血清骨硬化蛋白与维持性血液透析患者冠状动脉钙化的相关性研究

Association of serum sclerostin level with coronary artery calcification in maintenance hemodialysis patients

目的研究分析血清骨硬化蛋白与维持性血液透析(MHD)患者冠状动脉钙化的相关性。方法选择2016年1月至2017年1月在中国人民解放军第四五五医院血透中心接受维持性血液透析治疗患者共138例。检测患者血清骨硬化蛋白水平和相关临床资料,CT辅助检测患者冠状动脉钙化并进行评分。利用多因素Logistic回归分析骨硬化蛋白与维持性血液透析患者冠状动脉钙化的相关性,并用ROC曲线分析骨硬化蛋白对维持性血液透析患者诊断价值。结果 Logistic回归分析显示骨硬化蛋白为冠状动脉钙化的独立危险因素(OR=1.362,95%CI=1.073～1.724,P=0.032)。血清骨蛋白诊断冠状动脉钙化积分(coronary artery calcification score,CACs)的ROC曲线分析,AUC=0.826,95%CI=0.759～0.892,P=0.000。诊断值为47.71 ng/L,诊断敏感度为0.607,特异性为0.938。结论血清高浓度骨硬化蛋白是维持性血液透析患者冠状动脉钙化的独立危险因素,骨硬化蛋白对MHD患者的冠脉钙化具有诊断意义。

Objective To study the association of serum sclerostin level with coronary artery calcification in maintenance hemodialysis(MHD) patients. Methods The clinical data of 138 patients receiving MHD during January 2016 to January 2017 in Hemodialysis Center of our hospital were collected. Patients were examined for serum sclerostin levels and related clinical data, CT-assisted detection of coronary artery calcification score. Multivariate logistic regression was used to analyze the correlation between sclerostin and coronary artery calcification in MHD patients. The ROC curve was used to analyze the diagnostic value of sclerostin in MHD patients. Results Logistic regression analysis showed that sclerostin was an independent risk factor for coronary artery calcification(OR=1.362, 95% CI=1.073-1.724, P=0.032). The analysis on the ROC curve of sclerostin for coronary artery calcifications revealed AUC=0.826, 95% CI=0.759-0.892, P=0.000. The diagnostic value of slerostin was 47.71 ng/L, the diagnostic sensitivity was 0.607, and the specificity was 0.938. Conclusions The high concentration of sclerostin is an independent risk factor for coronary artery calcification in MHD patients. It is significant for sclerostin to diagnose coronary artery calcification in MHD patients.