摘要
目的 探究血浆糖基化终末产物(advanced glycation end products,AGEs)与颈-股脉搏波传导速度(carotid-femoral pulse wave velocity,cf-PWV)及尿微量白蛋白/肌酐(albumin/creatinine ratio,ACR)的关系。方法 研究对象为至上海交通大学医学院附属瑞金医院进行动态血压监测的患者。通过问卷调查采集高血压患者的一般情况及既往病史,使用欧姆龙上臂式血压计(HEM-7051)测量患者肱动脉血压,采集空腹血测定患者总胆固醇、三酰甘油及空腹血糖等各项生化指标,通过酶联免疫吸附法测定血浆AGEs水平。以尿ACR及SpygmoCor软件测定的cf-PWV作为高血压靶器官损害的指标。结果 175例研究对象平均年龄(51.23±11.38)岁,其中男性78例,占比44.57%。男性血浆AGEs水平高于女性[(7.80±6.37)μg/ml vs (4.41±3.62)μg/ml,P <0.001];在靶器官损害方面,男性尿ACR水平低于女性[(1.18±0.70)mg/mmolvs (2.10±2.17) mg/mmol,P <0.001];cf-PWV无显著差异(P=0.27)。未校正相关危险因素前,血浆AGEs水平与空腹血糖(r=0.163,P=0.030)、血肌酐(r=0.219,P=0.003)、尿ACR(r=0.150,P=0.046)呈正相关,与高密度脂蛋白胆固醇(r=-0.206,P=0.006)呈负相关,与cf-PWV未见明显相关性(r=0.101,P=0.182)。进一步通过多元逐步线性回归分析发现,在校正相关危险因素后,血浆AGEs水平每升高1μg/ml,尿ACR增加2.2%(P=0.023);而cf-PWVP改变无统计学意义(P=0.738)。结论 血浆AGEs水平是尿ACR的独立危险因素。
Objective To investigate the association between plasma advanced glycation end products(AGEs) and carotid-femoral pulse wave velocity(cf-PWV) and urine albumin/creatinine ratio(ACR) in adults with hypertension.Methods The study subjects were patients who went to Ruijin hospital,Shanghai Jiao Tong university school of medicine for ambulatory blood pressure monitoring.The general condition and medical history of the hypertensive patients were collected through questionnaire survey,the brachial artery blood pressure was measured by Omron upper arm sphygmomanometer(HEM-7051),fasting blood was collected to determine biochemical indexes,including total cholesterol,triacylglycerol,and fasting blood glucose,and plasma AGEs concentration was measured by enzyme-linked immunosorbent assay.Urine ACR and cf-PWV measured by SpygmoCor software were used as indicators of target organ damage in hypertension.Results The mean age of the 175 subjects was(51.23±11.38) years old,of which 78 were male(44.57%),accounting for 44.57%.The plasma AGEs level was higher in males compared to females[(7.80±6.37)μg/ml vs(4.41±3.62)μg/ml,P<0.001].In terms of target organ damage,urinary ACR level in males was lower compared to females[(1.18±0.70)mg/mmol vs(2.10±2.17) mg/mmol,P<0.001].There was no significant difference in cfPWV(P=0.27).Before adjusting for related risk factors,plasma AGEs concentrations were positively correlated with fasting glucose(r=0.163,P=0.030),blood creatinine(r=0.219,P=0.003),and urinary ACR(r=0.150,P=0.046),and negatively correlated with high density lipoprotein cholesterol(r=-0.206,P=0.006).There was no significant correlation with cf-PWV(r=0.101,P=0.182).Multivariate stepwise linear regression analysis revealed that after adjustment for relevant risk factors,urinary ACR increased by 2.2% for each 1 μg/ml increase in plasma AGEs(P=0.023).There was no significant change in cf-PWVP(P=0.738).Conclusions Plasma AGEs concentration is an independent risk factor for the urinary ACR.
作者
刘常远
常桂丽
李明春
胡哲
操群安
陈静
初少莉
陈歆
LIU Changyuan;CHANG Guili;LI Mingchun;HU Zhe;CAO Qunan;CHEN Jing;CHU Shaoli;CHEN xin(Department of Hypertension,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China;Shanghai Institute of Hypertension,Shanghai 200001,China)
出处
《世界临床药物》
CAS
2023年第12期1279-1285,共7页
World Clinical Drug
基金
上海市卫生健康委员会卫生行业临床研究专项(20204Y0001)
瑞金医院北部院区院级课题项目(2020ZY21)。
关键词
糖基化终末产物
颈-股脉搏波传导速度
尿微量白蛋白/肌酐
advanced glycation end product
carotid-femoral pulse wave velocity
urinary albumin/creatinine ratio
