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血管生物标志物(血清内皮素和内脂素 1)、NT-proBNP 与慢性肾脏病 IgA 肾病患者肾功能的关系:一项横断面研究。

The Relationship between Vascular Biomarkers (Serum Endocan and Endothelin-1), NT-proBNP, and Renal Function in Chronic Kidney Disease, IgA Nephropathy: A Cross-Sectional Study.

机构信息

2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Centre, Medical School, University of Pécs, 7624 Pécs, Hungary.

National Dialysis Center Pécs, 7624 Pécs, Hungary.

出版信息

Int J Mol Sci. 2024 Sep 30;25(19):10552. doi: 10.3390/ijms251910552.

Abstract

IgA nephropathy (IgAN) is the most common primary glomerular disease. Endothelin-1 (ET-1) is one of the strongest vasoconstrictor materials in the blood. The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) is associated with renal function and poor outcomes in chronic kidney disease (CKD). Serum endocan is a biomarker associated with proinflammatory cytokines, and the increase in the serum level plays a critical role in inflammatory, proliferative, and neovascularization processes and is associated with poor cardiovascular outcomes in patients with CKD too. Identifying high-risk patients using biomarkers could help to optimize their treatment. Ninety patients with biopsy-confirmed IgAN were included in the study (50 males/40 females, mean age: 54.9 ± 14.4 years). Serum endocan, ET-1, and NT-proBNP were measured by enzyme-linked immunosorbent assay kits. Echocardiography was performed, and carotid-femoral pulse wave velocity (cfPWV) was measured by SphygmoCor in this cross-sectional study. Patients were divided into two groups based on serum endocan median level (cut-off: 44 ug/L). There was significantly higher aorta systolic blood pressure (SBPao) ( = 0.013), NT-proBNP ( = 0.028), albumin/creatinine ratio ( = 0.036), and uric acid ( = 0.045) in the case of the higher endocan group compared to the lower. There was also significantly higher SBPao ( = 0.037) and NT-proBNP ( = 0.038) in the case of higher endothelin-1 (ET-1) levels compared to the lower (cut-off: 231 pg/mL) group by the two-sample -test. Then, we divided the patients into two groups based on the eGFR (CKD 1-2 vs. CKD 3-5). The levels of serum endocan, NT-proBNP, cfPWV, SBPao, left ventricular mass index (LVMI), uric acid, and albuminuria were significantly higher in the CKD 3-5 group compared to the CKD 1-2 group. The serum endocan and NT-proBNP levels were significantly higher in the diastolic dysfunction group ( = 0.047, = 0.015). There was a significant increase in serum endocan levels (CKD 1 vs. CKD 5; = 0.008) with decreasing renal function. In IgAN, vascular biomarkers (endocan, ET-1) may play a role in endothelial dysfunction through vascular damage and elevation of SBPao. Serum endocan, ET-1, and NT-proBNP biomarkers may help to identify IgAN patients at high risk.

摘要

IgA 肾病 (IgAN) 是最常见的原发性肾小球疾病。内皮素-1 (ET-1) 是血液中最强的血管收缩物质之一。脑钠肽前体 (NT-proBNP) 的 N 端前体与慢性肾脏病 (CKD) 中的肾功能和不良预后相关。血清内皮细胞是与促炎细胞因子相关的生物标志物,其血清水平的升高在炎症、增殖和新生血管形成过程中起着关键作用,与 CKD 患者的不良心血管结局也有关。使用生物标志物识别高危患者有助于优化治疗。本研究纳入了 90 名经活检证实的 IgAN 患者(50 名男性/40 名女性,平均年龄:54.9±14.4 岁)。通过酶联免疫吸附试验试剂盒测量血清内皮素、ET-1 和 NT-proBNP。在这项横断面研究中,通过 SphygmoCor 进行了超声心动图检查,并测量了颈股脉搏波速度 (cfPWV)。根据血清内皮细胞中位水平(截距:44ug/L)将患者分为两组。与低内皮细胞组相比,高内皮细胞组的主动脉收缩压 (SBPao)(=0.013)、NT-proBNP(=0.028)、白蛋白/肌酐比值(=0.036)和尿酸(=0.045)明显更高。与低内皮素-1(ET-1)组相比(截距:231pg/mL),高内皮素-1(ET-1)组的 SBPao(=0.037)和 NT-proBNP(=0.038)也明显更高(两样本 t 检验)。然后,我们根据 eGFR(CKD 1-2 与 CKD 3-5)将患者分为两组。与 CKD 1-2 组相比,CKD 3-5 组的血清内皮细胞、NT-proBNP、cfPWV、SBPao、左心室质量指数(LVMI)、尿酸和蛋白尿明显更高。在舒张功能障碍组中,血清内皮细胞和 NT-proBNP 水平明显更高(=0.047,=0.015)。随着肾功能的下降,血清内皮细胞水平(CKD 1 与 CKD 5;=0.008)显著升高。在 IgAN 中,血管生物标志物(内皮素、内皮细胞)可能通过血管损伤和 SBPao 升高在血管内皮功能障碍中发挥作用。血清内皮细胞、内皮素-1 和 NT-proBNP 生物标志物有助于识别高危 IgAN 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f41f/11476882/27d9a73470aa/ijms-25-10552-g001.jpg

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