endocan and ADMA levels and CIMT were significantly higher while NMD was significantly lower in ADPKD group than control group. FMD and NMD were lower but serum ADMA level was higher in the ADPKD group than HT group; while serum endocan level and CIMT were not significantly different in ADPKD and HT groups. In ADPKD patients, CIMT value and serum endocan and ADMA levels were higher while NMD was lower in patients with eGFR≤60 mL/min/1.73 m than patients with eGFR>60 mL/min/1.73 m. Serum ADMA level was higher and NMD was lower in hypertensive ADPKD patients than non-hypertensive ones. Serum endocan level was higher in ADPKD patients with nephrolithiasis and a negative correlation was detected between serum endocan level and 24-hour urine volume. Conclusions Endothelial dysfunction and atherosclerosis are common conditions in ADPKD patients and it was further reinforced in our study. In order to clarify the relationship between serum endocan level and 24-hour urine volume, which is a remarkable finding in our study, larger studies that including the measurement of urine endocan may be useful.
引言 在本研究中,我们旨在确定常染色体显性多囊肾病(ADPKD)患者的内皮功能障碍(ED)和动脉粥样硬化情况。
材料与方法 本研究纳入了83名受试者(26名男性,平均年龄:46±11岁),分为三组,包括ADPKD组、高血压(HT)组和健康对照组。对各组进行血清内脂素和不对称二甲基精氨酸(ADMA)水平、血流介导的血管舒张功能(FMD)、硝酸甘油介导的血管舒张功能(NMD)以及颈动脉内膜中层厚度(CIMT)的评估。
结果 ADPKD组的血清内脂素和ADMA水平以及CIMT显著高于对照组,而NMD显著低于对照组。ADPKD组的FMD和NMD低于HT组,但血清ADMA水平高于HT组;ADPKD组和HT组的血清内脂素水平和CIMT无显著差异。在ADPKD患者中,估算肾小球滤过率(eGFR)≤60 mL/min/1.73 m²的患者CIMT值、血清内脂素和ADMA水平较高,而NMD较低。高血压ADPKD患者的血清ADMA水平较高,NMD较低。有肾结石的ADPKD患者血清内脂素水平较高,且血清内脂素水平与24小时尿量呈负相关。
结论 内皮功能障碍和动脉粥样硬化在ADPKD患者中较为常见,本研究进一步证实了这一点。为了阐明血清内脂素水平与24小时尿量之间的关系(这是本研究中的一个显著发现),纳入尿内脂素测量的更大规模研究可能会有所帮助。