Chen Wei-Ling, Liao Wei-Ting, Hsu Chien-Ning, Tain You-Lin
Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
J Clin Med. 2023 Sep 11;12(18):5894. doi: 10.3390/jcm12185894.
Cardiovascular disease (CVD) is a significant cause of mortality and morbidity among children with chronic kidney disease (CKD). The causes of pediatric CKD differ from those in adults, as congenital anomalies in the kidney and urinary tract (CAKUT) are the leading causes in childhood. Identifying ideal markers of CVD risk early is crucial for CKD children to improve their care. Previously, we screened differentially expressed proteins in CKD children with or without blood pressure (BP) abnormalities and identified pregnancy zone protein (PZP). In 106 children and adolescents with CKD stages G1-G4, we analyzed plasma PZP concentration. The associations between PZP and ambulatory BP monitoring (ABPM) profile, parameters of cardiac and carotid ultrasounds, indices of arterial stiffness, and nitric oxide (NO) parameters were determined. We observed that PZP positively correlated with arterial stiffness indices, beta index, and pulse wave velocity in CAKUT. CKD children with abnormalities in ABPM and night dipping displayed a higher PZP concentration than those without. Additionally, the PZP level was positively correlated with NO bioavailability. In conclusion, our results suggest PZP has differential influences on cardiovascular risk in CAKUT and non-CAKUT children. Identification of this relationship is novel in the pediatric CKD literature.
心血管疾病（CVD）是慢性肾脏病（CKD）患儿死亡和发病的重要原因。小儿CKD的病因与成人不同，因为肾脏和尿路先天性异常（CAKUT）是儿童期的主要病因。早期识别理想的CVD风险标志物对于改善CKD患儿的护理至关重要。此前，我们筛查了有或无血压（BP）异常的CKD患儿中差异表达的蛋白质，并鉴定出妊娠区蛋白（PZP）。在106名G1 - G4期CKD儿童和青少年中，我们分析了血浆PZP浓度。确定了PZP与动态血压监测（ABPM）曲线、心脏和颈动脉超声参数、动脉僵硬度指标以及一氧化氮（NO）参数之间的关联。我们观察到PZP与CAKUT中的动脉僵硬度指标、β指数和脉搏波速度呈正相关。ABPM和夜间血压下降异常的CKD患儿的PZP浓度高于无异常者。此外，PZP水平与NO生物利用度呈正相关。总之，我们的结果表明PZP对CAKUT和非CAKUT患儿的心血管风险有不同影响。在小儿CKD文献中，这种关系的识别是新颖的。
