健康人群尿蛋白成分与肾小球滤过率及颈动脉内中膜厚度增龄变化的关系  

Relationship Between Urinary Protein Components and Age-related Changes of Glomerular Filtration Rate and Carotid Intima-media Thickness in Healthy People

作　　者：夏熊芳[1] 李瑛[1] 李峥[1] 何雅億[1] 凌光辉[1] 李军[1] 

机构地区：[1]中南大学湘雅二医院肾内科、中南大学肾脏病研究所,湖南长沙410011

出　　处：《医学临床研究》2009年第12期2202-2205,共4页Journal of Clinical Research

基　　金：国家重点基础研究发展973计划（2007CB507400）,国家科技支撑计划（2007BA104B10）

摘　　要：【目的】4g讨健康人群尿白蛋白（ALB）、转铁蛋白（TRF）、β2-微球蛋白（β2-MG）与肾小球滤过率（GFR）及颈动脉内中膜厚度（C—IMT）增龄变化的关系，以期找到能够同时预测肾脏和心血管衰老性病态转化的标志性尿蛋白。【方法】将80名健康志愿者，按年龄分为4组（35～，45～，55～，≥65岁）。检测尿ALB、TRF、β2-MG及GFR，同时测定C-IMT。【结果】①随着年龄增长，GFR下降，CIMT增加。≥65岁组同其他三组相比，GFR下降和C—IMT增加均有统计学意义（P〈0．05）。②血压、血脂随着年龄增长在正常范围内呈上升趋势。收缩压（SBP）、舒张压（DBP）、甘油三酯（TG）、总胆固醇（TC）从45～岁年龄段开始，增加有统计学意义（P〈0．05）；脉压（PP）、低密度脂蛋白胆固醇（LDL-C）在65岁以上升高有统计学意义（P〈0．05）。GFR与SP、PP、体重指数（BMI）呈负相关（P均〈0．05）。C—IMT与TG、TC呈正相关（P均〈0．05）。③ACR（ALB／Cr）、TRF／Cr、β2-MG／Cr在各年龄组间均无统计学差异（P〉0．1），与GFR、C—IMT均无相关性（P〉0．1）。【结论】GFR和C—IMT分别是反映肾脏和心血管系统衰老程度的标志物。正常范围内的血压、血脂增高可能对肾脏和心血管系统衰老产生“潜在”的影响。ACR、TRF／Cr、β2-MG／Cr均不能作为预测肾脏或心血管衰老性病态转化的标志物。[Objective]To find the urinary protein which can be an indicator for the renal and cardiovascular transformation from normal changes to pathological lesions in the aging process through evaluating the relationship between urinary albumin（ALB）, transferrin（TRF）, beta-2-microglobulin（β2-MG） and age-related changes of glomerular filtration rate （GFR） and carotid intima-media thickness （C IMT） in healthy population. [Methods]Healthy participants （ n =80） were divided into four age groups （35-, 45-, 55-, ≥65 years）. GFR,C-IMT and the urinary level of ALB, TRF and β2-MG were determined. [Results]①GFR decreased and C-IMT increased with age. Compared to the other three groups, both the decrease of GFR and the increase of C-IMT were significant in subjects aged ≥65 years （ P〈0.05）. ②Blood pressure and blood lipid increased with age among normal range. Significant increases of systolic pressure （SP）, diastolic pressure （DP）, triglyceride （TG）, total cholesterol （TC） started from the subjects aged 45- years（ P 〈0.05）, while that of pulse pressure （PP） and low density lipoprotein cholesterol （LDL-C） started from 65 years old （ P 〈0.05）. GFR was negatively correlated with SP, PP and body mass index （BMI） （all P 〈0.05）. C-IMT was positively correlated with TG and TC （r=0. 234, 0. 251, all P〈0.05）. QACR, TRF/Cr and β2 MG/Cr had no statistical difference among four groups （ P 〉0.1）. And they were all not correlated with GFR or carotid IMT （ P 〉0.1）. [Conclusion]GFR and C-IMT are the markers for renal and cardiovascular aging, respectively. The increase of blood pressure and blood lipid among normal range could have ＂potential＂ effects on renal and cardiovascular aging. ACR, TRF/Cr and β2-MG/Cr all can＇t be the indicators for renal or cardiovascular transformation from normal changes to pathological lesions in the aging process.

关 键 词：蛋白尿 肾小球滤过率 颈动脉/解剖学和组织学 

分 类 号：R695.2[医药卫生—泌尿科学]