老年男性血清抵抗素水平与慢性肾病的关系

The relationship between the serum resistin level and chronic kidney disease in the elderly male patients

目的观察老年男性血清抵抗素水平与慢性肾病（CKD）的关系。方法入选843例老年男性住院患者,测定血清抵抗素、肌酐（Cr）、C反应蛋白（CRP）、胱抑素-C（Cystatin-C）,并测量身高、体质量、收缩压（SBP）及舒张压（DBP）,计算体质量指数（BMI）。在各连续变量之间进行相关分析,并以抵抗素为因变量进行线性回归分析。比较各浓度区间组中CKD的患病率。将患者分为CKD组和非CKD组,比较两组间的连续变量,并以CKD为因变量进行二元Logistic回归分析。结果抵抗素与肾小球滤过率（e GFR）、DBP呈负相关;与年龄、SBP、Cr、Cystatin-C和CRP呈正相关（P〈0.05）。Cystatin-C和CRP与抵抗素独立相关（P〈0.01）。CKD组年龄、SBP、抵抗素、Cystatin-C和Cr显著高于非CKD组,而e GFR和DBP显著低于非CKD组（P〈0.01）。抵抗素浓度较高组CKD组患病率显著高于浓度较低组（P〈0.01）。二元Logistic回归分析发现,抵抗素水平是CKD的独立危险因素（OR=1.170,95%CI为1.108~1.237,P〈0.01）,在校正年龄、CRP等因素后,该关系仍存在（OR=1.094,95%CI为1.024~1.168,P=0.008）。结论在老年男性中,Cystatin-C和CRP与血清抵抗素水平独立相关;抵抗素是CKD的独立危险因素,抵抗素可能通过炎症以及其他途径参与CKD的发病,二者之间的关系尚需进一步研究阐明。

Objective To investigate the relationship between serum resistin level and chronic kidney disease（CKD） in elderly male patients. Methods 843 elderly male patients were enrolled in the present study. The serum levels of resistin, creatinine（Cr）,C-reactive protein（CRP）,Cystatin-C were determined, and the height,body weight（and BMI）,systolic blood pressure（SBP） and diastolic blood pressure（DBP） were measured. Spearman correlation analysis and linear regression analysis（with resistin as dependent vari-able） were performed. The prevalence of CKD was compared between the four levels groups. The patients were divided into CKD group and non-CKD group. The continuous variables between the two groups were compared and logistic regressive analysis（with CKD as dependent variable） was performed. Results Resistin was negatively correlated with e GFR,DBP and was positively correlated with age,SBP,Cr,Cystatin-C and CRP（P〈0.05）. Cystatin-C and CRP were independently correlated with resistin（P〈0.01）. The age,SBP,resistin,Cystatin-C and Cr in the CKD group were significantly higher than those in the non-CKD group,and the e GFR and DBP were significantly lower. The prevalence of CKD in the higher resistin level group was significantly greater than that in the lower resistin level group（P〈0.01）. The logistic regressive analysis showed that the resistin level was the independent risk factor of CKD（OR = 1.170,95% CI 1.108 ~ 1.237,P〈0.01）,even after controlling for age and CRP（OR = 1.094,95% CI 1.024 ~ 1.168,P = 0.008）.Conclusion In the elderly male population,the Cystatin-C and CRP levels are independently correlated with the serum level of resistin;resistin may be the independent risk factors of CKD and it might play a role in the developments of CKD though pro-inflam-mation and other mechanisms which warrant further study.