Ho Chun-Yi, Lu Pei-Chen, Chen Wei-Ling, Liao Wei-Ting, Hsu Chien-Ning, Tain You-Lin
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
Department of Pediatrics, Kaohsiung Municipal Feng Shan Hospital-Under the Management of Chang Gung Medical Foundation, Kaohsiung 830, Taiwan.
Children (Basel). 2024 Sep 13;11(9):1124. doi: 10.3390/children11091124.
Pediatric CKD is associated with a high risk of cardiovascular disease (CVD). Early detection of subclinical CVD in childhood CKD can be achieved through various cardiovascular (CV) assessments, including carotid intima-media thickness (cIMT), ambulatory blood pressure monitoring (ABPM), and arterial stiffness indices. Lactoferrin (LF), a key functional glycoprotein found in breast milk, has been linked to several diseases and has potential as a biomarker.
In our study of 102 children with CKD stages G1-G4, we explored the relationship between LF and CV risk markers.
We found that LF concentration was not related to the severity or underlying causes of childhood CKD, but was positively correlated with overweight/obesity. Lower LF levels were correlated with increased cIMT and elevated arterial stiffness indices. Notably, abnormalities in ABPM profiles were observed in up to 60% of the children with CKD, with low LF levels linked to nighttime hypertension, nocturnal non-dipping, and ABPM abnormalities.
In conclusion, LF shows promise as a biomarker for detecting subclinical CVD in children with CKD. Its potential utility in early detection could be instrumental in guiding timely interventions and improving long-term CV outcomes, although further research is needed to clarify the underlying mechanisms.
儿童慢性肾脏病（CKD）与心血管疾病（CVD）的高风险相关。通过各种心血管（CV）评估，包括颈动脉内膜中层厚度（cIMT）、动态血压监测（ABPM）和动脉僵硬度指数，可以实现儿童CKD中亚临床CVD的早期检测。乳铁蛋白（LF）是母乳中发现的一种关键功能糖蛋白，与多种疾病有关，具有作为生物标志物的潜力。
在我们对102例G1 - G4期CKD儿童的研究中，我们探讨了LF与CV风险标志物之间的关系。
我们发现LF浓度与儿童CKD的严重程度或潜在病因无关，但与超重/肥胖呈正相关。较低的LF水平与cIMT增加和动脉僵硬度指数升高相关。值得注意的是，高达60%的CKD儿童观察到ABPM曲线异常，低LF水平与夜间高血压、夜间非勺型血压及ABPM异常有关。
总之，LF有望作为检测CKD儿童亚临床CVD的生物标志物。尽管需要进一步研究来阐明其潜在机制，但其在早期检测中的潜在效用可能有助于指导及时干预并改善长期CV结局。
