脂肪因子在慢性肾脏病动脉粥样硬化中作用的研究进展

Research progress on the role of adipokines in atherosclerosis of chronic kidney disease

心血管并发症是慢性肾脏病(chronic kidney disease,CKD)首要死亡原因,动脉粥样硬化(atherosclerosis,AS)对CKD患者心血管事件发生的早期预测和干预起着重要作用。脂肪组织被认为是一种活跃的内分泌器官,可分泌多种脂肪因子。近年研究发现,多个脂肪因子成员在AS的发生机制中具有重要调节作用。肾脏是多个脂肪因子清除的场所,CKD患者肾脏清除能力下降及存在着脂代谢异常、微炎症状态、胰岛素抵抗、钙磷代谢紊乱等一个或多个合并症可导致体内的脂肪因子谱异常。当体内促钙脂肪因子和抑钙脂肪因子失衡时会引起一系列反应影响血管壁状态,影响AS的发生发展。该文旨在讨论几个具有代表性的脂肪因子在CKD患者合并AS中的作用。

Cardiovascular complications are the leading cause of death in chronic kidney disease(CKD).Atherosclerosis(AS)plays an important role in the early prediction and intervention of cardiovascular events in patients with CKD.Adipose tissue is considered an active endocrine organ that secretes a variety of adipokines.Recent studies have found that multiple adipokines play an important regulatory role in the pathogenesis of AS.Kidney is the site where multiple adipokines are cleared,the decreased clearing ability of kidney in CKD patients and the presence of one or more complications like abnormal lipid metabolism,micro-inflammatory state,insulin resistance,calcium and phosphorus metabolism disorders can lead to the abnormalities in adipokines spectrum.The imbalance of calcium-promoting adipokines and calcium-inhibiting adipokines in the body will cause a series of reactions that affect the state of vascular wall and the occurrence and development of AS.This article aims to discuss the role of several representative adipokines in CKD patients with AS.