Τομέας Υγείας - Μητέρας - Παιδιού
Library of the School of Health Sciences

2015-12-16

2015

Τουρλάκης Δημήτριος

Αναπλ. Καθηγητής Παναγιώτης Βάκας

Συσχέτιση νεφρικής λειτουργίας εντός φυσιολογικών ορίων με υποκλινική αρτηριακή νόσο σε υγιείς μετεμμηνοπαυσιακές γυναίκες

Greek

Correlation between normal renal function and subclinical arterial arterial disease in healthy postmenopausal women

Introduction: Due to the continuous progress of science, more and more emphasis
is
given on prevention and early diagnosis of diseases. It could not be different
with regard to
cardiovascular disease when that is the first cause of death worldwide. Over
the years of a
woman's life, and particularly after menopause, various changes occur, which in
some of these
predispose to the development of cardiovascular disease. It is also well known
that the renal
function and the cardiovascular function are closely intertwined in the sense
that damage of one
system quite often lead to the other system.

Objective: The purpose of this study is to investigate a possible association
between
renal function level within normal limits, and subclinical arterial disease, in
other words before
the onset of clinical symptoms, in newly postmenopausal women, with the
ultimate aim of
preventing the progression of disease through changes in lifestyle or
pharmacological
inteventions.
The study aims therefore to assess the potential impact of renal function
variations in the
vascular structure before the development of hypertension.

Methods: This pilot study included 141 postmenopausal women without evidence of
renal dysfunction or hypertension. Markers of renal function and levels of
glomerular filtration
rate (GFR) using standard calculations (GFR based on levels of creatinine
[GFRepi]) and newer
creatinine and/or cystatin calculations (GFR based on levels of creatinine and
cystatin [GFRcr
cystatin] and GFR based on levels of cystatin [GFRcystatin]) were associated
with hemodynamic
parameters and markers of vascular structure (intima-media thickness [IMT] and
presence of
atheromatous plaques in carotid and femoral arteries).

Results: Levels of GFRepi, GFRcr cystatin, and GFRcystatin exhibited a
significant
negative correlation with femoral artery IMT, whereas levels of GFRepi
correlated significantly
with mean carotid bulb (CB) IMT. Multivariate analysis showed that CB-IMT was
predicted by
GFRepi levels and age (A-coefficient = 0.212, P = 0.020), whereas femoral
artery IMT was
predicted by GFRepi levels (A-coefficient = 0.293, P = 0.001). GFRepi levels
lower than the
25th percentile were associated with higher CB-IMT (P = 0.009), femoral artery
IMT (P =
0.001), and combined IMT (P = 0.035) compared with higher GFRepi levels.
Moreover, GFRepi
levels greater than the 25th percentile were associated with lower odds for the
presence of
atherosclerotic plaques at the CB and carotid arteries combined (CB: odds
ratio, 0.146; P =
0.006; combined: odds ratio, 0.249; P = 0.043) compared with lower GFRepi
levels.

Conclusions: A mild decrease in renal function within normal limits of GFR is
independently associated with the presence of subclinical atherosclerosis in a
sample of
apparently healthy young postmenopausal women. Assessment of GFR using
creatinine (vs
cystatin C) levels is a more sensitive marker of its association with IMT and
atherosclerotic
plaques in this postmenopausal population.

Renal function, Subclinical atherosclerosis, Glomerular filtration rate calculations, Intima media thickness, Menopause

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https://pergamos.lib.uoa.gr/uoa/dl/object/1308238