Possible association between telomere length and renal dysfunction in patients with chronic heart failure
Possible association between telomere length and renal dysfunction in patients with chronic heart failure
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DOI：
10.1016/j.amjcard.2008.03.040
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发表时间：
2008-07-15
影响因子：
2.8
通讯作者：
van Veldhuisen, Dirk J.
中科院分区：
文献类型：
--
作者：
van der Harst, Pim;Wong, Liza S. M.;van Veldhuisen, Dirk J.
肾功能损害与慢性心力衰竭（HF）患者预后不良有关。生物学老化的差异可能影响慢性HF患者发生肾功能不全的易感性。在本研究中，我们探讨了慢性心力衰竭患者白细胞端粒长度与肾功能的关系。我们研究了610例HF患者，年龄40 - 80岁，NYHA II-IV级，左心室射血分数≤ 0.40，肾小球滤过率采用肾脏疾病饮食改良（MDRD）公式估算，白细胞端粒长度采用有效的定量聚合酶链反应方法测定。随着MDRD公式四分位数的减少，性别和年龄调整的端粒长度比率稳步下降（平均值0.80，95%置信区间[CI] 0.73至0.88;平均值0.74，95% CI 0.68至0.81;平均值0.70，95% CI 0.63至0.76;平均值0.67，95% CI 0.61至0.73; P <0.01）。白细胞端粒长度与MDRD公式呈正相关（相关系数0.141; p <0.001）。在调整基线差异和基于倾向评分一对一匹配的敏感性分析后，这些发现仍然具有显著性。总之，根据MDRD公式估计，HF患者白细胞端粒长度缩短与肾功能下降相关。需要进一步的研究来确定白细胞端粒长度较短是否是该人群的原因或后果，以及它是否在HF肾功能不全的预后中起作用。(C)2008年爱思唯尔公司All rights reserved.
Renal function impairment relates to poor outcome in patients with chronic heart failure (HF). Differences in biological aging could affect the susceptibility to develop renal dysfunction in chronic HF. In the present study, we explored the association of leukocyte telomere length with renal function in patients with chronic HF. We studied 610 patients with HF, aged 40 to 80 years, NYHA class II-IV, with left ventricular ejection fraction of 0.40 or less. Glomerular filtration rate was estimated by the Modification of Diet in Renal Diseases (MDRD) formula, and telomere length of leukocytes was determined by a validated quantitative polymerase chain reaction- based method. Age-and gender-adjusted telomere length ratio decreased steadily with decreasing quartile of the MDRD formula (mean 0.80, 95% confidence interval [CI] 0.73 to 0.88; mean 0.74, 95% CI 0.68 to 0.81; 0.70 mean, 95% CI 0.63 to 0.76; mean 0.67, 95% CI 0.61 to 0.73; p < 0.01). Telomere length of leukocytes correlated positively with the MDRD formula (correlation coefficient 0.141; p < 0.001). These findings remained significant after adjustment for baseline differences and sensitivity analysis based on propensity score one-to-one matching. In conclusion, shorter leukocyte telomere length is associated with decreased renal function as estimated by the MDRD formula in patients with HF. Further studies will be needed to determine whether shorter leukocyte telomere length is the cause or consequence in this population and whether it plays a role in the prognosis of renal dysfunction in HF. (C) 2008 Elsevier Inc. All rights reserved.