维持性血液透析患者血清β-catenin水平与腹主动脉钙化的关系

Serumβ-catenin and abdominal aortic calcification in maintenance hemodialysis patients

目的:探讨维持性血液透析(MHD)患者血清β-catenin水平与腹主动脉钙化(AAC)的关系。方法:选取上海交通大学医学院附属仁济医院宝山分院MHD患者70例,使用腹部侧位平片检测AAC情况,根据CORD研究分组方法,将患者分为无或轻度钙化组、中度钙化组和重度钙化组。采用ELISA法检测患者血清β-catenin水平,观察MHD患者血清β-catenin水平与AAC评分(AACS)及人口学特性和生化指标的关系。结果:本组MHD患者AAC发生率为70%。腹主动脉重度钙化组血清β-catenin水平显著高于中度钙化组、无或轻度钙化组(P<0.05);中度钙化组血清β-catenin水平亦高于无或轻度钙化组(P<0.05)。相关性分析结果显示,MHD患者血清β-catenin水平与AACS、透析龄、甲状旁腺激素、血磷成正相关。Logistic回归分析结果显示,β-catenin水平升高、高体质量指数及高C反应蛋白水平是MHD患者发生AAC的独立危险因素(P<0.05),而血清白蛋白水平升高则属于保护因素(P<0.05)。血清β-catenin预测AAC的曲线下面积(AUC)为0.864(95%CI 0.766~0.961,P=0.000),约登指数为0.693,对应血清β-catenin水平值为211.63 pg/ml,其预测AAC的灵敏度为91.70%,特异度为77.60%。结论:MHD患者血清β-catenin升高可能与AAC相关。

Objective:To investigate the relationship between serumβ-catenin level and abdominal aortic calcification(AAC)in maintenance hemodialysis(MHD)patients.Methodology:A total of 70 MHD patients in our hospital were selected and AAC was detected using lateral abdominal plain film.According to the CORD grouping method,the patients were divided into three groups:no or mild calcification group,moderate calcification group and severe calcification group.Serumβ-catenin level was detected by ELISA,and the relationship between serumβ-catenin level and AAC score(AACS),demographic characteristics and biochemical indexes of MHD patients was observed.Results:The incidence of AAC in MHD patients was 70%.The serumβ-catenin level of severe abdominal aortic calcification group was significantly higher than that of moderate,no or mild calcification group,and the difference was statistically significant(P<0.05).The serumβ-catenin level in moderate calcification group was also higher than that in no or mild calcification group(P<0.05).Correlation analysis showed that serumβ-catenin level was positively correlated with AACS,dialysis age,parathyroid hormone and blood phosphorus in MHD patients.Logistic regression analysis showed that the increase ofβ-catenin level,high body mass index and high CRP level were independent risk factors for AAC in MHD patients(P<0.05),while the increase of serum albumin level was a protective factor(P<0.05).The area under the curve(AUC)of serumβ-catenin predicted AAC was 0.864(95%CI 0.766~0.961,P=0.000),the Yoden index was 0.693,corresponding to the serumβ-catenin level was 211.63pg/ml,the sensitivity of AAC prediction was 91.70%,the specificity was 77.60%.Conclusion:The increase of serumβ-catenin in MHD patients may be related to AAC.