维持性血液透析患者血清鸢尾素水平与腰椎骨密度的相关性

Correlation between serum irisin level and lumbar bone mineral density in maintenance hemodialysis patients

目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者血清鸢尾素水平与腰椎骨密度(bone mineral density,BMD)的关系。方法选择2019年1月~2021年12月于连云港市第一人民医院住院的200例MHD患者作为研究对象,进行横断面研究。根据腰椎T值将入组患者分为骨量正常组(T≥-1,n=119)、骨量减少组(-2.5<T<-1,n=53)和骨质疏松组(T≤-2.5,n=28)。比较3组患者临床资料和实验室指标差异。采用Pearson或Spearman相关性分析腰椎BMD(以T值表示)与临床资料和实验室指标的相关性。采用有序Logistic回归分析MHD患者腰椎BMD的影响因素。结果骨质疏松组血清鸢尾素水平为(4.88±1.03)μg/L,骨量减少组血清鸢尾素水平为(35.05±8.94)μg/L,骨量正常组血清鸢尾素水平为(62.15±18.44)μg/L,3组比较差异有统计学意义(F=14.036,P<0.001)。MHD患者腰椎BMD与体质量指数(r=0.329,P=0.001)、肌酐(r=0.295,P=0.005)、血清鸢尾素(r=0.448,P<0.001)呈正相关,与女性(r=-0.422,P<0.001)、年龄(r=-0.291,P=0.007)、尿素清除指数(Kt/V,r=-0.266,P=0.017)、尿素清除率(r=-0.270,P=0.014)和碱性磷酸酶(r=-0.292,P=0.007)呈负相关。有序Logistic回归分析结果显示血清鸢尾素水平是MHD患者腰椎BMD的影响因素(OR=0.466,95%CI:0.304~0.714,P<0.001)。结论MHD患者血清鸢尾素水平与腰椎BMD呈正相关,血清鸢尾素水平是MHD患者腰椎BMD的影响因素。

Objective To investigate the relationship between serum irisin level and lumbar bone mineral density(BMD)in maintenance hemodialysis(MHD)patients.Methods A total of 200 MHD patients hospitalized in The First People's Hospital of Lianyungang City from Jan 2019 to Dec 2021 were recruited as the subjects for cross-sectional study.Based on the T value of lumbar bone,patients were divided into normal bone mass group(t≥-1,n=119),osteopenia group(-2.5<t<-1,n=53)and osteoporosis group(t≤-2.5,n=28).Clinical data and laboratory indexes were compared among the three groups.Pearson or Spearman correlation was used to analyze the correlation between lumbar BMD(expressed as T value)and clinical and laboratory indicators.The influencing factors for lumbar BMD were analyzed by ordered logistic regression.Results The serum irisin levels were 4.88±1.03μg/L,35.05±8.94μg/L and 62.15±18.44μg/L in osteoporosis group,osteopenia group and normal bone mass group respectively(F=14.036,P<0.001).Lumbar BMD in MHD patients was positively correlated with body mass index(BMI),creatinine and serum irisin(r=0.329,0.295 and 0.448 respectively;P=0.001,0.005 and<0.001 respectively),and negatively correlated with female,age,urea clearance index(Kt/V),urea clearance rate and alkaline phosphatase(r=-0.422,-0.291,-0.266,-0.270 and-0.292 respectively;P<0.001,P=0.007,0.017,0.014 and 0.007 respectively).Ordered logistic regression showed that serum irisin level was an influencing factor for lumbar BMD in MHD patients(OR=0.466,95%CI:0.304~0.714,P<0.001).Conclusion There is a positive correlation between serum irisin level and lumbar BMD in MHD patients.Serum irisin level is an influencing factor for lumbar BMD in MHD patients.