Coronary artery calcification, ADMA, and insulin resistance in CKD patients
Coronary artery calcification, ADMA, and insulin resistance in CKD patients
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DOI：
10.2215/cjn.00010108
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发表时间：
2008-09-01
影响因子：
9.8
通讯作者：
Ohtake, Takayasu
中科院分区：
文献类型：
--
作者：
Kobayashi, Shuzo;Oka, Machiko;Ohtake, Takayasu
背景和目标：众所周知，在开始肾脏替代治疗之前，慢性肾脏病（CKD）患者会发生冠状动脉钙化（CAC），并涉及与CKD矿物质和骨骼疾病（CKD-MBD）相关的因素。然而，关于血浆不对称二甲基精氨酸（ADMA）水平、胰岛素抵抗和CAC之间的任何关联的信息很少。设计、设置、参与者和测量：共111例CKD患者（79名男性，32名女性;肾小球滤过率[GFR]中位数，33.7 ml/min/1.73 m2），无心血管疾病，与30名年龄匹配的健康受试者一起连续招募沿着。结果：CKD患者冠状动脉钙化积分（CACS）分布范围为0 ~ 2901，而年龄匹配的健康对照组（n = 30）CACS分布范围为0 ~ 307。GFR与CACS呈显著负相关。血浆ADMA水平与GFR呈负相关，与CACS呈正相关。当CACS分为四分位数（600，n = 17）时，与CACS患者相比，CACS >600的患者具有显著更高的HOMA-IR、血浆ADMA水平和纤维蛋白原沿着血清磷水平
Background and objectives: It is known that coronary artery calcification (CAC) develops in chronic kidney disease (CKD) before initiation of renal replacement therapy, and factors associated with CKD mineral and bone disorders (CKD-MBDs) are involved. However, little information is available about any association between plasma levels of asymmetric dimethylarginine (ADMA), insulin resistance, and CAC.Design, setting, participants, & measurements: A total of 111 CKD patients (79 men, 32 women; glomerular filtration rate [GFR] median, 33.7 ml/min per 1.73 m(2)), free of cardiovascular disease, were consecutively recruited along with 30 age-matched healthy subjects. Coronary artery calcification scores (CACS) were measured by multidetector-row CT according to Agatston score.Results: In CKD patients, CACS was distributed widely from 0 to 2901, while in age-matched, healthy control subjects (n = 30), CACS showed a range from 0 to 307. GFR had a significant negative correlation with CACS. Plasma ADMA levels were negatively correlated with GFR and positively correlated with CACS. When CACS was divided into quartiles (600, n = 17), the patients with CACS >600 had significantly higher values of HOMA-IR, plasma ADMA levels, and fibrinogen along with serum levels of phosphorus, compared with those in patients having CACS