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Hypertension:早期肾功能不全与HIV感染者高血压的发生有关!!!

2016-12-20 haofan MedSci原创

这些结果提示早期肾小球损伤和肾功能不全可能参与了HIV感染者高血压的发病机制.。在未感染的妇女中肾小管标志物与高血压的相关性应在其他研究中进行验证。

亚临床肾病与一般人群高血压的发生相关,但在HIV感染者中缺乏相关的数据。近日,心血管权威杂志Hypertension上发表一篇研究文章,研究者评估了来源于跨部门女性艾滋病研究的823例HIV感染者和267个未感染HIV的妇女肾脏功能和与高血压导致的肾功能损伤发生之间的关系。 

该研究为多中心、前瞻性队列研究,包含在美国的HIV感染和未感染的女性队列。研究人员测量了研究对象的基础肾脏生物标志物,包括采用血清胱抑素C估计的肾小球滤过率、尿白蛋白/肌酐比值;另外包括7个肾小管损伤的尿中生物标志物:α-1-微球蛋白、白细胞介素-18、肾损伤分子-1、中性粒细胞明胶酶相关的载脂蛋白、肝细胞脂肪酸-结合蛋白、N-乙酰β-尿和α1-酸-糖蛋白。研究者使用多变量Poisson回归评估了肾脏生物标志物与高血压发生之间的相关性,高血压发生被定义为连续2次因使用抗高血压药物而就诊。 

在9.6年的中位随访中,有288名HIV感染者(约35%)出现高血压。在HIV感染的妇女中,更高的尿白蛋白/肌酐比值与高血压的发生独立相关(尿白蛋白/肌酐比值每次增倍的相对危险度为1.13,95%可信区间为1.07-1.20),也与较低的估计肾小球滤过率(每降低10mL/min/1.73 m2肾小球滤过率相对危险度为1.10;95%可信区间为1.04–1.17)独立相关。


没有肾小管损伤和肾功能障碍的生物标志物与HIV感染妇女的高血压发生存在独立相关性。相反,在没有HIV感染的妇女中,尿白蛋白/肌酐比值与高血压发生不存在相关性,而尿中高水平的IL-18、α1-酸-糖蛋白和N-乙酰-β-D-氨基葡萄糖苷酶与高血压发病密切相关。 

这些结果提示早期肾小球损伤和肾功能不全可能参与了HIV感染者高血压的发病机制。在未感染的妇女中肾小管标志物与高血压的相关性应在其他研究中进行验证。 

原始出处:

Simon B. Ascher, et al. Association of Kidney Function and Early Kidney Injury With Incident Hypertension in HIV-Infected Women. Hypertension. 2016. 

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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    2017-11-22 yese
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    2017-01-18 feather89
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1850592, encodeId=8f76185059279, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Wed Nov 22 14:02:00 CST 2017, time=2017-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1726251, encodeId=e5701e26251cb, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Wed Jan 18 03:02:00 CST 2017, time=2017-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2038567, encodeId=bb9d203856ec0, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Fri Apr 21 12:02:00 CST 2017, time=2017-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1285008, encodeId=354012850089e, content=<a href='/topic/show?id=db45824e11f' target=_blank style='color:#2F92EE;'>#肾功能不全#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82471, encryptionId=db45824e11f, topicName=肾功能不全)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=jiangjun073, createdTime=Thu Dec 22 12:02:00 CST 2016, time=2016-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290214, encodeId=d17a1290214ce, content=<a href='/topic/show?id=f774890827' target=_blank style='color:#2F92EE;'>#HIV感染者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8908, encryptionId=f774890827, topicName=HIV感染者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f65b226, createdName=circumcision, createdTime=Thu Dec 22 12:02:00 CST 2016, time=2016-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501101, encodeId=3d4a1501101ba, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Thu Dec 22 12:02:00 CST 2016, time=2016-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=164822, encodeId=8d24164822cf, content=文章很好,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Dec 22 08:26:06 CST 2016, time=2016-12-22, status=1, ipAttribution=)]
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    2016-12-22 1e10c84am36(暂无匿称)

    文章很好,值得学习

    0

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