抄録
Background：End-stage renal failure is escalating due to the increased prevalence of renal damage (chronic kidney disease, CKD) secondary to arteriosclerosis resulting from metabolic syndrome (MetS). In congruence with the observed renal damage, the occurrence of cerebrovascular/cardiovascular disease (CCVD) affecting the patient's vital prognosis and quality of life also increases. Our previous study reported on surrogate markers utilized for the early diagnosis of CKD pathophysiologically based on MetS. In the present study, the vasodilator response is investigated for their potential diagnostic value in the early diagnosis of CCVD. Subjects and methods：The vasodilator responses (flow-mediated dilation [FMD] and nitroglycerin-induced dilation [NID]) to the right brachial artery were measured accordingly as efficient indicators to serve as surrogate markers for early diagnosis of CCVD in 208 Japanese males who are diagnosed with MetS. Before the analysis of FMD and NID data, the subjects were divided into groups according to the presence or absence of CCVD or the number of risk factors for MetS. Results：FMD values were generally extremely low and showed no significant differences between the two groups with respect to the presence of CCVD or the number of MetS risk factors. In contrast, NID values were generally low but the decrease in NID values was significant and was more marked in the group with CCVD and in those with MetS risk factors compared to their respective pairing groups. Conclusion：Although FMD values already showed a decrease at the time of MetS diagnosis, NID values showed a delayed decrease, and this decrease in NID values was accompanied by the onset of CCVD. These findings suggest that FMD (lowered values) may serve as a surrogate marker for the early prediction of CCVD due to arteriosclerosis and that NID (lowered values) may serve as a surrogate marker for the diagnosis of a progressive pathophysiological change in CCVD.
