维持性血液透析患者血清骨膜蛋白与腹主动脉钙化的关联

Relationship between serum osteoprotegerin and calcification of abdominal aorta in hemodialysis patients

目的探究维持性血液透析(maintenance hemodialysis,MHD)患者血清骨膜蛋白(periostin,POSTN)与腹主动脉钙化(abdominal aortic calcification,AAC)的关联。方法选择2022年10月─2023年10月于青岛市市立医院本部血液净化中心行MHD治疗>3个月的95例患者作为研究对象,收集研究对象的临床资料及实验室检查结果;ELISA检测所有入选者的血清POSTN水平;应用腹部侧位X线平片评估MHD患者的AAC情况,并计算AAC积分(abdominal aortic calcification score,AACs);采用Pearson相关性分析及单因素、多因素二元Logistic回归分析模型探究MHD患者腹主动脉钙化的危险因素。结果MHD患者组血清POSTN水平高于健康对照组(Z=-8.744,P<0.001)。相关性分析显示MHD患者血清POSTN水平与AACs、透析龄、甲状旁腺激素、β_(2)微球蛋白、低密度脂蛋白呈正相关(r=0.755、0.622、0.202、0.212、0.233,P<0.001、<0.001、0.049、0.039、0.023),与肾小球滤过率呈负相关(r=-0.695,P<0.001)。单因素及多因素二元Logistic回归分析结果:调整了透析龄、甲状旁腺激素等混杂因素后,血清POSTN水平是MHD患者发生腹主动脉中重度钙化的独立危险因素(OR=1.597,95%CI:1.005~2.536,P=0.047)。结论MHD患者的血清POSTN水平较健康人群高,且与腹主动脉钙化相关。

Objective To investigate the relationship between serum periostin(POSTN)and abdominal aortic calcification(AAC)in patients on maintenance hemodialysis(MHD).Methods A total of 95 patients treated with MHD for more than 3 months in the Blood Purification Center of Qingdao Municipal Hospital from October 2022 to October 2023 were selected as the study subjects.Clinical data and laboratory results were collected.ELISA was used to detect the serum POSTN level.Lateral abdominal X-ray film was conducted to evaluate AAC and to calculate AAC score.Pearson correlation analysis and univariate and multivariate binary logistic regression models were applied to investigate the risk factors for AAC in MHD patients.Results①Serum POSTN was higher in the MHD patient group than in the healthy control group(Z=-8.744,P<0.001).②Correlation analysis found that serum POSTN level was positively correlated with AAC score(r=0.755,P<0.001),dialysis age(r=0.622,P<0.001),parathyroid hormone(r=0.202 P=0.049),β_(2)-microglobulin(r=0.212,P=0.039),and low-density lipoprotein(r=0.233,P=0.023),and was negatively correlated with glomerular filtration rate(r=-0.695,P<0.001).③Results of univariate and multivariate binary logistic regression analyses showed that after adjusting for confounders including dialysis age and parathyroid hormone,serum POSTN was an independent risk factor for occurrence of AAC in MHD patients(OR=1.597,95%CI:1.005~2.536,P=0.047).Conclusion Serum POSTN level was higher in MHD patients than in healthy population.Higher serum POSTN was associated with AAC in MHD patients.