JAHA:脱氧胆酸与慢性肾功能不全患者冠状动脉钙化的关系

2022-03-25 MedSci原创 MedSci原创

在CRIC研究参与者中,DCA与CAC的患病率、发生率或进展无关。

血管钙化在慢性肾脏病(CKD)中很常见。66%的慢性肾功能不全队列(CRIC)研究参与者表现出中度至重度冠状动脉钙化(CAC)。血管钙化与动脉僵硬度相关,这会促进左心室肥大和CKD进展,并且还与CKD患者的心血管疾病事件和死亡率独立相关。必须更好地了解血管钙化的病理生理学,以确定预防和减缓CKD进展的治疗目标。

脱氧胆酸(DCA)是一种次级胆汁酸,已有研究报道其会促进血管钙化。在一小部分患有晚期慢性肾病的个体中,较高的DCA水平与常见的冠状动脉钙化(CAC)相关。DCA水平是否与2至4期慢性肾脏病不同人群的CAC患病率、发病率和进展相关尚未明确。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,在慢性肾功能不全队列(CRIC)研究中,研究人员使用多变量调整回归模型评估了空腹血清DCA水平与计算机断层扫描CAC之间的横断面(n=1057)和纵向(n=672)关联。

受试者平均年龄为57±12岁,47%为女性,41%为黑人。基线时,64%的受试者伴有CAC(CAC评分>0 Agatston单位)。在横断面分析中,根据人口统计学和临床​因素调整的模型显示,与无CAC相比,DCA水平和CAC>0之间没有关联(log DCA每增加1个SD的患病率为1.08[95%CI为0.91-1.26)。DCA与CAC事件(log DCA每增加1个SD的发生率为1.08[95%CI为0.85–1.39])或CAC进展(log DCA每增加1个SD,对应的Agatston单位>100和>200的风险分别为1.05[95%CI为0.84–1.31]和1.26[95%CI为0.77–2.06])无关。

由此可见,在CRIC研究参与者中,DCA与CAC的患病率、发生率或进展无关。

原始出处:

Anna Jovanovich,et al.Deoxycholic Acid and Coronary Artery Calcification in the Chronic Renal Insufficiency Cohort.JAHA.2022.https://www.ahajournals.org/doi/full/10.1161/JAHA.121.022891

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    2023-03-07 yese
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    2022-03-26 zhaohui6731
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肾脏疾病、富含脂质的斑块和巨噬细胞是冠状动脉钙化快速进展的独立预测因子。基线时血管炎症和随后的稳定结果可能与钙化斑块快速进展有关。

Metabolism:脂蛋白(a)与冠状动脉钙化的关系

Lp(a)升高与CAC体积绝对增加相关,特别是在炎症和凝血标记物水平较高的受试者中。这些结果表明,Lp(a)可作为CAC进展的潜在生物标志物。

JAHA:HIV感染者冠状动脉钙化和斑块特征

与HIV阴性个体相比,HIV感染者的非钙化冠状动脉斑块患病率更高,冠状动脉钙化患病率相似。未来对冠状动脉钙化和斑块进展的研究可以进一步阐明HIV感染者的亚临床动脉粥样硬化。

Heart:什么?运动竟然会加速冠状动脉钙化的进展

已有多项研究证明,规律运动有助于预防心脏病、中风、糖尿病、乳腺癌和结肠癌等非传染性疾病。