CKD患者同型半胱氨酸与GFR的相关性

doi:10.3969/j.issn.1673-8640.2015.11.010

摘要/Abstract

摘要： 目的

探讨慢性肾病(CKD)患者血清同型半胱氨酸(Hcy)与肾小球滤过率(GFR)的相关性。

方法

选择就诊的CKD疑似患者289例,其中134例确诊为CKD (CKD组),另155例作为非CKD组。检测血清Hcy、肌酐(Cr)、尿酸(UA)、血糖(Glu)、血脂[包括甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平,分析Hcy与GFR的相关性。

结果

CKD组Hcy水平明显高于正常对照组(P<0.01),Cr、UA、GFR明显低于正常对照组(P<0.01)。按Hcy水平分组,与<15 μmol/L组相比,15~30 μmol/L组和>30 μmol/L组的GFR、Cr明显降低(P<0.05),UA则略有升高。Hcy和GFR呈负相关性(r=-0.398,P<0.01)。Hcy水平评价GFR的受试者工作特征(ROC)曲线下面积(AUC)为0.706(95%可信区间:0.643~0.745)。

结论

CKD患者Hcy水平明显升高,与GFR有较好的相关性。

关键词: 同型半胱氨酸, 肾小球滤过率, 慢性肾病

Abstract: Objective

To investigate the correlationship between homocysteine (Hcy) and glomerular filtration rate (GFR) in patients with chronic kidney disease (CKD).

Methods

A total of 289 suspected CKD patients were enrolled. A total of 134 cases were diagnosed as CKD (CKD group), and the other 155 cases were as non-CKD group. The levels of serum Hcy, creatinine (Cr), uric acid (UA), glucose (Glu) and blood lipids [triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C)]were determined. The correlationship between Hcy and GFR was analyzed.

Results

The levels of Hcy in CKD group were significantly higher than those in control group (P<0.01), while Cr, UA and GFR were significantly lower (P<0.01). According to Hcy level, compared with the group of <15 μmol/L, the groups of 15-30 μmol/L and >30 μmol/L decreased significantly for GFR and Cr (P<0.05), and UA increased slightly. Hcy was negatively correlated with GFR (r=-0.398, P<0.01). The area under the receiver operating characteristic (ROC) curve (AUC) for Hcy was 0.706 [95% confidence interval (CI): 0.643-0.745].

Conclusions

Hcy increases significantly in CKD patients and has a good correlation with GFR.

Key words: Homocysteine, Glomerular filtration rate, Chronic kidney disease

中图分类号:

R446.1

李萍珠. CKD患者同型半胱氨酸与GFR的相关性[J]. 检验医学, 2015, 30(11): 1100-1103.

LI Pingzhu. Correlationship between homocysteine and glomerular filtration rate in patients with chronic kidney disease[J]. Laboratory Medicine, 2015, 30(11): 1100-1103.

图/表 5

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组别	例数	年龄(岁)	Hcy (μmol/L)	Cr (μmol/L)	Glu (mmol/L)	TG (mmol/L)
CKD组	134	74.2±13.3	18.7±8.9^*	66.9±15.2^**	5.5±1.3	1.7±1.2
非CKD组	155	72.5±15.2	13.8±7.7	98.1±21.3	5.7±1.3	1.5±0.8
P值		0.656	<0.01	<0.001	0.205	0.082
组别	例数	TC (mmol/L)	LDL-C (mmol/L)	HDL-C (mmol/L)	UA (μmol/L)	GFR [mL/(min·1.73 m²)]
CKD组	134	4.1±1.4	2.5±0.9	1.3±0.5	308.4±68.1^*	63.8±27.7^**
非CKD组	155	4.2±1.4	2.4±0.9	1.2±0.4	350.2±45.4	121.2±31.8
P值		0.806	0.199	0.345	<0.01	<0.001

组别	例数	年龄(岁)	Hcy (μmol/L)	Cr (μmol/L)	Glu (mmol/L)	TG (mmol/L)
CKD组	134	74.2±13.3	18.7±8.9^*	66.9±15.2^**	5.5±1.3	1.7±1.2
非CKD组	155	72.5±15.2	13.8±7.7	98.1±21.3	5.7±1.3	1.5±0.8
P值		0.656	<0.01	<0.001	0.205	0.082
组别	例数	TC (mmol/L)	LDL-C (mmol/L)	HDL-C (mmol/L)	UA (μmol/L)	GFR [mL/(min·1.73 m²)]
CKD组	134	4.1±1.4	2.5±0.9	1.3±0.5	308.4±68.1^*	63.8±27.7^**
非CKD组	155	4.2±1.4	2.4±0.9	1.2±0.4	350.2±45.4	121.2±31.8
P值		0.806	0.199	0.345	<0.01	<0.001

Hcy (μmol/L)	例数	GFR[mL/(min·1.73 m²)]	UA(μmol/L)	Cr(μmol/L)
≤15	147	116±35	296±86	96±27
15~30	120	82±38^*	323±93	73±25^*
>30	22	56±30^*	340±110	62±18^*

Hcy (μmol/L)	例数	GFR[mL/(min·1.73 m²)]	UA(μmol/L)	Cr(μmol/L)
≤15	147	116±35	296±86	96±27
15~30	120	82±38^*	323±93	73±25^*
>30	22	56±30^*	340±110	62±18^*