慢性肾脏病患者血清Klotho蛋白水平与肾纤维化的关系

Relationship between Serum Klotho Protein Level and Renal Fibrosis in Patients with Chronic Kidney Disease

目的探讨慢性肾脏病(chronic kidney disease,CKD)患者血清Klotho蛋白表达水平与肾间质纤维化程度的相关性。方法对46例确诊的CKD患者采用肌氨酸氧化酶法测定血肌酐(Scr)、尿素氮(Bun)水平,并计算肾小球滤过率水平(GFR);经放射免疫分析法检测层黏连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(C-Ⅳ),并使用酶联免疫吸附法(ELISA)测定血清Klotho蛋白表达水平,结合CKD分期和肾纤维化水平进行分析。结果不同CKD分期患者Klotho蛋白、Scr、Bun及GFR水平差异均有统计学意义(P<0.05);Scr与Bun水平随CKD分期增加而增高,而GFR与Klotho蛋白表达水平随CKD分期的增加而降低。中度纤维化血清HA、C-Ⅳ及LN水平均高于轻度纤维化(P<0.05),重度纤维化血清HA、PC-Ⅲ、C-Ⅳ及LN水平明显高于中度纤维化(P<0.05),且中度纤维化血清Klotho蛋白表达水平显著低于轻度纤维化,重度纤维化患者血清Klotho蛋白表达水平显著低于中度纤维化(均P<0.05)。结论血清Klotho蛋白表达水平对于CKD患者肾纤维化的临床诊断有一定的参考价值。

Objective To investigate the correlation between expression of serum Klotho protein and degree of renal interstitial fibrosis in patients with chronic kidney disease(CKD).Methods Serum creatinine(Scr)and urea nitrogen(Bun)levels were measured by creatine oxidase method in 46 patients with CKD,and calculate glomerular filtration rate level(GFR).The levels of laminin(LN),hyaluronic acid(HA),typeⅢprocollagen(PC-Ⅲ)and typeⅣcollagen(C-Ⅳ)were detected by radioimmunoassay.The expression of Klotho in serum was determined by ELISA.Results The levels of Klotho,Scr,Bun and GFR were significantly different among patients with different stages of CKD(P<0.05).Serum Scr and Bun levels were elevated with increased CKD stages,while the levels of GFR and Klotho were reduced with increased CKD stages(P<0.05).Serum HA,C-Ⅳand LN levels in moderate fibrosis group were higher than those in mild fibrosis group(P<0.05).Furthermore,serum HA,PC-Ⅲ,C-Ⅳand LN levels in severe fibrosis group were higher than those in moderate fibrosis group(P<0.05).Serum levels of Klotho protein in moderate fibrosis were significanfly lower than those in mild fibrosis,and the levels of Klotho in severe fibrosis were significantly lower than those in moderate fibrosis(all P<0.05).Conclusion Serum Klotho protein level has certain reference value for clinical diagnosis of renal fibrosis in CKD patients.