Hypertension, glomerular hypertrophy and nephrosclerosis: the effect of race.
Hypertension, glomerular hypertrophy and nephrosclerosis: the effect of race.
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DOI：
10.1093/ndt/gft480
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发表时间：
2014-07
期刊：
影响因子：
--
通讯作者：
Bertram JF
中科院分区：
文献类型：
--
作者：
Hughson MD;Puelles VG;Hoy WE;Douglas-Denton RN;Mott SA;Bertram JF
非裔美国人比白色美国人有更严重的高血压肾硬化症，可能在相似的血压水平。与白人相比，非裔美国人的肾小球体积增加，但尚不确定这与肾硬化症的关系，以及它是否有助于或补偿肾小球硬化症。对171名非裔美国人和131名白人的尸检肾脏进行了体视解剖/分离器估计，获得了肾小球数量（Nglom）和平均肾小球体积（Vglom）。88名非洲裔美国人和49名白人被确定为高血压。肾硬化通过肾小球硬化百分比、皮质纤维化比例和小叶间动脉内膜厚度进行形态学测量，并通过年龄、种族、性别、体重指数（BMI）和血压进行Vglom分析。非裔美国人高血压（58.5%）比白人（35.8%）更常见，高血压时血压水平更高（P = 0.02）。与非高血压受试者相比，白色女性（P = 0.02）中高血压受试者的Nglom显著较低，但白色男性（P = 0.34）或非洲裔美国女性（P = 0.10）或男性（P = 0.41）则无此差异。对于每个种族和性别，肾小球硬化、皮质纤维化和动脉内膜增厚与年龄（P < 0.001）和高血压（P < 0.001）有统计学相关性，Vglom增加与高血压（P < 0.001）和BMI（P < 0.001）相关。在多变量分析中，非裔美国人种族与Vglom增加（P = 0.01）和动脉内膜增厚（P < 0.01）相关，而种族与血压之间的相互作用表明，肾硬化的严重程度（包括Vglom增加）与高血压直接相关，而种族无显著影响。高血压相关的Vglom增大存在于轻度肾小球硬化中，并且随着肾小球硬化严重程度的增加而变化不大。肾小球肥大被认为是高血压肾病的一个不可分割的特征，似乎先于肾小球硬化而不是代偿肾小球硬化。种族对Vglom和动脉内膜增厚的影响似乎与非裔美国人中更频繁和更严重的高血压有关。
African Americans have more severe hypertensive nephrosclerosis than white Americans, possibly at similar levels of blood pressure. Glomerular volume is increased in African Americans relative to whites, but it is uncertain how this relates to nephrosclerosis and whether it contributes to or compensates for glomerulosclerosis. Stereological disector/fractionator estimates of glomerular number (Nglom) and average glomerular volume (Vglom) were obtained on autopsy kidneys of 171 African Americans and 131 whites. Eighty-eight African Americans and 49 whites were identified as hypertensive. Nephrosclerosis was measured morphometrically as the percentage of glomerulosclerosis, proportion of cortical fibrosis and interlobular artery intimal thickness, and analyzed with Vglom by age, race, gender, body mass index (BMI) and blood pressure. African Americans were more frequently hypertensive (58.5%) than whites (35.8%) and when hypertensive had higher levels of blood pressure (P = 0.02). Nglom was significantly lower in hypertensive compared with non-hypertensive subjects among white women (P = 0.02) but not white males (P = 0.34) or African American females (P = 0.10) or males (P = 0.41). For each race and gender, glomerulosclerosis, cortical fibrosis and arterial intimal thickening were statistically correlated with age (P < 0.001) and hypertension (P < 0.001) and increased Vglom with hypertension (P < 0.001) and BMI (P < 0.001). In multivariate analysis, African American race was associated with increased Vglom (P = 0.01) and arterial intimal thickening (P < 0.01), while interactions between race and blood pressure indicated that the severity of nephrosclerosis including increased Vglom was linked most directly to hypertension without significant contributions from race. The hypertension-associated enlargement of Vglom was present with mild degrees of glomerulosclerosis and changed little as the severity of glomerulosclerosis increased. Glomerular hypertrophy was identified as an integral feature of hypertensive nephropathy and appeared to precede rather than compensate for glomerulosclerosis. An effect of race on Vglom and arterial intimal thickening seemed to be related to the more frequent and more severe hypertension among African Americans.
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DOI：
10.1126/science.1193032
发表时间：
2010-08-13
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Genovese G;Friedman DJ;Ross MD;Lecordier L;Uzureau P;Freedman BI;Bowden DW;Langefeld CD;Oleksyk TK;Uscinski Knob AL;Bernhardy AJ;Hicks PJ;Nelson GW;Vanhollebeke B;Winkler CA;Kopp JB;Pays E;Pollak MR
通讯作者：
Pollak MR
影响因子：
8.3
作者：
Fields, LE;Burt, VL;Sorlie, P
通讯作者：
Sorlie, P
影响因子：
19.6
作者：
Hill, GS;Heudes, D;Bariéty, J
通讯作者：
Bariéty, J
影响因子：
--
作者：
LAW, CM;DESWIET, M;FALL, CHD
通讯作者：
FALL, CHD
影响因子：
19.6
作者：
Fogo, A;Breyer, JA;Wright, JT
通讯作者：
Wright, JT