慢性肾脏病患者瘦素、脂联素与OPG及腹主动脉钙化的相关性

The correlation of leptin,adiponectin,OPG and abdominal aortic calcification in patients with chronic kidney disease

目的CKD 3~5期患者的血清瘦素、脂联素、OPG、RANKL水平AAC之间的关系,探讨瘦素、脂联素是否通过OPG/RANKL/RANK信号通路影响CKD患者血管钙化。方法检测CKD 3~5期患者外周血中瘦素、脂联素、OPG、RANKL水平,行腹部侧位片了解有无钙化并计算钙化评分。结果CKD组血清OPG、瘦素水平高于健康对照组(P<0.05),脂联素、RANKL水平差异无统计学意义;钙化评分与年龄、碱性磷酸酶、OPG显著相关(P<0.01),与甲状旁腺素、OPG/RANKL比值相关(P<0.05)。结论在CKD 3~5期患者瘦素、脂联素与血管钙化的关系尚不明确,也不通过OPG/RANKL/RANK信号通路发挥作用;血清OPG水平和OPG/RANKL比值可预测CKD患者腹主动脉钙化,可能是有应用前景的指标。

Objective To investigate the relationship between serum levels of leptin,adiponectin,osteoprotectin(OPG)and nuclear factorκB receptor activator ligand(RANKL)and abdominal aortic calcification(Aorta abdominalis calcification AAC)in patients with chronic kidney disease(CKD)stage 3-5.To discuss whether leptin and adiponectin affect vascular calcification in patients with CKD through OPG/RANKL/RANK signaling pathway.Methods The levels of leptin,adiponectin,OPG and RANKL in peripheral blood of CKD 3-5 patients were detected,and the calcification score was calculated by lateral abdominal radiography.Results The levels of serum OPG and leptin in CKD group were higher than those in healthy control group(P<0.05),there was no statistical significance in adiponectin and RANKL levels;Calcification score was significantly correlated with age,alkaline phosphatase and OPG(P<0.01),correlated with parathyroid hormone and OPG/RANKL ratio(P<0.05).Conclusions The relationship between leptin,adiponectin and vascular calcification in CKD 3-5 patients is not clear,and they do not play a role through OPG/RANKL/RANK signaling pathway.Serum OPG level and OPG/RANKL ratio can predict abdominal aortic calcification in patients with CKD,which may be a promising indicator for application.