摘要
目的观察慢性肾脏病（CKD）患者血清脂肪细胞型脂肪酸结合蛋白（A．FABP）的变化，并初步探讨其与CKD动脉粥样硬化（AS）的相关性。方法选取CKD患者138例为研究对象，根据评估肾小球滤过率（eGFR）值将CKD患者分为CKD早期组『eGFR≥60m1．min-1．（1．73m2）-1、CKD中期组[60ml·min-1·（1．73m2）-1〉eGFR≥15ml·min-1·（1．73m2）-1]、CKD晚期组[eGFR〈15ml·min-1·（1．73m2）-1]，应用酶联免疫吸附试验（ELISA）测定各组患者血清A-FABP、白细胞介素6（IL．6）和单核细胞趋化因子1（MCP．1）的水平。采用彩色多普勒超声技术测定患者颈总动脉内膜一中层（IMT）厚度。再根据是否伴有颈总动脉病变，将CKD组分为CKD伴AS组、CKD不伴AS组。结果CKD各组患者血清A．FABP水平均高于对照组（P〈0．05），其中以CKD晚期组升高最明显（P〈0．01）。FFA随着eGFR的下降有上升趋势，且CKD早期组与对照组间差异有统计学意义（P〈0．05）。经Pearson相关分析，A—FABP与FFA呈正相关（r=0．825，P〈0．01），与IL-6（r=0．569，P〈0．01）、MCP-1（r=0．657，P〈0．01）亦呈正相关。CKD伴AS组患者血清A—FABP水平高于CKD不伴AS组，且差异有统计学意义（P〈0．01）。结论CKD患者血清A．FABP及FFA水平随肾功能减退有升高趋势，AS可能与血清A．FABP水平的升高有关。推测A-FABP可能主要通过促进炎性反应和活化巨噬细胞参与AS的形成。
Objective To investigate the expression of serum adiopocyte fatty acid binding protein（A- FABP） in chronic kidney disease （CKD） and the role that A- FABP plays in CKD with atherosclerosis. Methods A total of 138 patients with CKD and 20 health control volunteers （HC） were involved in this study. The levels of serum A-FABP, free fatty acid （FFA）, interleukin- 6 （IL-6）, monocyte chemotactic protein I（MCP- 1） were measured by enzyme- linked immunosorbent assay （ELISA）. Inteima-media thickness of common carotid artery was measured by color doppler ultrasound. Results According to the progression of glomerular filtration rate（GFR）, the patients with CKD were divided into three groups： group CKD1-2[eGFR≥ 60 ml-min-1 （1.73 m2）-1], group CKD 3-4[60 ml. min-l. （1.73 m2）-1 〉 eGFR ≥ 15 ml. min-1. （1.73 m2）-1], group CKD5[eGFR 〈 15 ml. min-1. （1.73 m2）-1]. The levels of serum A-FABP were relatively higher in CKD than that in HC group（P 〈 0.05）, and that in the group CKD5 were the most highest （P 〈 0.01）. The level of serum FFA in group CKD 1-2 was relatively higher than that in group HC （P 〈 0.05）, and FFA had a rising trend with decreased eGFR. The level of serum A-FABP was positively correlated with the levels of serum FFA （r = 0.825, P 〈 0.01）, and also positively correlated with IL-6 （r = 0.569, P 〈 0.01）, MCP-l（r = 0.657, P 〈 0.01） in CKD by Pearson correlation analysis. The levels of A- FABP in 56 patients of CKD with vascular atherosclerosis were significantly higher than that in 82 patients without vascular atherosclerosis （P 〈 0.01）. Conclusion Serum A- FABP maybe play an important role in the progression of vascular atherosclerosis in CKD.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2013年第12期883-887,共5页
Chinese Journal of Nephrology
