血浆钙调蛋白作为小儿慢性肾脏病亚临床心血管疾病的生物标志物

Plasma Calmodulin as a Biomarker of Subclinical Cardiovascular Disease in Pediatric Chronic Kidney Disease.

作者信息

Lee Hsin-Jung, Liao Wei-Ting, Hsu Chien-Ning, Tain You-Lin, Lu Pei-Chen

机构信息

Division of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.

Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.

出版信息

Children (Basel). 2025 May 4;12(5):599. doi: 10.3390/children12050599.

DOI:10.3390/children12050599

PMID:40426778

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12109911/

Abstract

BACKGROUND

Calmodulin is a calcium-signaling protein implicated in cardiac remodeling and could be released extracellularly. It was previously identified as differentially expressed in hypertensive pediatric chronic kidney disease (CKD). This study assessed plasma calmodulin as a cardiovascular disease (CVD) biomarker in pediatric CKD and compared it with traditional risk markers.

METHODS

We conducted a cross-sectional study of 81 children with CKD aged 3-18 years. All underwent clinical assessments and echocardiography; 44 had carotid ultrasound, and 38 completed ambulatory blood pressure monitoring (ABPM).

RESULTS

Most participants had preserved renal function (median eGFR, 104.4 mL/min/1.73 m). Plasma calmodulin levels were significantly associated with early markers of CVD, including interventricular septal thickness, left ventricular mass, carotid intima-media thickness, and ABPM systolic measures (all r > 0.2; < 0.05). In multivariable analysis, only calmodulin and office systolic blood pressure (BP) independently predicted abnormal BP profiles.

CONCLUSIONS

Plasma calmodulin may serve as a sensitive, though non-specific, early CVD biomarker in pediatric CKD and could complement conventional screening tools.

摘要

背景

钙调蛋白是一种参与心脏重塑的钙信号蛋白，可释放到细胞外。它先前被确定在高血压儿童慢性肾脏病（CKD）中存在差异表达。本研究评估血浆钙调蛋白作为儿童CKD中心血管疾病（CVD）生物标志物，并将其与传统风险标志物进行比较。

方法

我们对81名3至18岁的CKD儿童进行了一项横断面研究。所有患儿均接受了临床评估和超声心动图检查；44例进行了颈动脉超声检查，38例完成了动态血压监测（ABPM）。

结果

大多数参与者肾功能正常（估算肾小球滤过率中位数为104.4 mL/min/1.73 m²）。血浆钙调蛋白水平与CVD的早期标志物显著相关，包括室间隔厚度、左心室质量、颈动脉内膜中层厚度和ABPM收缩压测量值（所有r>0.2；P<0.05）。在多变量分析中，只有钙调蛋白和诊室收缩压能独立预测异常血压情况。