Lipid-lowering treatment and inflammatory mediators in diabetes and chronic kidney disease
Lipid-lowering treatment and inflammatory mediators in diabetes and chronic kidney disease
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DOI：
10.1111/eci.12230
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发表时间：
2014-03-01
影响因子：
5.5
通讯作者：
Hjemdahl, Paul
中科院分区：
文献类型：
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作者：
Almquist, Tora;Jacobson, Stefan H.;Hjemdahl, Paul
背景：炎症可能是糖尿病（DM）和慢性肾脏疾病（CKD）患者心血管风险增高的原因之一。单核细胞趋化蛋白-1 （MCP-1）促进单核细胞募集进入动脉粥样硬化病变，并参与糖尿病肾病。干扰素γ (IFN)在动脉粥样硬化中很重要，并增加包括MCP-1在内的趋化因子的合成。他汀类降脂治疗（LLT）可能具有抗炎作用，依折替米贝联合治疗提供额外的胆固醇降低。方法在安慰剂磨合期后，在一项随机、双盲、交叉研究中比较辛伐他汀单独(S)或辛伐他汀+依折替米贝（S+E）对炎症参数的影响。18例估计肾小球滤过率（eGFR） 15-59mL/minx173m(2) （CKD 3-4期）（DM-CKD）和21例eGFR bb0 - 75mL/min（仅DM）的DM患者被纳入研究。结果在基线水平上，单核细胞趋化蛋白1 (MCP-1) （P=003）、IFN （P=002）、肿瘤坏死因子- (TNF) （P=003）、TNF - (P=003)、TNF - (P=003)和TNF - (P=003)均呈阳性
BackgroundInflammation may contribute to the high cardiovascular risk in diabetes mellitus (DM) and chronic kidney disease (CKD). Monocyte chemoattractant protein-1 (MCP-1) facilitates the recruitment of monocytes into atherosclerotic lesions and is involved in diabetic nephropathy. Interferon gamma (IFN) is important in atherosclerosis and increases the synthesis of chemokines including MCP-1. Lipid-lowering treatment (LLT) with statins may have anti-inflammatory effects, and ezetimibe cotreatment provides additional cholesterol lowering.MethodsAfter a placebo run-in period, the effects of simvastatin alone (S) or simvastatin + ezetimibe (S+E) were compared in a randomized, double-blind, cross-over study on inflammatory parameters. Eighteen DM patients with estimated glomerular filtration rate (eGFR) 15-59mL/minx173m(2) (CKD stages 3-4) (DM-CKD) and 21 DM patients with eGFR >75mL/min (DM only) were included.ResultsAt baseline, monocyte chemoattractant protein 1 (MCP-1) (P=003), IFN (P=002), tumour necrosis factor- (TNF) (P