Cigarette smoking reduced renal function deterioration in hypertensive patients may be mediated by elevated homocysteine.
Cigarette smoking reduced renal function deterioration in hypertensive patients may be mediated by elevated homocysteine.
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吸烟减少高血压患者肾功能恶化可能是由同型半胱氨酸升高介导的
DOI：
10.18632/oncotarget.13308
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发表时间：
2016-12-27
期刊：
影响因子：
--
通讯作者：
Huang H
中科院分区：
文献类型：
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作者：
Huang F;Chen J;Liu X;Han F;Cai Q;Peng G;Zhang K;Chen W;Wang J;Huang H
高同型半胱氨酸（HCY）和吸烟都是高血压患者的重要危险因素。然而，它们对高血压患者肾功能恶化是否有交叉作用，其作用机制尚不清楚。在本研究中，来自中国南方的3033名诊断为原发性高血压，肾小球滤过率（eGFR）估计为bbb30 ml/min/1.73 m2的参与者参加了这项横断面研究。我们收集了人口统计和临床数据。并对中介效应进行了分析。结果显示，与不吸烟者相比，吸烟者的HCY水平（13.10（11.20−16.87）比11.00(8.90−13.40)umol/L, P < 0.001）显著升高，eGFR水平（79.71（66.83−91.05）比82.89(69.80−95.85)ml/min/1.73m2, P < 0.001）显著降低。HCY水平和吸烟与eGFR降低独立相关。同时，eGFR水平与HCY呈显著负相关（P < 0.001），并且这种相关性在当前吸烟者中可能更强。每天吸烟超过20支会加速早期肾功能恶化（OR = 1.859, P = 0.019）。进一步的中介效应分析表明，吸烟与肾功能恶化之间的关系是由HCY介导的。HCY升高占吸烟导致高血压患者肾功能恶化的因果效应的56.94%。我们的研究结果表明，吸烟与高血压患者肾功能恶化有关，而吸烟与肾功能恶化的关系可能是由HCY升高介导的。因此，降hcy治疗可能有利于高血压吸烟患者肾功能恶化。
Elevated homocysteine (HCY) and smoking are both important risk factors for hypertensive patients. However, whether they have crossing effect on renal function deterioration of hypertensive patients and what is the underlying mechanism are unclear. In the present study, 3033 participants diagnosed as essential hypertension with estimated glomerular filtration rate (eGFR)> 30 ml/min/1.73 m2 from southern China were enrolled in this cross-sectional study. We collected the demographic and clinical data. In addition, the mediation effects were analyzed. The results showed that, comparing with non-smokers, smokers had significant higher levels of HCY (13.10 (11.20−16.87) vs. 11.00 (8.90−13.40) umol/L, P < 0.001) and lower eGFR (79.71 (66.83−91.05) vs. 82.89 (69.80−95.85) ml/min/1.73m2, P < 0.001). HCY levels and smoking were independently associated with decreased eGFR. Meanwhile, eGFR levels were significantly negatively correlated with HCY (P < 0.001), and this correlation might be stronger in current smokers. Current smoker consuming over 20 cigarettes per day would accelerate early renal function deterioration (OR = 1.859, P = 0.019). The mediation effects analysis further showed that the association between smoking and renal function deterioration was mediated by HCY. And elevated HCY was accounted for 56.94% of the estimated causal effect of smoking on renal function deterioration in hypertensive patients. Our findings indicated that cigarette smoking was associated with renal function deterioration in hypertensive patients, and the association between cigarette smoking and renal function deterioration was probably mediated by elevated HCY. Therefore, HCY-lowering therapy may be beneficial for renal function deterioration in hypertensive smoking patients.