慢性肾脏病患者血清骨保护素水平及与腹主动脉钙化的相关性分析

Relationship between serum osteoprotegerin and abdominal aortic calcification

目的观察慢性肾脏病(CKD)3-5D期患者血清骨保护素(OPG)变化,并探讨和腹主动脉钙化(AAC)的相关性。方法选取86例CKD 3-5D期患者为研究对象,根据腹主动脉有无钙化分为AAC组和non-AAC组,应用ELISA法测定各组患者血清OPG水平;采用腹部侧位片评估AAC程度。结果 86例CKD患者中AAC 51例(59.3%)。51例ACC患者OPG明显高于35例non-AAC患者(P<0.01)。CKD5期未行肾脏替代治疗患者血清OPG显著高于CKD3-4期患者(P<0.05);CKD5D期血清OPG水平和CKD5期未行肾脏替代治疗患者OPG差异无统计学意义。血清OPG与e GFR呈显著负相关(r=-0.357,P=0.011),与AAC程度相关(r=0.258,P=0.017)。Logistic回归分析发现:男性(β=2.568,P=0.048)、吸烟(β=4.337,P=0.013)、OPG(β=1.273,P=0.003)是影响AAC的主要因素。结论在CKD患者中,血管钙化发生率高,随着肾功能恶化,血清OPG水平有升高趋势。男性、吸烟及OPG是AAC的危险因素,可能参与AAC的发生与发展。

Objective To determine serum osteoprotegerin （ OPG） level in chronic kidney disease（ CKD） and its relationship with abdominal aortic calcification （AAC）. Methods Eighty-six patients with CKD 3-5D were recrui-ted in the study. The level of serum OPG was measured by enzyme-linked immunlsorbent assay. AAC score was as-sessed by abdominal lateral X-ray examination. Results According to the presence of AAC, the patients with CKD3-5D were divided into two groups, AAC group （n=51） and non-AAC group （n=35）. Serum OPG in group AAC was relatively higher than that in non-AAC group （ P =0. 004 ） , serum OPG （ 13. 41 ± 2. 46 ） ng/ml versus OPG（11. 04 ± 2. 75） ng/ml. The level of serum OPG in CKD5 patients was higher than in CKD3-4 patients （P〈0. 05）, serum OPG （11. 75 ± 2. 85） ng/ml versus OPG （10. 39 ± 2. 78） ng/ml. But there was no difference be-tween predialysis CKD5 and CKD5D patients. The level of serum OPG was significantly associated with eGFR（r=-0. 357,P=0. 011）,AAC degree（r=0. 258, P=0. 017）. Logistic analysis showed that male （β=2. 568, P=0. 048）, smoking habits（β=4. 337, P=0. 013）and OPG （β=1. 273, P=0. 003） were associated with moderate to severe AAC. Conclusion The level of serum OPG is higher in patients with CKD5 than that of CKD3-4. The results suggest that higher OPG maybe play an important role in AAC progression.