FOLIC ACID FOR VASCULAR OUTCOME REDUCTION IN TRANSPLANTATION (FAVORIT)

叶酸可减少移植时的血管结局（最受欢迎）

• 批准号: 7376999
• 负责人: Lawrence G. Hunsicker
• 金额: $ 6.55万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7376999
• 关键词: FOLIC; ACID; VASCULAR; OUTCOME; REDUCTION

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Patients with chronic renal disease occupy the highest risk stratum for subsequent arteriosclerotic cardiovascular disease (CVD) events. The excess risk of CVD in chronic renal disease is due in part to a higher prevalence of established arteriosclerotic risk factors, including older age, hypertension, diabetes, dyslipidemia, and physicial inactivity. However, unique renal insufficiency/"uremia"-related risk factors likely also contribute to this excess CVD risk. Prominent among these unique risk factors in the chronic renal disease population are elevated levels of the putatively atherothrombotic sulfur amino acid homocysteine. Homozygous genetic disorders (i.e., the "homocystinurias") resulting in marked hyperhomocysteinemia (total homocysteine levels of 100 to 500 umol/L) are clearly associated with precocious atherothrombotic events, and total homocysteine (tHcy)-lowering treatment appears to reduce the incidence of such outcomes among these patients. In addition, pooled data from prospective observational studies suggest that mild to moderate hyperhomocysteinemia (tHcy levels of 12 to 99 umol/L) may also be a significant risk factor for arteriosclerotic CVD among general populations of men and women. However, randomized, controlled clinical trial data confirming these reported associations are unavailable. Moreover, the impact of cereal grain flour fortification with folic acid on plasma tHcy levels within the general population may obfuscate the results from any such trials conducted in the United States. Chronic renal disease patients, including renal transplant recipients, have an excess prevalence of mild to moderate hyperhomocysteinemia, which has been independently linked to their development of CVD outcomes in recent prospective observational studies. These investigators hypothesize that lowering tHcy levels in patients with chronic renal disease will reduce their excess incidence of arteriosclerotic CVD outcomes.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构适用于该中心，这不一定是调查员的机构。慢性肾脏疾病的患者在随后的动脉硬化心血管疾病（CVD）事件中占据最高风险层。慢性肾脏疾病中CVD的过多风险部分是由于已建立的动脉硬化危险因素的患病率更高，包括年龄较大，高血压，糖尿病，血脂异常和物理不活跃。但是，独特的肾功能不全/与“尿毒症”相关的风险因素也可能导致过多的CVD风险。在这些独特的危险因素中，在慢性肾脏疾病人群中的突出因素是较高的动脉粥样硬化硫氨基酸同型半胱氨酸的水平升高。纯合遗传疾病（即，“同型结构化尿症”）导致明显的高质性结构血症（总的共囊糖苷水平为100至500 UMOL/L）显然与早熟的动脉粥样硬化性事件，以及较较低的患者的整体治疗相关，可降低这些渗透性。此外，来自前瞻性观察性研究的汇总数据表明，轻度至中度的高层结晶性血症（12至99 UMOL/L的THCY水平）也可能是男性和女性一般人群中动脉硬化CVD的重要危险因素。但是，确认这些报告的关联的随机，受控的临床试验数据是不可用的。此外，谷物粉强化用叶酸对普通人群内血浆THCY水平的影响可能会掩盖美国在美国进行的任何此类试验的结果。慢性肾脏疾病患者，包括肾脏移植受者，患有轻度至中度的高型心霉状血症的患病率过高，在最近的前瞻性观察研究中，这与其CVD结果的发展独立联系。这些研究者假设降低慢性肾脏疾病患者的THCY水平将减少其动脉硬化CVD结局的过多发生率。