血清分泌型卷曲蛋白5水平与原发性高血压患者早期肾损害的相关性

doi:10.3969/j.issn.1004-583X.2023.12.003

摘要/Abstract

摘要：

目的分析血清分泌型卷曲蛋白5(secreted frizzled-related protein 5,SFRP5)水平与原发性高血压早期肾损害的相关性。方法选取2017年1-12月就诊于河北医科大学第二医院首次诊断为原发性高血压患者88例和同时期健康体检者32例(A组)。根据尿白蛋白/肌酐比值(urine albumin creatine ratio,UACR)对88例原发性高血压患者进行分组,无早期肾损害者(UACR<30 mg/g)41例(B组),存在早期肾损害(30 mg/g≤UACR≤300 mg/g)者47例(C组)。比较3组SFRP5、胱抑素C(cystatin C,Cys-C)、尿素氮、肌酐水平。结果 ①C组SFRP5水平低于A组、B组( $P$ <0.01),B组SFRP5水平低于A组( $P$ <0.05)。②C组Cys-C水平高于A组、B组( $P$ <0.01)。③SFRP5与UACR、Cys-C呈负相关( $r$ =-0.839, $P$ <0.01; $r$ =-0.378, $P$ <0.05)。Cys-C 与UACR呈正相关( $r$ =0.625, $P$ <0.01)。④SFRP5是高血压肾损害的独立保护因子(β=-0.036, $P$ <0.01),Cys-C是高血压肾损害的独立危险因素(β=0.288, $P$ <0.01)。结论 SFRP5是高血压患者早期肾损害的保护性因子,有可能成为高血压患者早期肾损害预测和治疗的新靶点之一,为临床用药和评价药物疗效提供新的方向。

关键词: 高血压, 早期肾损害, 血清分泌型卷曲蛋白5, 胱抑素C, 尿微量白蛋白/肌酐

Abstract:

Objective To investigate the correlation between serum secreted frizzled-related protein 5 (SFRP5) and early renal damage in patients with essential hypertension. Methods During January 2017 to December 2017, a total of 88 patients who were initially diagnosed as essential hypertension in the Second Hospital of Hebei Medical University were recruited, and they were divided into group B (UACR<30 mg/g, $n$ =41) and group C (30 mg/g≤UACR≤300 mg/g, $n$ =47) based on the urine albumin creatine ratio (UACR). During the same period, 32 healthy volunteers receiving physical examinations were included in group A. Serum SFRP5, cystatin C (Cys-C), blood urea nitrogen and serum creatinine were compared. Results Serum SFRP5 was significantly lower in group C than that of group A and group B ( $P$ <0.01), which was significantly lower in group B than that of group A ( $P$ <0.05). Cys-C was significantly higher in group C than that of group A and group B ( $P$ <0.01). SFRP5 was negatively correlated with UACR ( $r$ =-0.839, $P$ <0.01) and Cys-C ( $r$ =-0.378, $P$ <0.05). Cys-C was positively correlated with UACR ( $r$ =0.625, $P$ <0.01). SFRP5 was an independent protective factor for hypertensive renal damage (β=-0.036, $P$ <0.01), and Cys-C was an independent risk factor for it (β=0.288, $P$ <0.01). Conclusion SFRP5 may be a protective factor for renal damage in hypertension, serving as a potential predictive and therapeutic target for it. Our findings provide a new direction for clinical medication and evaluation of drug efficacy.

Key words: hypertension, early renal damage, secreted frizzled-related protein 5 (SFRP5), cystatin C (Cys-C), urinary albumin/creatinine ratio

中图分类号:

R544.1

刘奕, 崔坤, 刘畅, 赵浩天, 李丽, 薛红元. 血清分泌型卷曲蛋白5水平与原发性高血压患者早期肾损害的相关性[J]. 临床荟萃, 2023, 38(12): 1073-1077.

Liu Yi, Cui Kun, Liu Chang, Zhao Haotian, Li Li, Xue Hongyuan. Correlation between serum secreted frizzled-related protein 5 and early renal damage in patients with essential hypertension[J]. Clinical Focus, 2023, 38(12): 1073-1077.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2023.12.003

