The relationship between the concentration of plasma homocysteine and chronic kidney disease: a cross sectional study of a large cohort
The relationship between the concentration of plasma homocysteine and chronic kidney disease: a cross sectional study of a large cohort
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DOI：
10.1007/s40620-019-00618-x
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发表时间：
2019-10-01
影响因子：
3.4
通讯作者：
Krause, Ilan
中科院分区：
文献类型：
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作者：
Cohen, Eytan;Margalit, Ili;Krause, Ilan
背景高浓度的同型半胱氨酸被认为是发展为动脉粥样硬化和冠状动脉疾病的危险因素。这项研究的目的是评估慢性肾脏疾病(CKD)患者的同型半胱氨酸浓度。方法收集2000年至2014年期间在以色列筛查中心接受检查的个人的医疗记录。对17010名受试者进行了横断面分析，其中67%是男性。结果同型半胱氨酸浓度的四分位数与估计的肾小球滤过率有显著差异，即同型半胱氨酸浓度越高，肾小球滤过率越低(p<；0.0001)。在CKD患者中，血浆同型半胱氨酸水平与肾损害分期相关。每1.73m(2)中同型半胱氨酸平均浓度为16.3(5.9)mU/min，而每1.73m(2)中同型半胱氨酸浓度为11.5(5.5)mU/L。在对年龄、吸烟状况、体重指数、高血压和糖尿病进行调整后，这些发现仍然显著(p<；0.0001)。与同型半胱氨酸浓度<15 mU/L的受试者相比，同型半胱氨酸浓度等于或大于15 mU/L的受试者发生EGFR和lt的优势比(95%CI)高；每1.73m(2)有60mL/min；未校正模型为8.30(6.17~11.16)；调整年龄吸烟状况、体重指数、高血压和糖尿病的模型为7.43(5.41~10.21)。结论CKD患者血浆同型半胱氨酸水平升高。这可能会增加这些患者发生动脉粥样硬化和冠状动脉疾病的风险。
Background High concentrations of homocysteine are considered a risk factor for developing atherosclerosis and coronary artery disease. The aim of this study was to assess the concentrations of homocysteine in subjects with chronic kidney disease (CKD). Methods Data were collected from medical records of individuals examined at a screening center in Israel between the years 2000-2014. Cross sectional analysis was carried out on 17,010 subjects; 67% were men. Results Significant differences were observed between four quartiles of homocysteine concentrations and estimated glomerular filtration rate (eGFR)-the higher the homocysteine concentration, the lower the eGFR (p < 0.0001). In subjects with CKD, homocysteine plasma levels were correlated with the stage of renal impairment. Mean (SD) homocysteine concentrations in subjects with eGFR < 60 mL/min per 1.73 m(2) compared to subjects with eGFR >= 60 mL/min per 1.73 m(2) were: 16.3 (5.9) vs. 11.5 (5.5) mu mol/L respectively. These findings remained significant after adjustment for age, smoking status, body mass index, hypertension and diabetes mellitus (p < 0.0001). Compared to subjects with homocysteine concentrations less than 15 mu mol/L, those with homocysteine concentrations equal and above 15 mu mol/L, had a significantly higher odds ratio (95% CI) of having an eGFR < 60 mL/min per 1.73 m(2); non adjusted model, 8.30 (6.17-11.16); adjusted model for age smoking status, body mass index, hypertension and diabetes mellitus, 7.43 (5.41-10.21). Conclusion Plasma homocysteine concentrations are higher in subjects with CKD. This may contribute to an increased risk for developing atherosclerosis and coronary artery disease in these patients.