[1]石新慧,任东升,陶雅非,等.血清sclerostin和Klotho蛋白水平对维持性血液透析患者血管钙化的预测价值[J].新乡医学院学报,2022,39(5):429-433.[doi:10.7683/xxyxyxb.2022.05.006]
　SHI Xinhui,REN Dongsheng,TAO Yafei,et al.Predictive value of serum sclerostin and Klotho protein levels for angiosteosis in patients undergoing maintenance hemodialysis[J].Journal of Xinxiang Medical University,2022,39(5):429-433.[doi:10.7683/xxyxyxb.2022.05.006]
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血清sclerostin和Klotho蛋白水平对维持性血液透析患者血管钙化的预测价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年5
页码:
429-433
栏目:
临床研究
出版日期:
2022-05-05

文章信息/Info

Title:
Predictive value of serum sclerostin and Klotho protein levels for angiosteosis in patients undergoing maintenance hemodialysis
作者:
石新慧1; 任东升1; 陶雅非1; 谷　裕1; 徐　光1; 李　征2; 李海剑1
（1.南阳市中心医院肾病风湿免疫科，河南　南阳　473000；2.南阳市中心医院泌尿外科，河南　南阳　473000）
Author(s):
SHI Xinhui1; REN Dongsheng1; TAO Yafei1; GU Yu1; XU Guang1; LI Zheng2; LI Haijian1
(1.Department of Nephrology,Rheumatology and Immunology,Nanyang Central Hospital,Nanyang 473000,Henan Province,China;2.Department of Urology,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)
关键词:
sclerostin蛋白; Klotho蛋白; 维持性血液透析; 血管钙化; 预测价值
Keywords:
sclerostin protein; Klotho protein; maintenance hemodialysis; angiosteosis; predictive value
分类号:
R459.5
DOI:
10.7683/xxyxyxb.2022.05.006
文献标志码:
A
摘要:
目的　探讨血清sclerostin、Klotho蛋白水平对维持性血液透析（MHD）患者血管钙化的预测价值。方法　选择2017年10月至2019年10月南阳市中心医院收治的105例MHD患者为研究对象，根据是否有血管钙化将患者分为血管钙化组（n=69）和非血管钙化组（n=36）。通过查阅病历采集2组患者的临床资料，采用单因素分析和多因素logistic回归分析MHD患者血管钙化的影响因素，采用受试者工作特征（ROC）曲线评估血清sclerostin、Klotho蛋白水平对MHD患者血管钙化的预测价值。结果　单因素分析结果显示，性别、年龄、体质量指数、吸烟史、饮酒史、原发疾病、血清肌酐、血尿素氮、尿素清除指数、血红蛋白、白蛋白、血清超敏C反应蛋白、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、收缩压、舒张压、血清磷、钙磷乘积与MHD患者血管钙化无关（P>0.05），而透析龄及校正的血清钙、全段甲状旁腺激素、sclerostin蛋白、Klotho蛋白与MHD患者血管钙化有关（P<0.05）。多因素logistic回归分析结果显示，透析龄及校正的血清钙、全段甲状旁腺激素、sclerostin蛋白为MHD患者血管钙化的独立危险因素，而血清Klotho蛋白为MHD患者血管钙化的独立保护因素（P<0.05）。ROC曲线显示，血清sclerostin、Klotho蛋白预测MHD患者血管钙化的曲线下面积（AUC）分别为0.870、0.840；以血清sclerostin蛋白87.575 pmol·L-1、Klotho蛋白393.220 ng·L-1为最佳临界值，血清sclerostin蛋白预测MHD患者血管钙化的敏感度和特异度分别为71.0%、88.9%，血清Klotho蛋白预测MHD患者血管钙化的敏感度和特异度分别为73.9%、94.4%；血清sclerostin、Klotho蛋白联合检测预测MHD患者血管钙化的AUC、敏感度和特异度分别为0.903、85.5%、97.2%；血清sclerostin蛋白与Klotho蛋白预测MHD患者血管钙化的AUC、敏感度、特异度比较差异均无统计学意义（P>0.05）；血清sclerostin、Klotho蛋白联合检测预测MHD患者血管钙化的AUC、敏感度和特异度显著高于二者单独检测（P<0.05）。结论　血清sclerostin、Klotho蛋白与MHD患者的血管钙化有关，血清sclerostin蛋白为MHD患者血管钙化的独立危险因素，而血清Klotho蛋白为MHD患者血管钙化的独立保护因素；血清sclerostin、Klotho蛋白对MHD患者的血管钙化均有一定的预测价值，且二者联合检测的预测价值较高，血清sclerostin、Klotho蛋白可作为MHD患者血管钙化的预测指标。
Abstract:
Objective　To investigate the predictive value of serum sclerostin and Klotho protein levels for angiosteosis in patients undergoing maintenance hemodialysis (MHD).Methods　A total of 105 MHD patients admitted to Nanyang Central Hospital from October 2017 to October 2019 were selected as the research subjects,and the patients were divided into angiosteosis group (n=69) and non-angiosteosis group (n=36) according to whether there was angiosteosis.The clinical data