• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文学位 >Association of circulating leukocyte levels with hypertension and hypertension-related renal damage.
【24h】

Association of circulating leukocyte levels with hypertension and hypertension-related renal damage.

机译：循环白细胞水平与高血压和高血压相关肾损害的关系。

获取原文
获取原文并翻译 | 示例
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

The kidney plays a major role in the regulation of blood pressure (BP). Renal defects cause abnormal renal pressure natriuresis and diuresis leading to essential hypertension. Even though these defects are difficult to identify in hypertensive patients, animal studies suggest that renal inflammation (infiltration of inflammatory cells) is involved in the pathogenesis of hypertension and may be connected to systemic low-grade inflammation. Recent population-based studies have shown that systemic inflammatory markers, including total white blood cells (WBC), are associated with incident hypertension and the risk of kidney dysfunction. However, the relationship between circulating specific leukocyte types and hypertension and hypertension-associated renal dysfunction in human remains unclear.;The primary hypothesis of my study is that hypertension is associated with specific circulating leukocytes and these leukocyte types contribute to kidney damage, which initiate or exacerbate hypertension. The manifestations of hypertension in African-Americans are more severe than in whites, and the hypertension associated renal damage is also 4-6 times greater than in whites. Therefore, the above hypothesis may be especially applicable to African-Americans. The objectives of this study were to determine: (1) whether there is an independent association between the levels of specific circulating leukocytes (neutrophils, monocytes, lymphocytes) and BP parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP)]; (2) whether there is an independent association between the levels of specific circulating leukocytes (neutrophils, monocytes, lymphocytes) and the risk of kidney function decrease; and (3) whether these specific circulating leukocyte levels predict declining kidney function.;The Atherosclerosis Risk in Communities (ARIC) Study data include complete BP measurements, WBC profile and plasma creatinine measurements in both whites and African-Americans, with strict quality controls and standard measurements. Therefore, ARIC study data were used in this study with both cross-sectional and prospective observational designs. The results show that in African-Americans, but much less so in whites, increased neutrophil levels and decreased lymphocyte levels are significantly associated with elevated BP but do not influence the rate of change of BP over time; moreover, in the ARIC population, increased circulating neutrophil levels and decreased lymphocyte levels are significantly associated with the incidence of chronic kidney disease (CKD). Higher neutrophil and lower lymphocyte tertiles predict the incidence of CKD after adjustment for covariates. In a subgroup of ARIC participants who have hypertension at baseline, but neither diabetes nor hyperuricemia, the same relationship between specific circulating leukocytes and CKD incidence was found, and this relationship was stronger than in the population as a whole. Comparisons between African-Americans and whites suggested that African-Americans had similar but stronger patterns of association than whites between circulating leukocytes and CKD incidence in both the whole study population and in the subgroup of ARIC participants who have hypertension at baseline, although the differences between race groups were not statistically significant.;These findings suggest that specific circulating leukocytes (neutrophils and lymphocytes) play an important role in the regulation of BP. Specific circulating leukocytes could mediate increases in renal reactive oxygen species (ROS), angiotensin II (Ang II) and inflammation. These mechanisms may lead to pathological functional and structural changes in the kidney including nephrosclerosis, and may contribute to the development of hypertension and /or hypertension-related kidney damage, especially in African-Americans.
机译：肾脏在血压（BP）的调节中起主要作用。肾功能不全会引起异常的肾压钠尿和利尿，导致原发性高血压。尽管在高血压患者中很难识别这些缺陷，但动物研究表明，肾脏炎症（炎性细胞浸润）与高血压的发病机制有关，并且可能与全身性低度炎症有关。最近的基于人群的研究表明，全身性炎症标记物，包括总白细胞（WBC），与突发性高血压和肾功能不全的风险有关。然而，循环中特定的白细胞类型与人的高血压以及与高血压相关的肾功能障碍之间的关系仍不清楚。我的主要假设是高血压与特定循环中的白细胞相关，这些白细胞类型导致肾脏损害，从而引发或加剧高血压。非裔美国人的高血压表现比白人严重，与高血压相关的肾脏损害也比白人大4-6倍。因此，以上假设可能特别适用于非裔美国人。这项研究的目的是确定：（1）特定循环白细胞（中性粒细胞，单核细胞，淋巴细胞）的水平与BP参数[收缩压（SBP），舒张压（DBP），平均动脉压（MAP）和脉压（PP）]； （2）特定循环白细胞（中性粒细胞，单核细胞，淋巴细胞）的水平与肾功能降低的风险之间是否存在独立的联系； （3）这些特定的循环白细胞水平是否预示着肾功能的下降。社区的动脉粥样硬化风险（ARIC）研究数据包括白人和非裔美国人的完整BP测量，WBC曲线和血浆肌酐测量，并进行严格的质量控制和标准尺寸。因此，本研究使用ARIC研究数据进行横断面和前瞻性观察设计。结果表明，在非洲裔美国人中，但在白人中，中性粒细胞水平的升高和淋巴细胞水平的降低与血压升高显着相关，但不影响血压随时间的变化率，而在白人中则更是如此。此外，在ARIC人群中，循环中性粒细胞水平的升高和淋巴细胞水平的降低与慢性肾脏病（CKD）的发生率显着相关。调整协变量后，较高的中性粒细胞和较低的淋巴细胞三分位数可预测CKD的发生率。在基线时患有高血压但既没有糖尿病也没有高尿酸血症的ARIC参与者亚组中，发现特定循环白细胞与CKD发生率之间存在相同的关系，并且这种关系比整体人群更强。非裔美国人和白人之间的比较表明，在整个研究人群和基线患有高血压的ARIC参与者亚组中，非裔美国人在循环白细胞和CKD发病率上的白人之间的联系方式均与白人相似但更强。不同种族之间没有统计学意义。;这些发现表明，特定的循环白细胞（中性粒细胞和淋巴细胞）在调节BP中起重要作用。特定的循环白细胞可介导肾活性氧（ROS），血管紧张素II（Ang II）和炎症的增加。这些机制可能导致肾脏的病理功能和结构变化，包括肾硬化，并且可能导致高血压和/或与高血压相关的肾脏损害的发展，尤其是在非裔美国人中。

著录项

  • 作者

    Tian, Niu.;

  • 作者单位

    The University of Mississippi Medical Center.;

  • 授予单位 The University of Mississippi Medical Center.;
  • 学科 Health Sciences Medicine and Surgery.;Health Sciences Public Health.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 141 p.
  • 总页数 141
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号