血清HO-1、HIF-1α及FGF23对腹膜透析患者血管钙化的影响

Effect of serum HO-1,HIF-1αand FGF23 on vascular calcification in peritoneal dialysis patients

目的探讨血清血红素加氧酶-1(heme oxygenase-1,HO-1)、低氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)及成纤维细胞生长因子23(fibroblast growth factor23,FGF23)对腹膜透析患者血管钙化的影响。方法选取2019年5月—2022年5月焦作煤业(集团)有限责任公司中央医院收治的109例腹膜透析患者,采用腹部侧位X线平片检测腹膜透析患者血管钙化情况。根据是否发生腹主动脉钙化分为钙化组、无钙化组。比较2组血清HO-1、HIF-1α、FGF23水平、临床资料,采用Logistic回归分析腹膜透析患者腹主动脉钙化的影响因素,采用ROC曲线分析血清HO-1、HIF-1α、FGF23水平对腹主动脉钙化的预测价值。结果钙化组血清HO-1水平低于无钙化组(t=5.762,P<0.001),HIF-1α、FGF23水平高于无钙化组(t=8.176、9.382,均P<0.001、<0.001);Logistic回归分析显示年龄(OR=1.359,95%CI 1.048~1.763,P<0.001)、血磷(OR=1.994,95%CI 1.123~3.539,P<0.001)、HO-1(OR=0.857,95%CI 0.762~0.964,P<0.001)、HIF-1α(OR=2.211,95%CI 1.156~4.228,P<0.001)、FGF23(OR=3.916,95%CI 1.957~7.836,P<0.001)是腹膜透析患者发生腹主动脉钙化的影响因素;HO-1、HIF-1α、FGF23及三者联合预测腹主动脉钙化的AUC分别为0.789、0.868、0.902、0.972。结论血清HO-1、HIF-1α、FGF23水平是腹膜透析患者腹主动脉钙化的独立影响因素,三者均对腹主动脉钙化具有一定预测价值,联合预测价值更高。

Objective To investigate the effects of serum heme oxygenase-1(HO-1),hypoxia inducible factor-1α(HIF-1α)and fibroblast growth factor 23(FGF23)on vascular calcification in peritoneal dialysis(PD)patients.Methods A total of 109 PD patients admitted to The Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.from May 2019 to May 2022 were selected.Lateral abdominal plain radiographs were used to detect vascular calcification in the PD patients.According to the presence or absence of abdominal aortic calcification,patients were divided into the calcification group and the non-calcification group.Clinical data and serum HO-1,HIF-1αand FGF23 were compared between the two groups.Logistic regression was used to analyze the influencing factors of abdominal aortic calcification in PD patients.The predictive values of serum HO-1,HIF-1αand FGF23 for abdominal aortic calcification were analyzed by ROC curve.Results Serum HO-1 was lower,and serum HIF-1αand FGF23 levels were higher in calcification group than in non-calcification group(t=5.762,8.176,and 9.382 respectively;P<0.001).Logistic regression showed that age(OR=1.359,95%CI 1.048~1.763,P<0.001),serum phosphorus(OR=1.994,95%CI 1.123~3.539,P<0.001),HO-1(OR=0.857,95%CI 0.762~0.964,P<0.001),HIF-1α(OR=2.211,95%CI 1.156~4.228,P<0.001)and FGF23(OR=3.916,95%CI 1.957~7.836,P<0.001)were the factors affecting the presence of abdominal aortic calcification in PD patients.The AUC predicted by HO-1,HIF-1α,FGF23 and their combination were 0.789,0.868,0.902 and 0.972 respectively.Conclusions Serum HO-1,HIF-1αand FGF23 levels are the independent influencing factors for abdominal aortic calcification in PD patients.Anyone of the three lev-els has a predictive value,but their combined has a higher predictive value for the presence of abdominal aortic calcification.