维持性血液透析患者血清Sfrp5、Klotho水平变化及其与钙磷代谢的关系

Changes of serum Sfrp5 and Klotho levels in maintenance hemodialysis patients and their relationship with calcium and phosphorus metabolism

目的通过测定维持性血液透析患者血清分泌型卷曲相关蛋白5(Sfrp5)、Klotho水平,探讨其与钙磷代谢的关系。方法选取门诊接受维持性血液透析治疗的患者80例作为透析组,选取同时段内体检的健康志愿者80例作为对照组。对比两组的数据,探讨维持性血液透析患者血清Sfrp5、Klotho水平变化及其与钙磷代谢的关系。结果透析组的血清Sfrp5、Klotho水平低于对照组(t=15.118、13.090,P<0.001),透析组的血清Sfrp5、Klotho水平与钙磷乘积(Ca×P)、全段甲状旁腺激素(iPTH)之间均呈负相关(r=-0.468、-0.475、-0.521、-0.503,P<0.001),出现颈动脉硬化患者的血清Sfrp5、Klotho水平低于未发生颈动脉硬化患者(t=5.223、7.839,P<0.001),透析组不同腹主动脉钙化积分(AAC)亚组的血清Sfrp5、Klotho水平数据差异均有统计学意义(F=35.057、49.598,P<0.001),透析组腹主动脉钙化程度与血清Sfrp5、Klotho水平之间呈负相关(r_s=-0.510、-0.498,P<0.001)。结论维持性血液透析患者血清Sfrp5、Klotho水平明显低于健康人群,其血清Sfrp5、Klotho水平与Ca×P、iPTH、颈动脉硬化、主动脉钙化之间均有密切关系。

Objective To measure the levels of serum secreted frizzled related protein 5(Sfrp5)and Klotho in maintenance hemodialysis patients and to investigate their correlations with calcium and phosphorus metabolism.Methods Eighty patients with maintenance hemodialysis in our hospital between September 2017 and November 2018 were enrolled as the dialysis group.Eighty healthy people received physical examination in our hospital at the same time were selected as the control group.To investigate the changes of serum Sfrp5 and Klotho levels and their correlations with calcium and phosphorus metabolism.Results The serum levels of Sfrp5 and Klotho in the dialysis group were significantly lower than those in the control group(t=15.118,13.090,P<0.001).There were negative correlations between serum Sfrp5 and Klotho levels with calcium,phosphorus product(Ca×P)and intact parathyroid hormone(iPTH)in the dialysis group(r=-0.468,-0.475,-0.521,-0.503,P<0.001).The serum levels of Sfrp5 and Klotho in patients with carotid atherosclerosis were lower than those in patients without carotid atherosclerosis(t=5.223 and 7.839,P<0.001).There were significant differences in serum Sfrp5 and Klotho levels between the dialysis group and the AAC subgroup(F=35.057,49.598,P<0.001).There were negative correlations between the degree of abdominal aortic calcification and serum Sfrp5 and Klotho levels in the dialysis group(r_s=-0.510,-0.498,P<0.001).Conclusion In patients with maintenance hemodialysis,serum Sfrp5 and Klotho levels are significantly reduced.There are close correlation between serum Sfrp5 and Klotho levels and calcium,phosphorus product(Ca×P),intact parathyroid hormone(iPTH),carotid atherosclerosis,and aortic calcification.