血清FGF23联合25羟维生素D水平检测对腹膜透析患者腹主动脉血管钙化的预测价值

Predictive Value of Serum FGF23 Combined with 25-hydroxyvitamin D Levels in Peritoneal Dialysis Patients with Abdominal Aortic Vascular Calcification

目的:探讨血清成纤维细胞生长因子23(FGF23)联合25羟维生素D水平检测对腹膜透析患者腹主动脉血管钙化的预测价值。方法:回顾性分析2018年05月—2020年05月医院收治的100例腹膜透析患者的临床资料,其中腹主动脉血管钙化患者(记为血管钙化组)53例,腹主动脉血管无钙化患者(记为血管无钙化组)47例。对比两组生化指标及血清FGF23、25羟维生素D水平,采用Logistic回归分析腹膜透析患者腹主动脉血管钙化的影响因素,分析血清FGF23联合25羟维生素D水平检测对腹膜透析患者腹主动脉血管钙化的预测价值。结果:血管钙化组透析龄、血肌酐(Scr)、碱性磷酸酶(ALP)、血磷、血钙水平、钙磷乘积、低密度脂蛋白胆固醇(LDLC)、质金属蛋白酶-9(MMP-9)、脂蛋白相关磷脂酶A2(LP-PLA2)、FGF23水平高于血管无钙化组(P<0.05);血管钙化组血清FGF23水平高于血管无钙化组(P<0.05),血管钙化组血清25羟维生素D水平低于血管无钙化组(P<0.05);Logistic回归分析显示钙磷乘积、LDLC、血清FGF23、25羟维生素D是腹膜透析患者腹主动脉血管钙化的的影响因素(P<0.05);ROC曲线分析显示血清FGF23、25羟维生素D及二者联合预测腹主动脉血管钙化的ROC曲线下面积分别为0.710(95%CI:0.600~0.823)、0.748(95%CI:0.651~0.845)、0.886(95%CI:0.793~0.938)。结论:与无腹主动脉血管钙化患者相比,腹主动脉血管钙化患者血清FGF23水平高、25羟维生素D水平低,血清FGF23联合25羟维生素D对腹主动脉血管钙化具有较高预测价值。

Objective:To explore the predictive value of serum fibroblast growth factor 23(FGF23)combined with 25-hydroxyvitamin D levels in the prediction of abdominal aortic vascular calcification in peritoneal dialysis patients.Methods:The clinical data of 100 patients with peritoneal dialysis admitted to the hospital from May 2018~May 2020 were retrospectively analyzed.Among them,53 patients with abdominal aortic vascular calcification(recorded as the vascular calcification group)and patients without abdominal aortic vascular calcification(Recorded as vascular noncalcification group)47 cases.The biochemical indexes and serum FGF23 and 25-hydroxyvitamin D levels of the two groups were compared.Logistic regression was used to analyze the influencing factors of abdominal aortic vascular calcification in peritoneal dialysis patients.The predictive value of serum FGF23 combined with 25-hydroxyvitamin D levels in peritoneal dialysis patients with abdominal aortic vascular calcification was analyzed.Results:Dialysis age,blood creatinine(Scr),alkaline phosphatase(ALP),blood phosphorus,blood calcium level,calcium phosphorus product,low-density lipoprotein cholesterol(LDLC),and metalloproteinase-9(MMP-9)in the vascular calcification group,lipoprotein-related phospholipase A2(LP-PLA2),and FGF23 levels were higher than the vascular noncalcification group(P<0.05).The serum FGF23 level in the vascular calcification group was higher than that in the non-vascular calcification group(P<0.05),and the serum 25-hydroxyvitamin D level in the vascular calcification group was lower than that in the non-vascular calcification group(P<0.05).Logistic regression analysis showed that roduct of calcium and phosphorus,LDLC,serum FGF23,and 25-hydroxyvitamin D are the influencing factors of abdominal aortic vascular calcification in peritoneal dialysis patients(P<0.05).ROC curve analysis showed that the area under the ROC curve of serum FGF23,25-hydroxyvitamin D and their combination to predict abdominal aortic vascular calcification was 0.710(95%CI:0.600~0.823),0.748(95%CI:0.651~0.845)and 0.886(95%CI:0.793~0.938).Conclusion:Compared with patients without abdominal aortic vascular calcification,patients with abdominal aortic vascular calcification have higher serum FGF23 levels and low 25-hydroxyvitamin D levels.Serum FGF23 combined with 25-hydroxyvitamin D has a higher predictive value for abdominal aortic vascular calcification.