https://huicui.hebmu.edu.cn/CN/Y2023/V38/I12/1073

图/表 6

表1 3组一般临床资料比较

Tab.1 Comparison of clinical characteristics in the three groups

组别		例数	年龄(岁)		性别[例(%)]			吸烟[例(%)]				BMI(kg/m²)		BUN(mmol/L)
组别		例数	年龄(岁)		男		女	是		否		BMI(kg/m²)		BUN(mmol/L)
A组		32	65.42±5.46		18(56.3)		14(43.7)	11(34.4)		21(65.6)		24.03±1.22		7.04±2.11
B组		41	65.83±6.31		24(58.5)		17(41.5)	14(34.1)		27(65.9)		25.54±1.41		7.35±1.80
C组		47	66.39±5.97		28(59.6)		19(40.4)	16(34.0)		31(66.0)		25.39±1.03		7.62±2.07
$P$ 值			0.551		0.521			0.630				0.211		0.482
组别	SCr(μmol/L)			TC(mmol/L)		TG(mmol/L)			LDL-C(mmol/L)		HDL-C(mmol/L)		FPG(mmol/L)
A组	87.82±11.43			4.26±0.35		1.29±0.18			2.90±0.78		1. 38±0.27		5.51±0.35
B组	89.62±10.51			4.55±0.67		1.40±0.45			2.98±0.83		1.29±0.75		5.63±0.49
C组	92.36±12.16			4.48±1.04		1.37±0.62			3.19±0.94		1.28±0.91		5.71±0.57
$P$ 值	0.110			0.431		0.452			0.140		0.162		0.264

表1 3组一般临床资料比较

Tab.1 Comparison of clinical characteristics in the three groups

组别		例数	年龄(岁)		性别[例(%)]			吸烟[例(%)]				BMI(kg/m²)		BUN(mmol/L)
组别		例数	年龄(岁)		男		女	是		否		BMI(kg/m²)		BUN(mmol/L)
A组		32	65.42±5.46		18(56.3)		14(43.7)	11(34.4)		21(65.6)		24.03±1.22		7.04±2.11
B组		41	65.83±6.31		24(58.5)		17(41.5)	14(34.1)		27(65.9)		25.54±1.41		7.35±1.80
C组		47	66.39±5.97		28(59.6)		19(40.4)	16(34.0)		31(66.0)		25.39±1.03		7.62±2.07
$P$ 值			0.551		0.521			0.630				0.211		0.482
组别	SCr(μmol/L)			TC(mmol/L)		TG(mmol/L)			LDL-C(mmol/L)		HDL-C(mmol/L)		FPG(mmol/L)
A组	87.82±11.43			4.26±0.35		1.29±0.18			2.90±0.78		1. 38±0.27		5.51±0.35
B组	89.62±10.51			4.55±0.67		1.40±0.45			2.98±0.83		1.29±0.75		5.63±0.49
C组	92.36±12.16			4.48±1.04		1.37±0.62			3.19±0.94		1.28±0.91		5.71±0.57
$P$ 值	0.110			0.431		0.452			0.140		0.162		0.264

图1 3组SFRP5水平比较注:与C组比较,* P<0.01,# P<0.01

Fig.1 Comparison of SFRP5 in the three groups

表2 3组SFRP5、Cys-C水平比较

Tab.2 Comparison of SFRP5 and Cys-C levels in the three groups

组别	例数	SFRP5(ng/ml)	Cys-C(mg/L)
A组	32	19.27±2.83	0.86±0.11
B组	41	17.72±2.52^*	0.87±0.10
C组	47	7.20±2.79^*#	2.50±0.50^*#
$F$ 值		257.377	358.278
$P$ 值		<0.01	<0.01

表2 3组SFRP5、Cys-C水平比较

Tab.2 Comparison of SFRP5 and Cys-C levels in the three groups

组别	例数	SFRP5(ng/ml)	Cys-C(mg/L)
A组	32	19.27±2.83	0.86±0.11
B组	41	17.72±2.52^*	0.87±0.10
C组	47	7.20±2.79^*#	2.50±0.50^*#
$F$ 值		257.377	358.278
$P$ 值		<0.01	<0.01

图2 EH合并早期肾损害患者SFRP5、Cys-C、UACR相关性分析

Fig.2 Correlation analysis of SFRP5, Cys-C and UACR in EH patients with early renal damage

表3 EH合并早期肾损害患者UACR与SFRP5、Cys-C相关性分析

Tab. 3 Correlation analysis between UACR and SFRP5, Cys-C in EH patients with early renal damage

自变量	$r$	$P$
SFRP5(ng/ml)	-0.839	<0.01
Cys-C(mg/L)	0.625	<0.01

表3 EH合并早期肾损害患者UACR与SFRP5、Cys-C相关性分析

Tab. 3 Correlation analysis between UACR and SFRP5, Cys-C in EH patients with early renal damage

自变量	$r$	$P$
SFRP5(ng/ml)	-0.839	<0.01
Cys-C(mg/L)	0.625	<0.01

表4 多元线性回归分析

Tab.4 Multiple Linear regression analysis

自变量	β	BE	beta	$t$ 值	$P$ 值
SFRP5	-0.036	0.007	-0.444	-5.255	<0.01
Cys-C	0.288	0.047	0.517	6.120	<0.01

表4 多元线性回归分析

Tab.4 Multiple Linear regression analysis

自变量	β	BE	beta	$t$ 值	$P$ 值
SFRP5	-0.036	0.007	-0.444	-5.255	<0.01
Cys-C	0.288	0.047	0.517	6.120	<0.01

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