School of Medicine, Tzu-Chi University, Hualien, Taiwan.
Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Medicine (Baltimore). 2022 Jul 22;101(29):e29558. doi: 10.1097/MD.0000000000029558.
Aortic stiffness (AS) is a major predictor of cardiovascular disease and mortality in patients with chronic kidney disease (CKD) and adipocyte fatty acid-binding protein (A-FABP) is a novel adipokine that is positively correlated with AS in the general population. Therefore, we investigated the correlation between serum A-FABP levels and AS in nondialysis CKD patients. Fasting blood samples and baseline characteristics were obtained in 270 patients with nondialysis CKD. Serum A-FABP concentrations were determined by enzyme immunoassay and carotid-femoral pulse wave velocity (cfPWV) measurements were acquired using a validated tonometry system. Patients with cfPWV >10 m/s formed the AS group, while those with values ≤10 m/s comprised the comparison group. Among 270 CKD patients, 92 patients (34.1%) were in the AS group. Compared to those in the comparison group, patients in the AS group were older (P < .001), had a higher prevalence of diabetes, along with higher serum A-FABP level (P < .001), larger waist circumference (P = .004), and lower estimated glomerular filtration rate (P = .001) but higher levels of body fat mass (P = .010), systolic blood pressure (P < .001), fasting glucose (P = .014), blood urea nitrogen (P = .009), and serum creatinine (P = .004). The serum log-A-FABP level was positively associated with log-cfPWV (β = 0.178, P = .001) in nondialysis CKD patients and multivariable logistic regression analysis identified serum A-FABP (P = .006), age (P = .001), and systolic blood pressure (P = .015) as independent predictors of AS in nondialysis-dependent CKD patients. Elevated A-FABP levels may be a significant predictor of AS in nondialysis CKD patients.
主动脉僵硬(AS)是慢性肾脏病(CKD)患者心血管疾病和死亡率的主要预测因子,脂肪细胞脂肪酸结合蛋白(A-FABP)是一种新型脂肪因子,在普通人群中与 AS 呈正相关。因此,我们研究了非透析 CKD 患者血清 A-FABP 水平与 AS 的相关性。纳入 270 例非透析 CKD 患者,检测空腹血样本和基线特征。采用酶联免疫吸附法测定血清 A-FABP 浓度,采用经过验证的张力测量系统测量颈股脉搏波速度(cfPWV)。cfPWV>10m/s 的患者为 AS 组,cfPWV≤10m/s 的患者为对照组。270 例 CKD 患者中,92 例(34.1%)为 AS 组。与对照组相比,AS 组患者年龄更大(P<0.001),糖尿病患病率更高,血清 A-FABP 水平更高(P<0.001),腰围更大(P=0.004),估算肾小球滤过率更低(P=0.001),体脂肪量更高(P=0.010),收缩压更高(P<0.001),空腹血糖更高(P=0.014),血尿素氮更高(P=0.009),血肌酐更高(P=0.004)。非透析 CKD 患者血清 log-A-FABP 水平与 log-cfPWV 呈正相关(β=0.178,P=0.001),多变量 logistic 回归分析表明,血清 A-FABP(P=0.006)、年龄(P=0.001)和收缩压(P=0.015)是非透析依赖 CKD 患者 AS 的独立预测因子。升高的 A-FABP 水平可能是非透析 CKD 患者 AS 的重要预测因子。