Background

Arterial stiffness is associated with an increased risk of cardiovascular diseases. Augmentation index (AIx@75), a measure of arterial stiffness and wave reflection, has not been evaluated in patients with primary nephrotic syndrome (PNS). We investigated whether central and peripheral vascular profiles, hemodynamic parameters, and biochemical tests are associated with AIx@75 in PNS patients.

Methods

This observational study involved 38 children and adolescents with PNS (12.14 ± 3.65 years) and 37 healthy controls (13.28 ± 2.80 years). Arterial stiffness and vascular and hemodynamic parameters were measured noninvasively using the Mobil-O-Graph® (IEM, Stolberg, Germany). In the PNS group, biochemical tests and corticosteroid dosage/treatment time were analyzed.

Results

Peripheral and central systolic blood pressure (SBPp, SBPc) Z-scores were significantly higher in the PNS patients. AIx@75 was significantly higher in the PNS patients (25.14 ± 9.93%) than in controls (20.84 ± 7.18%). In the control group, AIx@75 negatively correlated with weight (r = − 0.369; p = 0.025), height (r = − 0.370; p = 0.024), and systolic volume/body surface (r = − 0.448; p = 0.006). In the PNS group, a univariate linear correlation showed that AIx@75 negatively correlated with weight (r = − 0.360; p = 0.027), height (r = 0.381; p = 0.18), and systolic volume/body surface (r = − 0.447; p < 0.002) and positively with the Z-score of SBPp (r = 0.407; p = 0.011), peripheral diastolic blood pressure (DBPp, r = 0.452; p = 0.004), SBPc (r = 0.416; p = 0.009), DBPc (r = 0.407; p = 0.011), triglycerides (r = 0.525; p = 0.001), and cholesterol [total (r = 0.539; p < 0.001), LDLc (r = 0.420; p = 0.010), and non-HDLc (r = 0.511; p = 0.001)].

Conclusions

Early abnormalities of AIx@75 and vascular parameters suggest that patients with PNS, even in stable condition, present subclinical indicators for the development of cardiovascular disease.

中文翻译：

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增强指数是心血管事件的预测指标，在患有原发性肾病综合征的儿童和青少年中升高。

背景

动脉僵硬与心血管疾病的风险增加有关。尚未对原发性肾病综合征（PNS）的患者进行增强指数（AIx @ 75）的测量，该指数是动脉僵硬度和波反射的一种度量。我们调查了PNS患者中枢和外周血管分布，血液动力学参数和生化检查是否与AIx @ 75相关。

方法

这项观察性研究涉及38名PNS儿童和青少年（12.14±3.65岁）和37名健康对照（13.28±2.80岁）。使用Mobil-O-Graph®（IEM，德国斯托尔贝格）以无创方式测量动脉僵硬度以及血管和血液动力学参数。在PNS组中，分析了生化测试和皮质类固醇剂量/治疗时间。

结果

PNS患者的外周和中央收缩压（SBPp，SBPc）Z评分显着较高。PNS患者的AIx @ 75显着高于对照组（20.84±7.18％）（25.14±9.93％）。在对照组中，AIx @ 75与体重（r  = − 0.369；p  = 0.025），身高（r  = − 0.370；p  = 0.024）和收缩体积/体表（r  = − 0.448；p  = 0.006 ）呈负相关。）。在PNS组中，单变量线性相关性表明AIx @ 75与体重（r  = − 0.360; p  = 0.027），身高（r  = 0.381; p = 0.18）和收缩体积/体表（r  =-0.447; p  <0.002），与SBPp的Z评分呈正相关（r  = 0.407; p  = 0.011），周围舒张压（DBPp，r  = 0.452; p  = 0.004），SBPc（r  = 0.416; p  = 0.009），DBPc（r  = 0.407; p  = 0.011），甘油三酸酯（r  = 0.525; p  = 0.001）和胆固醇[总计（r  = 0.539; p  <0.001 ），LDLc（r  = 0.420; p  = 0.010）和非HDLc（r  = 0.511;p  = 0.001）]。

结论

AIx @ 75和血管参数的早期异常表明，即使处于稳定状态，PNS患者也呈现出心血管疾病发展的亚临床指标。