of patients in the two groups were collected by consulting the case history.The influencing factors of angiosteosis in MHD patients were analyzed by univariate analysis and multivariate logistic regression.The predictive value of serum sclerostin and Klotho protein levels on angiosteosis in MHD patients was evaluated by receiver operating characteristic (ROC) curve.Results　The univariate analysis showed that the gender,age,body mass index,smoking history,drinking history,primary disease,serum creatinine,blood urea nitrogen,urea clearance index,hemoglobin,albumin,serum high-sensitivity C-reactive protein,total cholesterol,triacylglycerol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,systolic blood pressure,diastolic blood pressure,serum phosphorus and calcium-phosphorus product were not associated with angiosteosis in MHD patients (P>0.05),while the dialysis age,corrected serum calcium,intact parathyroid hormone,sclerostin protein and Klotho protein were related to angiosteosis in MHD patients (P<0.05).The multivariate logistic regression showed that the dialysis age,corrected serum calcium,intact parathyroid hormone and sclerostin protein were independent risk factors for angiosteosis in MHD patients,while serum Klotho protein was an independent protective factor for angiosteosis in MHD patients (P<0.05).The ROC curve showed that the area under curve (AUC) of serum sclerostin and Klotho proteins for predicting angiosteosis in MHD patients was 0.870 and 0.840,respectively.Taking serum sclerostin protein 87.575 pmol·L-1 and Klotho protein 393.220 ng·L-1 as the optimal cut-off values,the sensitivity and specificity of serum sclerostin protein in predicting angiosteosis in MHD patients were 71.0% and 88.9%,respectively;the sensitivity and specificity of serum Klotho protein in predicting angiosteosis in MHD patients were 73.9% and 94.4%,respectively;the AUC,sensitivity and specificity of the combined detection of serum sclerostin and Klotho proteins in predicting angiosteosis in MHD patients were 0.903%,85.5% and 97.2%,respectively.There was no significant difference in AUC,sensitivity and specificity between serum sclerostin protein and Klotho protein in predicting angiosteosis in MHD patients (P>0.05).The AUC,sensitivity and specificity of the combined detection of serum sclerostin and Klotho protein in predicting angiosteosis in MHD patients were significantly higher than those detected alone (P<0.05).Conclusion　The serum sclerostin and Klotho proteins are related to angiosteosis in MHD patients,the serum sclerostin protein is an independent risk factor for angiosteosis,while the serum Klotho protein is an independent protective factor for angiosteosis in MHD patients.The serum sclerostin protein and Klotho protein have certain predictive value for angiosteosis in MHD patients,and the combined detection of them has higher predictive value.The serum sclerostin protein and Klotho protein can be used as predictors of angiosteosis in MHD patients.

