慢性肾脏病患者肾素-血管紧张素系统与血浆β-淀粉样蛋白相关性研究

Correlation between renin-angiotensin system and plasma beta-amyloid peptide in patients with chronic kidney disease and its significance

目的:分析慢性肾脏病(CKD)患者肾素-血管紧张素系统(RAS)与血浆β-淀粉样蛋白(Aβ)的相关性,进而探究CKD与阿尔茨海默病(AD)的关系。方法:收集CKD患者33例(CKD组)、年龄及性别相当的健康体检者35例(对照组)为研究对象。记录所有研究对象一般临床资料(包括性别、年龄)、生活方式(包括饮酒、吸烟)、共病(包括高血压、糖尿病)以及实验室检查指标(包括肌酐、尿素氮、二氧化碳、尿酸、胱抑素C)。检测血浆肾素、血管紧张素Ⅱ、Aβ1-40、Aβ1-42水平并计算Aβ1-40/Aβ1-42。采用多重线性回归分析CKD患者各项指标与血浆Aβ的相关性。结果:两组年龄与性别,以及吸烟、饮酒、糖尿病情况,二氧化碳水平比较,差异无统计学意义(均P>0.05)。CKD组高血压患病数高于对照组(P<0.05)。CKD组肾素、血管紧张素Ⅱ、肌酐、尿素氮、尿酸、胱抑素C水平均高于对照组(均P<0.05)。CKD组Aβ1-40和Aβ1-42水平高于对照组,Aβ1-40/Aβ1-42低于对照组(均P<0.05)。CKD患者血管紧张素Ⅱ与Aβ1-40、Aβ1-40/A1-42呈负相关,与Aβ1-42呈正相关(均P<0.05);胱抑素C与Aβ1-40、Aβ1-40/A1-42呈正相关(均P<0.05);肌酐与Aβ1-40/Aβ1-42呈正相关性(P<0.05)。结论:CKD患者RAS与血浆Aβ存在相关性,而Aβ沉积为AD的主要病理学特征,故CKD与AD密切相关。

Objective:To study the correlation between renin-angiotensin system and plasma beta-amyloid peptide(Aβ)in patients with chronic kidney disease(CKD),and to explore the relationship between CKD and Alzheimer’s disease(AD).Methods:33 CKD patients(CKD group)and 35 healthy subjects of the same age and sex(control group)were collected as study subjects.General clinical data(including gender,age),lifestyle(including alcohol consumption,smoking),comorbidities(including hypertension,diabetes),and laboratory tests(including creatinine,urea nitrogen,carbon dioxide,uric acid,and cystatin C)were recorded for all subjects.Plasma levels of renin,angiotensinⅡ,Aβ1-40 and Aβ1-42 were measured and Aβ1-40/Aβ1-42 was calculated.Multiple linear regression was used to analyze the correlation between various indexes and plasma Aβin CKD patients.Results:There was no significant difference between the two groups in terms of age,sex,smoking,alcohol consumption and diabetes mellitus(all P>0.05).The prevalence of hypertension in CKD group was higher than that in control group(P<0.05).The levels of renin,angiotensinⅡ,creatinine,urea nitrogen,uric acid and cystatin C in CKD group were higher than those in control group(all P<0.05).The levels of Aβ1-40 and Aβ1-42 in CKD group were higher than those in control group,and Aβ1-40/Aβ1-42 was lower than that in control group(all P<0.05).AngiotensinⅡwas negatively correlated with Aβ1-40 and Aβ1-40/A1-42 and positively correlated with Aβ1-42 in CKD patients(all P<0.05).Cystatin C was positively correlated with Aβ1-40 and Aβ1-40/A1-42(all P<0.05).Creatinine was positively correlated with Aβ1-40/Aβ1-42(P<0.05).Conclusion:There is a correlation between RAS and plasma Aβin patients with CKD,and Aβdeposition is the main pathological feature of AD,so CKD is closely related to AD.