目的:这项研究调查了与普通人群相比,肾移植供体是否经历了动脉僵硬度增加,以及动脉僵硬度如何随时间变化。
方法:我们的研究包括59名肾移植供体和27名健康志愿者。所有受试者都进行了心踝血管指数测量。我们研究了成纤维细胞生长因子23,klotho,单核细胞趋化蛋白-1,N末端B型利钠肽,硫酸吲哚酚,和对甲苯基硫酸酯水平。
结果:捐献后6~11年的捐献者心踝血管指数水平(8.02±0.24m/s)高于捐献后2~6年的捐献者(7.02±0.27m/s)和健康志愿者(6.65±0.22m/s)。心踝血管指数水平与年龄(r=0.382,P<.001)和甘油三酯水平(r=0.213,P=.049)呈正相关,血尿素氮(r=0.263,P=0.014),肌酐(r=0.354,P=.001),钙(r=0.228,P=0.035),硫酸吲哚酚(r=0.219,P=0.042),对甲苯基硫酸酯(r=0.676,P≤.001),和单核细胞趋化蛋白-1(r=0.451,P≤.001),与估计的肾小球滤过率呈负相关(r=-0.383,P<.001)。多元线性回归分析显示年龄(P=0.026,B=0.244),平均动脉血压(P<.001,B=0.446),血尿素氮(P=.006,B=0.302),肌酐(P=.032,B=0.236),估计肾小球滤过率(P=0.003,B=-0.323),成纤维细胞生长因子-23(P=0.007,B=0.294),N末端B型利钠肽前体(P=0.005,B=0.304),和单核细胞趋化蛋白-1(P≤.001,B=0.434)独立预测心踝血管指数水平。
结论:即使没有其他危险因素,肾供体应密切关注动脉僵硬和心血管疾病,尤其是在肾移植后的长期(>5年)。
OBJECTIVE: This study investigated whether kidney transplant donors experience increased arterial stiffness compared with the general population and how arterial stiffness changes over time.
METHODS: Our study included 59 kidney transplant donors and 27 healthy volunteers. All subjects underwent cardio-ankle vascular index measurements. We studied fibroblast growth factor23, klotho, monocyte chemoattractant protein-1, N-terminal pro-B-type natriuretic peptide, indoxyl sulfate, and p-cresyl sulfate levels.
RESULTS: Cardio-ankle vascular index level was higher in donors 6 to 11 years after donation (8.02 ± 0.24 m/s) than in donors 2 to 6 years after donation (7.02 ± 0.27 m/s) and healthy volunteers (6.65 ± 0.22 m/s). Cardioankle vascular index level was positively correlated with age (r = 0.382, P < .001) and levels of triglyceride (r = 0.213, P = .049), blood urea nitrogen (r = 0.263, P = .014), creatinine (r = 0.354, P = .001), calcium (r = 0.228, P = .035), indoxyl sulfate (r = 0.219, P = .042), p-cresyl sulfate (r = 0.676, P ≤ .001), and monocyte chemoattractant protein-1 (r = 0.451, P ≤ .001) and negatively correlated with estimated glomerular filtration rate (r = -0.383, P < .001). Multiple linear regression analysis revealed that age (P = .026, B = 0.244), mean arterial blood pressure (P < .001, B = 0.446), blood urea nitrogen (P = .006, B = 0.302), creatinine (P = .032, B = 0.236), estimated glomerular filtration rate (P = .003, B = -0.323), fibroblast growth factor-23 (P = .007, B = 0.294), N-terminal pro-B-type natriuretic peptide (P = .005, B = 0.304), and monocyte chemoattractant protein-1 (P ≤ .001, B = 0.434) independently predicted cardio-ankle vascular index levels.
CONCLUSIONS: Even without additional risk factors, kidney donors should be followed closely for arterial stiffness and cardiovascular disease, especially in the long-term (>5 years) after kidney transplant.