Department of Nephrology, Blood Purification Center, Zhongshan City People's Hospital, Zhongshan 528403, China.
Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou 510080, China.
Exp Gerontol. 2022 Jun 15;163:111805. doi: 10.1016/j.exger.2022.111805. Epub 2022 Apr 8.
Chronic Kidney Disease (CKD) is independently associated with increased cardiovascular disease (CVD) risk. The aim of this study was to investigate the potential roles of B lymphocyte populations with cardiac remodeling in elderly patients with advanced CKD.
We designed a retrospective study in a cohort of 167 patients (84 advanced CKD patients with stage 4-5 and 83 non-CKD controls). B cell subsets: CD19(+)CD5(+) and CD19(+)CD5(-) B cells were identified by flow cytometry. Correlation of B cells subsets with cardiac remodeling and clinical data in elderly CKD patients were analyzed.
In this study, we found that the prevalence of hypertension was more common in CKD patients than in the control subjects (P < 0.05). Spearman's analysis showed that CD19(+)CD5(+) B cells were negatively correlated with high sensitivity C-reactive protein (hsCRP), β2-microglobulin (β2-MG), serum creatinine (SCr), pro-brain natriuretic peptide (pro-BNP), high-sensitivity troponin T (TNT-hs), left ventricle end-diastolic dimension (LVDD), left ventricle end-systolic dimension (LVSD) and left ventricular mass (LVM), and CD19(+)CD5(-) B cells were negatively correlated with β2-MG, SCr, pro-BNP and TNT-hs (P < 0.05). In contrary, left ventricular ejection fractions (LVEF) was positively correlated with CD19(+)CD5(+) and CD19(+)CD5(-) B cells (P < 0.05). In addition, patients with higher levels of CD19(+)CD5(+) B cells exhibited lower level of pro-BNP, TNT-hs, interventricular septum (IVS), LVSD and LVM (P < 0.05). Higher levels of CD19(+)CD5(-) B cells also presented lower levels of pro-BNP, TNT-hs and LVSD, but higher levels of LVEF (P < 0.05). Cox regression analysis showed that patients with higher levels of LVSD, lower CD19(+)CD5(+)and CD19(+)CD5(-) B cells counts have a higher risk of all-cause mortality (P < 0.05).
Our results showed that CD19(+)CD5(+) and CD19(+)CD5(-) B lymphocytes were negatively correlated with ventricular hypertrophy-related echocardiographic parameters in advanced CKD patients, which indicated that B lymphocytes might be involved in pathogenesis and improve cardiac remodeling in CKD patients.
慢性肾脏病(CKD)与心血管疾病(CVD)风险增加独立相关。本研究旨在探讨心脏重构中 B 淋巴细胞亚群在老年 CKD 患者中的潜在作用。
我们设计了一项回顾性队列研究,纳入了 167 名患者(84 名 CKD 进展期患者[第 4-5 期]和 83 名非 CKD 对照组)。通过流式细胞术鉴定 B 细胞亚群:CD19(+)CD5(+)和 CD19(+)CD5(-)B 细胞。分析老年 CKD 患者中 B 细胞亚群与心脏重构和临床数据的相关性。
在本研究中,我们发现 CKD 患者的高血压患病率高于对照组(P<0.05)。Spearman 分析显示,CD19(+)CD5(+)B 细胞与高敏 C 反应蛋白(hsCRP)、β2-微球蛋白(β2-MG)、血清肌酐(SCr)、脑利钠肽前体(pro-BNP)、高敏肌钙蛋白 T(TNT-hs)、左心室舒张末期内径(LVDD)、左心室收缩末期内径(LVSD)和左心室质量(LVM)呈负相关,CD19(+)CD5(-)B 细胞与β2-MG、SCr、pro-BNP 和 TNT-hs 呈负相关(P<0.05)。相反,左心室射血分数(LVEF)与 CD19(+)CD5(+)和 CD19(+)CD5(-)B 细胞呈正相关(P<0.05)。此外,CD19(+)CD5(+)B 细胞水平较高的患者 pro-BNP、TNT-hs、室间隔(IVS)、LVSD 和 LVM 水平较低(P<0.05)。CD19(+)CD5(-)B 细胞水平较高的患者 pro-BNP、TNT-hs 和 LVSD 水平较低,而 LVEF 水平较高(P<0.05)。Cox 回归分析显示,LVSD 较高、CD19(+)CD5(+)和 CD19(+)CD5(-)B 细胞计数较低的患者全因死亡率风险更高(P<0.05)。
我们的结果表明,CD19(+)CD5(+)和 CD19(+)CD5(-)B 淋巴细胞与 CKD 患者与心室肥厚相关的超声心动图参数呈负相关,这表明 B 淋巴细胞可能参与 CKD 患者的发病机制并改善心脏重构。