Association of plasma resistin with glomerular filtration rate and albuminuria in hypertensive adults
Association of plasma resistin with glomerular filtration rate and albuminuria in hypertensive adults
复制标题
DOI：
10.1161/hypertensionaha.107.095257
复制
发表时间：
2007-10-01
期刊：
影响因子：
8.3
通讯作者：
Kullo, Iftikhar J.
中科院分区：
文献类型：
--
作者：
Ellington, Allison A.;Malik, A. Rauoof;Kullo, Iftikhar J.
抵抗素是近年来发现的一种促炎细胞因子，与胰岛素抵抗、炎症和肾功能不全密切相关。我们调查了1575名无冠心病或中风的高血压成人（857名黑人和718名非西班牙裔白人）血浆肌酐与估计肾小球滤过率和蛋白尿的相关性。抵抗素用固相夹心免疫测定法测定，肾小球滤过率用血清肌酐估计，尿白蛋白用尿白蛋白：肌酐比值表示。校正冠心病危险因素后（年龄、性别、体重指数、吸烟史、收缩压、糖尿病、总脂蛋白胆固醇和高密度脂蛋白胆固醇）和使用肾素-血管紧张素受体阻滞剂和他汀类药物，在两个种族组中，较高的血浆肌酐水平与较低的估计肾小球滤过率相关（均P < 0.0001）;在进一步调整胰岛素抵抗标记物后，（胰岛素抵抗的稳态模型评估）和炎症标志物（血浆C-反应蛋白），并且在两个种族的有糖尿病和无糖尿病的受试者中观察到（均P < 0.0001）。在黑人糖尿病患者中，较高的血浆肌酐水平与较高的尿白蛋白：肌酐比值相关（P < 0.0001）和非西班牙裔白色糖尿病患者（P = 0.032），与冠心病危险因素、高血压药物使用和他汀类药物使用无关;在对胰岛素抵抗和C-反应蛋白的稳态模型评估进行额外调整后，这种关联仍然显著。在高血压成人患者中，较高的循环肌酐水平与较低的估计肾小球滤过率和增加的尿白蛋白：肌酐比值在合并糖尿病的存在。这种关联独立于冠心病危险因素、胰岛素抵抗和炎症标志物。
Resistin, a recently discovered proinflammatory cytokine, has been variably associated with insulin resistance, inflammation, and renal dysfunction. We investigated the association of plasma resistin with estimated glomerular filtration rate and albuminuria in 1575 hypertensive adults without known coronary heart disease or stroke (857 blacks and 718 non-Hispanic whites). Resistin was measured by a solid phase sandwich immunoassay, estimated glomerular filtration rate was estimated from serum creatinine, and albuminuria was expressed as urine albumin: creatinine ratio. After adjustment for coronary heart disease risk factors (age, sex, body mass index, smoking history, systolic blood pressure, diabetes, and total and high-density lipoprotein cholesterol) and use of renin-angiotensin blockers and statins, higher plasma resistin levels were associated with lower estimated glomerular filtration rate in both ethnic groups (each P < 0.0001); the association remained significant after further adjustment for a marker of insulin resistance (homeostasis model assessment for insulin resistance) and a marker of inflammation (plasma C-reactive protein) and was seen in subjects with and without diabetes (each P < 0.0001) in both ethnic groups. Higher plasma resistin levels were associated with a higher urine albumin: creatinine ratio in black subjects with diabetes (P < 0.0001) and non-Hispanic white subjects with diabetes (P = 0.032), independent of coronary heart disease risk factors, hypertension medication use, and statin use; the association remained significant after additional adjustment for homeostasis model assessment for insulin resistance and C-reactive protein. In adults with hypertension, higher circulating resistin levels were associated with a lower estimated glomerular filtration rate and with increased urine albumin: creatinine ratio in the presence of concomitant diabetes. This association was independent of coronary heart disease risk factors and markers of insulin resistance and inflammation.