肾脏雄激素调节蛋白与老年男性高血压肾病相关性的病例对照研究

Correlation of kidney androgen-regulated protein with hypertensive nephropathy in the elderly male patients: a case-control study

目的探讨肾脏雄激素调节蛋白与老年男性高血压肾病的相关性。方法根据广州生物库队列中收集的2008年以来约10 000名中老年男性门诊及住院的信息,筛选出高血压肾病老年(>60岁)患者23例,按1∶3比例配对有高血压无肾病组69例,按年龄1∶4比例配对健康对照组92例。用酶联免疫吸附实验(ELISA)测定血清中总睾酮(TT)、游离睾酮(FT)及肾脏雄激素调节蛋白(KAP)水平。结果 3组年龄、教育、职业、高密度脂蛋白、低密度脂蛋白、空腹血糖差异无统计学意义(P>0.05)。与健康组比较,高血压肾病组和高血压无肾病组腰围、体质指数、总胆固醇、三酰甘油、收缩压、舒张压明显增高(P<0.05)。与健康组和高血压无肾病组比较,高血压肾病组尿素及肌酐明显增高(P<0.05)。与健康组比较,高血压肾病组和高血压无肾病组性激素TT及FT明显下降(P<0.05)。高血压肾病组KAP(74.50±68.44)ng/m L显著高于(P<0.05)健康对照组(32.60±19.02)ng/m L和高血压无肾病组(30.50±19.29)ng/m L。从KAP与肾功能的相关分析看出:KAP与尿素及肌酐有明显的线性相关(回归系数分别为0.784和0.544,P<0.001)。结论血清KAP在老年男性高血压肾病的发生和发展中可能起到一定作用。

Objective To evaluate the correlation between kidney androgen- regulated protein and hypertensive nephropathy in the elderly patients. Methods A case control study was performed on 184 elderly men from the Guangzhou Biobank Cohort Study,including 92 healthy persons,69 patients with non- hypertensive nephropathy,and 23 patients with hypertensive nephropathy. The serum concentrations of total testosterone（ TT）,free testosterone（ FT） and kidney androgen- regulated protein were examined by enzyme- linked immunosorbent assay. Results No significant differences could be drawn among the age,education,occupation,high- density lipoprotein,low- density lipoprotein,or fasting blood glucose among the 3 groups（ P〉0. 05）. Compared with health group,hypertension history,Body mass index（ BMI）,waist circumference,total cholesterol,triglyceride,systolic blood pressure and diastolic blood pressure were significantly higher in the other 2 groups（ P〈0. 05）. The concentrations of TT and FT were significantly lower in hypertensive nephropathy group and in non- hypertensive nephropathy group than in health group（ P〈0. 05）. The concentration of KAP in hypertensive nephropathy group（ 74. 50 ncentrang / m L） was significantly higher than in health group（ 32. 60 r than ng/m L） and non- hypertensive nephropathy group（ 30. 50 ypertenng/m L）（ P〈0. 05）. The concentration of KAP was significantly positively correlated with the concentrations of urea and urine creatinine. Conclusion KAP may play a role in the occurrence and development of hypertensive nephropathy in elderly males.