Cytomegalovirus Seropositivity Is Associated with Increased Arterial Stiffness in Patients with Chronic Kidney Disease
Cytomegalovirus Seropositivity Is Associated with Increased Arterial Stiffness in Patients with Chronic Kidney Disease
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DOI：
10.1371/journal.pone.0055686
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发表时间：
2013-02-25
期刊：
影响因子：
3.7
通讯作者：
Ferro, Charles J.
中科院分区：
文献类型：
--
作者：
Wall, Nadezhda A.;Chue, Colin D.;Ferro, Charles J.
背景资料：慢性肾脏疾病患者心血管风险增加，传统风险因素无法完全解释，但似乎与动脉僵硬度增加有关。巨细胞病毒（CMV）感染与心血管风险增加有关，尽管其机制尚不清楚。我们研究是否CMV血清阳性与慢性肾脏病患者动脉僵硬度增加相关。方法和主要发现：在215例非糖尿病慢性肾脏病患者中，CMV血清阳性使用抗CMV IgG ELISA测定。在升主动脉、近端降主动脉和远端降主动脉中测量脉搏波速度并评估主动脉扩张性。CMV血清阳性患者在所有3个节段的脉搏波速度较高，主动脉扩张性较低。这些差异（除了升主动脉扩张性）在年龄、性别和肾功能相匹配的子队列中持续存在，当整个队列被分成四分位数时。在多变量分析中，CMV血清阳性是脉搏波速度和近端和远端降主动脉扩张性的独立决定因素。结论：在慢性肾脏疾病患者中，CMV血清阳性与动脉僵硬度增加和近端降主动脉和远端降主动脉扩张性降低相关。这些结果表明，需要进一步的研究，以检查CMV作为一个可能的原因动脉疾病和心血管风险增加的患者与CKD，可能是更广泛的CMV血清阳性患者与肾功能正常。
Background: Patients with chronic kidney disease have an increased cardiovascular risk that is not fully explained by traditional risk factors but appears to be related to increased arterial stiffness. Cytomegalovirus (CMV) infection is associated with increased cardiovascular risk although the mechanisms for this are unknown. We examined whether CMV seropositivity was associated with increased arterial stiffness in patients with chronic kidney disease.Methodology and Principal Findings: In 215 non-diabetic patients with chronic kidney disease, CMV seropositivity was determined using an anti-CMV IgG ELISA. Pulse wave velocity was measured and aortic distensibility assessed in the ascending, proximal descending and distal descending thoracic aorta. Patients seropositive for CMV had a higher pulse wave velocity and lower aortic distensibility at all 3 levels. These differences (except for ascending aortic distensibility) persisted in a subcohort matched for age, gender and renal function, and when the whole cohort was divided into quartiles of age. In multivariable analyses, CMV seropositivity was an independent determinant of pulse wave velocity and proximal and distal descending aortic distensibility.Conclusions: In patients with chronic kidney disease, CMV seropositivity is associated with increased arterial stiffness and decreased distensibility of the proximal descending and distal aorta. These findings suggest that further research is required to examine CMV as a possible cause of arterial disease and increased cardiovascular risk in patients with CKD and may be relevant more widely for CMV seropositive patients with normal renal function.