慢性肾衰患者褪黑素水平、氧化应激、炎症水平与骨密度相关性研究

Correlation between melatonin level,oxidative stress,inflammation level and bone mineral density in patients with chronic renal failure

目的研究慢性肾功能衰竭维持性血液透析(MHD)中褪黑素(MT)水平、氧化应激和炎症状态与骨密度(BMD)的关系。方法选择我院收治的94例慢性肾功能衰竭患者,于2016年5月至2019年2月接受MHD治疗3个月以上;按照BMD分为骨质疏松组(观察组,n=49)和非骨质疏松组(对照组,n=45)。通过酶联免疫吸附试验检测患者血清高级氧化蛋白产物(AOPP),MT水平和炎症因子[肿瘤坏死因子-α(TNF-α),白细胞介素-6(IL-6)和IL-1](ELISA)。此外,通过硫代巴比妥酸(TBA)测定法检测血清中的丙二醛(MDA)水平,并检测腰椎BMD,然后进行相关性分析。结果观察组MT水平显着低于对照组,但AOPP和MDA水平显着高于对照组(P<0.05)。观察组炎症因子(TNF-α,IL-6和IL-1)水平明显高于对照组(P<0.05)。此外,观察组腰椎BMD和T值明显低于对照组(P<0.05)。Pearson相关分析显示AOPP、MDA、TNF-α、IL-6和IL-1水平与BMD呈负相关,但MT与BMD呈正相关(P<0.05)。结论MHD患者容易发生骨质疏松症;氧化应激和炎症程度与BMD呈负相关,但MT与BMD呈正相关。

Objective The relationship of melatonin(MT)level,oxidative stress and inflammatory status with osteoporosis in the maintenance hemodialysis(MHD)of chronic renal failure was investigated.Methods Ninety-four patients with chronic renal failure treated in our hospital and received MHD for more than 3 months from May 2016 to February 2019 were selected and divided into the osteoporosis group(observation group,n=49)and the non-osteoporosis group(control group,n=45)based on whether osteoporosis was presented.Serum advanced oxidation protein products(AOPP),MT level and inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and IL-1]in patients were detected using enzyme-linked immunosorbent assay(ELISA).Moreover,the malondialdehyde(MDA)level in serum was detected using thibabituric acid(TBA)assay and the spinal bone mineral density(BMD)was measured,followed by correlation analysis.Results The MT level in the observation group was significantly lower than that in the control group,but the levels of AOPP and MDA in the observation group were significantly higher than those in the control group(P<0.05).The levels of inflammatory factors(TNF-α,IL-6 and IL-1)in the observation group were significantly higher than those in the control group(P<0.05).Besides,the spinal BMD and T-score in the observation group were significantly lower than those in the control group(P<0.05).Pearson’s correlation analysis showed that AOPP,MDA,TNF-α,IL-6 and IL-1 levels were negatively correlated with BMD,but MT was positively correlated with BMD(P<0.05).Conclusion Osteoporosis occurs easily in MHD patients;oxidative stress and inflammatory degree were negatively correlated with BMD,but MT was positively correlated with BMD.