参考文献/References:

［1］　夏雪，王德光，郝丽，等.血液透析患者血管钙化及相关影响因素的调查分析［J］.中华疾病控制杂志，2018，22（8）：864-866.
XIA X,WANG D G,HAO L,et al.An investigation and analysis of influencing factors of vascular calcification in hemodialysis patients［J］.Chin J Dis Control Prev,2018,22(8):864-866.
［2］　曹倩颖，周晶晶，刘小菁，等.维持性血液透析患者骨硬化蛋白水平与血管钙化的相关性分析［J］.中国血液净化，2020，19（2）：103-107.
CAO Q Y,ZHOU J J,LIU X J,et al.Correlation between serum sclerostin level and vascular calcification in maintenance hemodialysis patients［J］.Chin J Blood Purif,2020,19(2):103-107.
［3］　WEI H L,LI H,SONG X H,et al.Serum klotho:a potential predictor of cerebrovascular disease in hemodialysis patients［J］.BMC Nephrol,2019,20(1):63.
［4］　吴雪莹，张琢，徐天华，等.维持性血液透析患者血清sclerostin与血管钙化相关性分析［J］.中国血液净化，2017，16（12）：793-797.
WU X Y,ZHANG Z,XU T H,et al.The correlation analysis of serum sclerostin and vascular calcification in maintenance hemodialysis patients［J］.Chin J Blood Purif,2017,16(21):793-797.
［5］　周春娅，邢继成，张晓娟，等.维持性血液透析患者血清Klotho蛋白水平与血管钙化的关系［J］.山东医药，2019，59（34）：60-62.
ZHOU C Y,XING J C,ZHANG X J,et al.Relationship between serum Klotho protein levels and vascular calcification in maintenance hemodialysis patients［J］.Shandong Med J,2019,59(34):60-62.
［6］　YAMADA S,GIACHELLI C M.Vascular calcification in CKD-MBD: roles for phosphate,FGF23,and Klotho［J］.Bone,2017,100:87-93.
［7］　张洋洋，云琛，褚畅，等.维持性血液透析患者血管钙化和血清骨硬化蛋白的相关因素［J］.实用医学杂志，2018，34（23）：3917-3920.
ZHANG Y Y,YUN C,CHU C,et al.Correlation between vascular calcification and serum sclerostin in maintenance hemodialysis patients［J］.J Pract Med,2018,34(23):3917-3920.
［8］　ZHANG Y X,TANG R N,WANG L T,et al.Role of crosstalk between endothelial cells and smooth muscle cells in vascular calcification in chronic kidney disease［J］.Cell Prolif,2021,54(13):e12980-e12989.
［9］　郑明楠，吴华，金实.FGF-23和Klotho蛋白水平在终末期肾病患者中与钙磷代谢及其伴发病的相关性［J］.西部医学，2019，31（2）：190-193.
ZHENG M N,WU H,JIN S.Relationship between FGF-23 and Klotho protein levels and the calcium and phosphorus metabolism,atherosclerosis and left ventricular hypertrophy in maintenance hemodialysis and peritoneal dialysis patients［J］.Med J West Chin,2019,31(2):190-193.
［10］　ZHENG S B,ZHENG Y,JIN L W,et al.Relationship between serum soluble klotho protein and coronary artery calcification and prognosis in patients on maintenance hemodialysis［J］.Iran J Public Health,2018,47(4):510-518.
［11］　姜瑞丰，施妙君，鄢巨振.维持性血液透析患者血清Sfrp5、Klotho水平变化及其与钙磷代谢的关系［J］.广东医学，2020，41（2）：152-155.
JIANG R F,SHI M J,YAN J Z.Changes of serum Sfrp5 and Klotho levels in maintenance hemodialysis patients and their relationship with calci-um and phosphorus metabolism［J］.Guangdong Med J,2020,41(2):152-155.
［12］　丁浩，曹娟，章旭，等.慢性肾脏病患者血清Klotho蛋白水平与血管钙化的相关性研究［J］.重庆医学，2017，46（36）：5093-5097.
DING J,CAO J,ZHANG X,et al.Study on correlation between serum Klotho protein level with vascular calcification in patients with chronic kidney disease［J］.Chongqing Med,2017,46(36):5093-5097.
［13］　郭正勇，赵观进，张慧泽，等.维持血液透析患者腹主动脉钙化与血清FGF-23、Klotho蛋白相关性［J］.实用医学杂志，2018，34（14）：2348-2352.
GUO Z Y,ZHAO G J,ZHANG H Z,et al.Relationship between abdominal aortic calcification and serum levels of FGF-23 and Klotho protein in maintenance hemodialysis patients［J］.J Pract Med,2018,34(14):2348-2352.
［14］　戴璇，李月红，姜埃利，等.骨硬化蛋白在慢性肾脏病发病及血管钙化中作用的研究进展［J］.山东医药，2019，59（32）：96-99.
DAI X,LI Y H,JIANG A L,et al.Progress in the role of osteosclerosis protein in chronic kidney disease and vascular calcification［J］.Shandong Med J,2019,59(32):96-99.
［15］　杨海，夏石榴，钱静.血液透析患者体内骨硬化蛋白水平与血管钙化程度及骨代谢指标的相关性分析［J］.中国临床医生杂志，2020，48（2）：187-189.
YANG H,XIA S L,QIAN J.Correlation analysis of bone sclerostin level and degree of vascular calcification and bone metabolism index in hemodialysis patients［J］.Chin J Clin,2020,48(2):187-189.

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更新日期/Last Update: 2022-05-05