Correlationship between homocysteine and glomerular filtration rate in patients with chronic kidney disease

doi:10.3969/j.issn.1673-8640.2015.11.010

Abstract

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

CLC Number:

R446.1

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

Figures/Tables 5

References 20

[1]	ZHANG L,WANG F,WANG L,et al.Prevalence of chronic kidney disease in China: a cross-sectional survey[J]. Lancet,2012,379(9818):815-822.
[2]	LEVI A,COHEN E,LEVI M,et al.Elevated serum homocysteine is a predictor of accelerated decline in renal function and chronic kidney disease: a historical prospective study[J]. Eur J Intern Med,2014,25(10):951-955.
[3]	POTTER K,HANKEY GJ,GREEN DJ,et al.Homocysteine or renal impairment: which is the real cardiovascular risk factor[J]. Arterioscler Thromb Vasc Biol,2008,28(6):1158-1164.
[4]	NationalKidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation,classification,and stratification[J]. Am J Kidney Dis,2002,39(2 Suppl 1):S1-S266.
[5]	NYMAN U,GRUBB A,STERNER G,et al.The CKD-EPI and MDRD equations to estimate GFR. Validation in the swedish Lund-Malmö study cohort[J]. Scand J Clin Lab Invest,2011,71(2):129-138.
[6]	KANG SS,WONG PW,MALINOW MR.Hyperhomocyst(e)inemia as a risk factor for occlusive vascular disease[J]. Annu Rev Nutr,1992,12:279-298.
[7]	WANG CY,CHEN ZW,ZHANG T,et al.Elevated plasma homocysteine level is associated with ischemic stroke in Chinese hypertensive patients[J]. Eur J Intern Med,2014,25(6):538-544.
[8]	CLARKE R,DALY L,ROBINSON K,et al.Hyperhomocysteinemia: an independent risk factor for vascular disease[J]. N Engl J Med,1991,324(17):1149-1155.
[9]	GUPTA M,SHARMA P,GARG G,et al.Plasma homocysteine: an independent or an interactive risk factor for coronary artery disease[J]. Clin Chim Acta,2005,352(1-2):121-125.
[10]	REFSUM H,UELAND PM,NYGÅRD O,et al. Homocysteine and cardiovascular disease[J]. Annu Rev Med,1998,49:31-62.
[11]	CHUANG CH,LEE YY,SHEU BF,et al. Homocysteine and C-reactive protein as useful surrogate markers for evaluating CKD risk in adults[J]. Kidney Blood Press Res,2013,37(4-5):402-413.
[12]	程清. 脂蛋白相关磷脂酶A2和同型半胱氨酸水平与动脉粥样硬化性心脑血管疾病关系的研究[J]. 检验医学,2015,30(1): 40-43.
[13]	姜宇海,王亚平. 冠心病患者同型半胱氨酸的变化及其临床价值[J]. 检验医学,2014,29(5): 576-577.
[14]	吴仕君,王胜梅. 冠心病患者血清Hcy和Cys C水平的变化[J]. 检验医学,2014,29(4): 327.
[15]	王国戗,杨彩玲,郭丽娟. 不同血压水平人群血管危险因子检测及其临床意义探讨[J]. 检验医学,2014,29(3): 254-257.
[16]	杨帆,徐冰馨,郭平,等. 原发性高血压患者血浆同型半胱氨酸水平的变化及相关性研究[J]. 检验医学,2013,28(12): 1069-1072.
[17]	肖锦华,孙钧铭,王亚萍,等. 2型糖尿病微血管病变患者血浆同型半胱氨酸检测及其意义[J]. 检验医学,2005,20(5): 421-423.
[18]	蒋小红,吕旭军. 同型半胱氨酸与2型糖尿病及2型糖尿病肾病的关系[J]. 检验医学,2010,25(3): 253-254.
[19]	ALVAREZ B,YUGUEROS X,FERNÁNDEZ E,et al. Relationship between plasma homocysteine and the morphological and immunohistochemical study of carotid plaques in patients with carotid stenosis over 70%[J]. Ann Vasc Surg,2012,26(4):500-505.
[20]	WANG T,WANG Q,WANG Z,et al.Diagnostic value of the combined measurement of serum hcy, serum cys C, and urinary microalbumin in type 2 diabetes mellitus with early complicating diabetic nephropathy[J]. ISRN Endocrinol,2013,2013:407452.

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^*