腹膜透析患者血清白蛋白、铁调素25及25羟维生素D与动脉僵硬度的相关性研究

The Correlation Between Serum Albumin,Fertin 25 and 25 Hydroxyvitamin D and Arterial Stiffness in Peritoneal Dialysis Patients

目的研究腹膜透析患者血清白蛋白、铁调素25及25羟维生素D与动脉僵硬度的相关性。方法选取2013年8月至2017年6月收治的87名腹膜透析患者,应用血流介导扩张反应(FMD)检测腹膜透析患者动脉僵硬度,并抽取患者空腹静脉血,采用ELISA法检测血清中25羟维生素D和铁调素25水平,全自动生化分析仪检测血清白蛋白水平。根据患者FMD均值将其分为两组,低FMD组(FMD <7.37%)和高FMD组(FMD≥7.37%)。比较两组患者的临床指标,并采用相关分析及多元逐步回归分析血清白蛋白、铁调素25及25羟维生素D与动脉僵硬度的关系。结果低FMD组血清铁调素25水平高于高FMD组[(44.18±2.16)vs(32.85±2.67)μg/L],差异有统计学意义(P <0. 05)。低FMD组血清25羟维生素D及FMD值低于高FMD组[(25.27±7. 73) vs(29. 80±10. 85) mmol/L;(6.16±2.07) vs(8.29±2.64)%],差异有统计学意义(P <0. 05)。Pearson相关分析显示年龄、收缩压、铁调素25水平与FMD呈负相关(P<0. 05);血清白蛋白、25羟维生素D水平与FMD呈正相关(P<0. 05)。线性回归分析结果提示,年龄、收缩压及铁调素25,血清白蛋白和25羟维生素D是FMD值降低的独立影响因素。结论腹膜透析患者血清铁调素25升高,白蛋白和25羟维生素D水平下降与动脉僵硬度有关,可能加速心血管疾病的发生发展。

Objective To study the correlation between serum albumin, fertin 25 and 25 hydroxyvitamin D and arterial stiftness in patients with peritoneal dialysis. Methods From August 2013 to June 2017, 87 peritoneal dialysis patients were selected for the study. Arterial stiffness was assessed by flow mediated dilation （FMD） in these patients. Fasting blood was extracted from the patients and the serum levels of 25 hydroxyvitamin D and hepcidin 25 were determined by ELISA, and the level of serum albumin was detected by automatic biochemical analyzer. According to the mean value of FMD, patients were divided into two groups, the low FMD group （FMD 〈7.37% ） and the high FMD group （FMD≥7.37%）. The clinical parameters of the two groups were compared. Correlation analysis and stepwise regression analysis were used to analyze the relationship between serum albumin, hepcidin 25 and 25 hydroxyvitamin D and arterial stiftness. Results The level of serum ferritin 25 in the low FMD group was significantly higher than that in the high FMD group[（44.18 ±2. 16） vs （32.85 ±2.67） mu g/Ll, （P 〈0.05）. For the low FMD group, the serum 25 hydroxyvitamin D and FMD valueswere lower than that of the high FMD group [ （25.27 ±7.73 ） vs （29.80 ± 10.85） mmol/L; （6.16 ± 2.07） vs （8.29 ± 2.64） ] （P 〈 0.05 ）. Pearson correlation analysis showed that age, systolic blood pressure and hepcidin 25 level were negatively correlated with FMD （P 〈 0.05 ）. The serum albumin and 25 hydroxyvitamin D levels were positively correlated with FMD （P 〈 0.05）. The results of linear regression analysis showed that age, systolic pressure and fertin 25, serum albumin and 25 hydroxyvitamin D were independent factors affecting the decrease of FMD value. Conclusion Serum ferritin 25 is elevated in peritoneal dialysis patients, while there is a decrease in serum albumin and 25 hydroxyvitamin D levels, which are associated with arterial stiffness. This might accelerate the development of cardiovascular disease.