ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2015, Vol. 24 ›› Issue (3): 231-236.

• 论文 • 上一篇    下一篇

腹膜透析患者血清可溶性klotho蛋白与腹主动脉钙化关联性的研究

  

  • 出版日期:2015-06-28 发布日期:2015-07-01

The serum soluble Klotho protein and abdominal aortic calcification in peritoneal dialysis patients

  • Online:2015-06-28 Published:2015-07-01

摘要:

【摘要】目的 了解腹膜透析(PD)患者腹主动脉钙化情况,并分析该人群血清可溶性Klotho蛋白(sKL)水平与腹主动脉钙化的关联性。方法 选取持续不卧床腹膜透(continuous ambulatory peritoneal dialysis,CAPD)3个月以上的PD患者80例,收集其临床资料,应用侧位腹平片评价腹主动脉钙化情况,并计算腹主动脉钙化积分(AAC),采用ELISA法检测血清sKL及成纤维细胞生长因子23(FGF23)浓度。Logistic回归分析法分析PD患者发生腹主动脉钙化的危险因素,受试者工作特征曲线(ROC)评价sKL预测腹主动脉钙化的准确性与特异性。结果 80例PD患者中,发生腹主动脉钙化患者41例(51.3%),钙化主要发生在第4腰椎节段,并随着节段的上升逐渐减少。血清sKL与AAC负相关,与FGF23无相关性。Logistic回归分析结果显示较低的血清sKL浓度( OR=0.969,95%CI 0.947~0.991,P<0.01)和较高年龄(OR=1.115,95%CI 1.044~1.191,P<0.01)是PD患者发生腹主动脉中、重度钙化的独立危险因素。ROC曲线下面积(AUC)显示sKL预测腹主动脉中、重度钙化的AUC为0.800(截点为361.50pg/mL,其准确性为71.4%,特异性为84.6%)。结论 PD患者血清sKL浓度降低与发生腹主动脉钙化显著相关,血清sKL浓度可能在腹主动脉钙化机制中起重要作用。

关键词: 腹膜透析, 腹主动脉, 钙质沉着症, 可溶性klotho

Abstract:

【Abstract】Objective: To investigate the clinic feature of peritoneal dialysis (PD) patients with abdominal aortic calcification, and to analyze the relationship between the levels of serum soluble Klotho protein (sKL) and abdominal aortic calcification. Methodology: Eighty patients with continuous ambulatory peritoneal dialysis(CAPD), who dialysis regularly for more than 3 months, were collected prospectively. The levels of serum sKL and Fibroblast growth factor 23 (FGF23) were detected by ELISA. Abdomen 1ateral plain was used as a criterion to determine the abdominal aorticcal cification. The abdominal aortic calcification score (AAC) was calculated. Logistic regression analysis was used to determine the risk factor of abdominal aortic calcification in PD patients. The ROC analysis was applied to evaluate the predict value of sKL in abdominal aortic calcification. Results: The abdominal aortic calcification was found in 41( 51.3%)patients, which was most severe in front of the fourth lumbar segment and ameliorated in higher lumbar levels. The sKL concentration was negatively correlated with AAC, and no correlation with FGF23. Logistic regression analysis showed that lower serum sKL level(OR=0.969, 95%CI 0.947~0.991, P<0.01)and higher age(OR=1.115, 95%CI 1.044~1.191, P<0.01)were independent risk factors for moderate to severe calcification of the abdominal aorta.ROC-AUC of serum sKL for moderate to severe abdominal aortic calcification was O.800 (cut off 361.50pg/ml,accuracy 71.4%,specificity 84.6%). Conclusions: The lower serum sKL is significantly associated with abdominal aorta calcification. Serum sKL may play an important role in the mechanism of abdominal aortic calcification in PD patients.

Key words: Peritoneal dialysis, abdominal aortic calcification, Calcinosis, Soluble Klotho