Markers of endothelial cell activation/injury: CD146 and thrombomodulin are related to adiponectin in kidney allograft recipients
Markers of endothelial cell activation/injury: CD146 and thrombomodulin are related to adiponectin in kidney allograft recipients
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DOI：
10.1159/000085827
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发表时间：
2005-01-01
影响因子：
4.2
通讯作者：
Mysliwiec, M
中科院分区：
文献类型：
--
作者：
Malyszko, J;Malyszko, JS;Mysliwiec, M
工作背景：脂联素可用于评估冠状动脉疾病（CAD）的风险，并可能与急性冠状动脉综合征的发生有关。脂联素水平的降低与一些心血管疾病的危险因素有关，如男性、肥胖和糖尿病。脂联素具有抗动脉粥样硬化的特性，并减弱内皮炎症反应。CD 146是一种新的细胞粘附分子，定位于内皮连接处。在肾移植受者中，内皮功能障碍和动脉粥样硬化几乎是普遍的。本横断面研究的目的是评估82例稳定肾移植受者（平均年龄45岁，移植后平均时间47个月）伴或不伴CAD患者的脂联素、CD 146和其他内皮细胞损伤标志物之间的可能关系。研究方法：脂联素和内皮损伤标志物：使用市售试剂盒评估CD 146、血管性血友病因子、血栓调节蛋白、ICAM、CD 40 L、P-选择素和其他止血标志物。结果如下：与非CAD患者相比，CAD患者有更明显的内皮功能障碍、促凝血状态和更低的脂联素水平。在单因素分析中，脂联素与CD 146（r = 0.29，p = 0.009），血栓调节蛋白（r = 0.37，p = 0.001），蛋白Z（r =-0.25，p = 0.03）、BMI（r =-0.26，p = 0.047）、血清肌酐（r = 0.26，p = 0.02）和尿素（r = 0.38，p = 0.001）。CD 146与血管性血友病因子显著相关（r = 0.33，p = 0.002），血栓调节蛋白（r = 0.25，p = 0.025），年龄（r = 0.34，p = 0.001），血小板（r =-0.33，p = 0.002），血清尿素（r = 0.24，p = 0.039），胆固醇（r = 0.24，p = 0.046），ICAM蛋白C活性（r =-0.26，p = 0.019），并与血清肌酐和移植后时间相关。多元线性回归分析显示，CD 146、血栓调节蛋白和尿素是脂联素的独立预测因子，CD 146的独立预测因子主要是患者年龄。结论：内皮功能障碍和促凝状态在CAD肾移植受者中更明显，特别是在GFR较低的受者中。在肾移植受者中，内皮细胞损伤的标志物相对于健康志愿者显著增加。脂联素的升高可能是对抗内皮损伤的防御机制，其反映为升高的CD 146和血栓调节蛋白。版权所有（C）2005 S. Karger AG，巴塞尔。
Background: Adiponectin may be used for assessing the risk of coronary artery disease ( CAD) and may be related to the development of acute coronary syndrome. Decreased adiponectin has been associated with some risk factors for cardiovascular diseases such as male sex, obesity and diabetes mellitus. Adiponectin has antiatherogenic properties and attenuates endothelial inflammatory responses. CD146, a novel cell adhesion molecule, is localized at the endothelial junction. In kidney allograft recipients, endothelial dysfunction and atherosclerosis are almost universal. The aim of this cross-sectional study was to evaluate possible relations between adiponectin, CD146, and other markers of endothelial cell injury in 82 stable kidney transplant recipients ( mean age 45 years, mean time after transplantation 47 months) with and without CAD. Methods: Adiponectin and markers of endothelial injury: CD146, von Willebrand factor, thrombomodulin, ICAM, CD40L, P-selectin and other hemostatic markers were assessed using commercially available kits. Results: Patients with CAD had evidence of more pronounced endothelial dysfunction, procoagulant state and lower adiponectin than patients without CAD. Adiponectin correlated significantly, in univariate analysis, with CD146 ( r = 0.29, p = 0.009), thrombomodulin ( r = 0.37, p = 0.001), protein Z ( r = - 0.25, p = 0.03), BMI ( r = - 0.26, p = 0.047), serum creatinine ( r = 0.26, p = 0.02) and urea ( r = 0.38, p = 0.001). CD146 correlated significantly with von Willebrand factor ( r = 0.33, p = 0.002), thrombomodulin ( r = 0.25, p = 0.025), age ( r = 0.34, p = 0.001), platelets ( r = - 0.33, p = 0.002), serum urea ( r = 0.24, p = 0.039), cholesterol ( r = 0.24, p = 0.046), ICAM ( r = 0.23, p = 0.036), protein C activity ( r = - 0.26, p = 0.019) and tended to correlate with serum creatinine and time after transplantation. In multivariate linear regression, independent predictors of adiponectin were CD146, thrombomodulin and urea, and of CD146 was mainly age of patients. Conclusions: Endothelial dysfunction and procoagulant state are more pronounced in kidney transplant recipients with CAD, particularly in those with lower GFR. In kidney transplant recipients, markers of endothelial cell injury are significantly increased relative to healthy volunteers. Elevation of adiponectin may be a defense mechanism against endothelial damage, reflected by elevated CD146 and thrombomodulin. Copyright (C) 2005 S. Karger AG, Basel.