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催乳素水平与慢性肾脏病及随后发生心血管事件的风险:一项基于人群的长期队列研究。

Prolactin levels and chronic kidney disease and the subsequent risk of cardiovascular events: A long term population based cohort study.

作者信息

Rojhani Ehsan, Rahmati Maryam, Firouzi Faegheh, Ziaeefar Pardis, Soudmand Saber Amanollahi, Azizi Fereidoun, Tehrani Fahimeh Ramezani, Behboudi-Gandevani Samira

机构信息

Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 1985717413, Tehran, Iran.

Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Sci Rep. 2025 Feb 28;15(1):7198. doi: 10.1038/s41598-025-87783-1.

Abstract

Both the clearance and secretion of prolactin are disrupted in chronic kidney disease (CKD). Evidence indicates that prolactin may play a role in cardiovascular (CV) disturbances. Considering the increased cardiovascular risk associated with CKD, this study investigates the relationship between prolactin levels, CKD, and the risk of CV events in both women and men, with an average follow-up period of 20 years. The study included 2,005 participants from the Tehran Lipid and Glucose Study (TLGS) who met the inclusion criteria. They were reassessed approximately every three years for a median follow-up of 19.0 years (Interquartile range (IQR):16.4-20.2), during which occurrences of CKD and CV events were recorded. A pooled logistic regression model examined the influence of Prolactin on CV events and its interaction with CKD. During follow-up, we identified 156 incident cases of CV events among men and 73 among women. Median (95%CI) PRL levels were 7.4 (5.5-10.5) ng/mL for men and 15.2 (10.3-23) ng/mL for women. The results of analyses showed that a history of CKD was associated with significantly higher odds of CV events for both men 4.2 (95% CI: 2.6-6.8) and women 5.5 (95% CI: 2.6-11.5). Results remained unchanged after adjustment for confounders including age, waist circumference, smoking, education, history of diabetes and hypertension, and family history of CV events. Interaction analyses revealed no statistically significant interaction between CKD and PRL on the odds of CV events in unadjusted and adjusted models. This consistent pattern was observed regardless of gender. Results of population-based data with over a median follow-up period of 20 years showed that CKD independently increases the risk of CV events in both men and women. However, our findings suggest that this elevated risk may not be substantially influenced by prolactin levels. Further investigation may be warranted to confirm these findings.

摘要

慢性肾脏病(CKD)患者的催乳素清除和分泌均受到干扰。有证据表明,催乳素可能在心血管(CV)紊乱中起作用。鉴于与CKD相关的心血管风险增加,本研究调查了催乳素水平、CKD与男性和女性CV事件风险之间的关系,平均随访期为20年。该研究纳入了2005名来自德黑兰血脂与血糖研究(TLGS)且符合纳入标准的参与者。他们大约每三年接受一次重新评估,中位随访期为19.0年(四分位间距(IQR):16.4 - 20.2),在此期间记录CKD和CV事件的发生情况。一个汇总逻辑回归模型检验了催乳素对CV事件的影响及其与CKD的相互作用。在随访期间,我们在男性中确定了156例CV事件的新发病例,在女性中确定了73例。男性催乳素水平中位数(95%CI)为7.4(5.5 - 10.5)ng/mL,女性为15.2(10.3 - 23)ng/mL。分析结果表明,CKD病史与男性4.2(95%CI:2.6 - 6.8)和女性5.5(95%CI:2.6 - 11.5)发生CV事件的显著更高几率相关。在对包括年龄、腰围、吸烟、教育程度、糖尿病和高血压病史以及CV事件家族史等混杂因素进行调整后,结果保持不变。交互分析显示,在未调整和调整模型中,CKD和催乳素对CV事件几率均无统计学上的显著交互作用。无论性别如何,均观察到这种一致的模式。基于人群的数据经过中位20年的随访期,结果表明CKD独立增加男性和女性CV事件的风险。然而,我们的研究结果表明,这种升高的风险可能不会受到催乳素水平的实质性影响。可能需要进一步研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77d/11871319/160e502d2349/41598_2025_87783_Fig1_HTML.jpg

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