慢性肾脏病矿物质和骨异常患者血清白细胞介素-18、分泌型Klotho 和骨保护素的表达及意义

Expression and significance of IL-18, sKlotho and OPG in serum of patients with CKD-MBD

目的:观察慢性肾脏病矿物质和骨异常(CKD-MBD)患者血清中白细胞介素-18 (IL-18)、分泌型Klotho(sKlotho)和骨保护素(OPG)的表达水平,分析其临床意义。方法:选择55例CKD-MBD患者作为观察组,选择50例慢性肾脏疾病(CKD)患者作为对照组,选择50例健康成人作为正常对照组。收集受试者血清标本,应用ELISA法检测三组血清中IL-18、sKlotho和OPG的表达。结果:三组IL-18、sKlotho和OPG的表达差别有统计学意义;观察组中IL-18、sKlotho和OPG在不同肾小球滤过率(GFR)的表达的差别有统计学意义;IL-18、sKlotho和OPG在不同基础疾病情况的表达中差别无统计学意义。观察组中IL-18与全段甲状旁腺激素(iPTH)、IL-18与碱性磷酸酶(ALP)具有正相关性,sKlotho、OPG均与iPTH、ALP之间无相关性。观察组中IL-18、sKlotho和OPG之间无明显相关性。结论:IL-18、sKlotho和OPG高表达在CKD-MBD中有重要作用,三者的表达水平与病变的进展有关。IL-18与iPTH、IL-18与ALP存在正相关性。联合检测血清中IL-18、sKlotho和OPG的表达可能成为CKD-MBD的早期诊断标志物。

Objective:To observe the levels of interleukin-18(IL-18), secretory Klotho(sKlotho) and osteoprotegerin(OPG) in patients with CKD-MBD, and to analyze their clinical significance. Methods:55 patients with CKD-MBD were selected as the observation group, 50 patients with chronic kidney disease(CKD) as the control group, and 50 healthy adults as the normal control group. Serum samples were collected, the expressions of IL-18, sKlotho and OPG were detected by ELISA. Results: The expressions of IL-18, sKlotho and OPG had statistical significant in the three groups. Expressions of IL-18, sKlotho and OPG had statistical significant in different GFR, while the expressions of IL-18, sKlotho and OPG had no statistical significant in different basic diseases in observation group. There were positive correlation between IL-18 and Ipth,IL-18 and ALP,while sKlotho and OPG were not correlated with iPTH and ALP.There was no correlation between IL-18, sKlotho and OPG in the observation group. Conclusion:Higher expressions of IL-18, sKlotho and OPG plays an important role in CKD-MBD. IL-18, sKlotho and OPG levels are related to the progress of pathological changes. Positive correlation are found between IL-18 and iPTH, IL-18 and ALP. Joint detection of IL-18,sKlotho and OPG may be an early diagnostic marker of CKD-MBD,and its mechanism is related to inflammation.