Chang Ho-Hsiang, Wang Chih-Hsien, Lin Yu-Li, Kuo Chiu-Huang, Liou Hung-Hsiang, Hsu Bang-Gee
Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan.
School of Medicine, Tzu Chi University, Hualien 97004, Taiwan.
Diseases. 2024 Dec 13;12(12):328. doi: 10.3390/diseases12120328.
BACKGROUND/OBJECTIVES: Myostatin, primarily produced by skeletal muscle, inhibits muscle growth and promotes protein degradation. It has been implicated in conditions such as obesity, insulin resistance, and cardiovascular disease. However, its association with endothelial function in chronic kidney disease (CKD) patients remains unclear. This study aimed to investigate the relationship between serum myostatin levels and endothelial function in 136 non-dialysis CKD patients at stages 3-5.
Fasting blood samples were collected to measure serum myostatin levels using enzyme-linked immunosorbent assay kits. Endothelial function was evaluated non-invasively by measuring the vascular reactivity index (VRI) with a digital thermal monitoring test.
VRI values were classified as poor (<1.0, = 25, 18.4%), intermediate (1.0 to <2.0, = 63, 46.3%), or good (≥2.0, = 48, 35.3%). Factors associated with poor vascular reactivity included older age ( = 0.026), elevated serum blood urea nitrogen ( = 0.020), serum creatinine ( = 0.021), urine protein-to-creatinine ratio (UPCR, = 0.013), and myostatin levels ( = 0.003), along with reduced estimated glomerular filtration rate ( = 0.015). Multivariate regression analysis identified older age, higher serum creatinine, and log-transformed myostatin levels as significant independent predictors of lower VRI.
These findings suggest that myostatin may serve as a potential biomarker for endothelial dysfunction in CKD patients. Future large-scale, longitudinal studies are warranted to confirm and extend our preliminary findings.
背景/目的：肌肉生长抑制素主要由骨骼肌产生，可抑制肌肉生长并促进蛋白质降解。它与肥胖、胰岛素抵抗和心血管疾病等状况有关。然而，其与慢性肾脏病（CKD）患者内皮功能的关联仍不明确。本研究旨在调查136例3 - 5期非透析CKD患者血清肌肉生长抑制素水平与内皮功能之间的关系。
采集空腹血样，使用酶联免疫吸附测定试剂盒测量血清肌肉生长抑制素水平。通过数字热监测试验测量血管反应性指数（VRI）对内皮功能进行无创评估。
VRI值分为差（<1.0，n = 25，18.4%）、中等（1.0至<2.0，n = 63，46.3%）或良好（≥2.0，n = 48，35.3%）。与血管反应性差相关的因素包括年龄较大（P = 0.026）、血清尿素氮升高（P = 0.020）、血清肌酐（P = 0.021）、尿蛋白与肌酐比值（UPCR，P = 0.013）和肌肉生长抑制素水平（P = 0.003），以及估计肾小球滤过率降低（P = 0.015）。多变量回归分析确定年龄较大、血清肌酐较高和经对数转换的肌肉生长抑制素水平是VRI降低的显著独立预测因素。
这些发现表明，肌肉生长抑制素可能是CKD患者内皮功能障碍的潜在生物标志物。未来有必要进行大规模纵向研究以证实并扩展我们的初步发现。
