血清Irisin及BMP-7对维持性血液透析患者并发腹主动脉钙化的诊断价值

Diagnostic value of serum irisin and BMP-7 in patients with maintenance hemodialysis complicated with abdominal aortic calcification

目的探讨血清鸢尾素(Irisin)及骨形态发生蛋白7(BMP-7)对维持性血液透析(MHD)患者并发腹主动脉钙化的诊断价值。方法收集MHD患者132例,根据腹主动脉钙化评分将其分为钙化组(70例)、未钙化组(62例)。收集患者临床资料,用酶联免疫吸附法检测血清Irisin、BMP-7水平,用单因素和多因素Logistic回归分析MHD患者腹主动脉钙化的影响因素,用受试者工作特征(ROC)曲线评价血清Irisin、BMP-7对MHD患者并发腹主动脉钙化的诊断价值。结果高龄、长透析龄、高水平的iPTH及低水平的血清Irisin、BMP-7是MHD患者发生腹主动脉钙化的独立危险因素(P均<0.05)。血清Irisin诊断MHD患者腹主动脉钙化的ROC曲线下面积(AUC)为0.789,最佳截断值为45.8 ng/mL,此时敏感度为82%,特异度为87%,准确度78%;血清BMP-7诊断MHD患者腹主动脉钙化的AUC为0.801,最佳截断值为1056 pg/mL,敏感度为85%,特异度为79%,准确度为83%;血清Irisin、BMP-7联合诊断MHD患者腹主动脉钙化的AUC为0.886,敏感度为88%,特异度为82%,准确度为89%。结论血清Irisin、BMP-7水平低的MHD患者易并发腹主动脉钙化,二者对MHD患者并发腹主动脉钙化的诊断价值高。

Objective To investigate the diagnostic value of serum irisin and bone morphogenetic protein 7(BMP-7)in patients with maintenance hemodialysis(MHD)complicated with abdominal aortic calcification.Methods Totally 132 patients with MHD were collected and were divided into the calcification group(70 cases)and non-calcification group(62 cases)according to the abdominal aortic calcification score.Clinical data were collected,serum irisin and BMP-7 levels were detected by enzyme-linked immunosorbent assay,the influencing factors of abdominal aortic calcification in MHD patients were analyzed by univariate and multivariate Logistic regression,and the diagnostic value of serum irisin and BMP-7 in patients with MHD complicated with abdominal aortic calcification was evaluated by receiver operating characteristics(ROC)curve.Results Advanced age,long dialysis age,high level of iPTH and low level of serum irisin and BMP-7 were independent risk factors for vascular calcification in MHD patients(all P<0.05).The area under the ROC curve(AUC)of serum irisin in diagnosing vascular calcification in MHD patients was 0.789,the optimal cut-off value was 45.8 ng/mL,the sensitivity was 82%,the specificity was 87%,and the accuracy was 78%.The AUC of serum BMP-7 in the diagnosis of vascular calcification in MHD patients was 0.801,the optimal cut-off value was 1056 pg/mL,the sensitivity was 85%,the specificity was 79%,and the accuracy was 83%.The AUC of the combined detection of serum irisin and BMP-7 in the diagnosis of vascular calcification of MHD patients was 0.886,the sensitivity was 88%,the specificity was 82%,and the accuracy was 89%.Conclusion Patients with MHD with low serum irisin and BMP-7 levels are prone to abdominal aortic calcification,and serum irisin and BMP-7 have higher diagnosis value for abdominal aortic calcification in MHD patients.