Kalantar-Zadeh Kamyar, Brennan Marie-Luise, Hazen Stanley L
Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90509-2910, USA.
Am J Kidney Dis. 2006 Jul;48(1):59-68. doi: 10.1053/j.ajkd.2006.03.047.
During inflammation, myeloperoxidase (MPO) is released, for which its measurement in systemic circulation may be used as an index of leukocyte activation and oxidant stress. MPO levels correlate with angiographic evidence of coronary atherosclerosis and cardiovascular events in subjects with chest pain within the general population. We hypothesized that serum MPO levels are associated with adverse clinical outcomes in maintenance hemodialysis (MHD) patients.
MPO levels were determined in serum samples from 356 MHD patients at the start of a 3-year cohort.
Patients (46% women, 28% blacks, 54% with diabetes) were 54.6 +/- 14.6 (SD) years old and had undergone MHD for a median period of 26 months. Measured serum MPO level was 2,005 +/- 1,877 pmol/L (median, 1,444 pmol/L; interquartile range, 861 to 2,490 pmol/L). MHD patients with greater total body fat had greater MPO levels. MPO level had statistically significant (P < 0.01) and positive correlations with values for serum C-reactive protein (CRP; r = +0.15), interleukin 6 (IL-6; r = +0.23), tumor necrosis factor alpha (TNF-alpha; r = +0.21), and white blood cell count (r = +0.21). A death hazard ratio for each 1,000-pmol/L increase in serum MPO level was 1.14 (95% confidence interval [CI], 1.03 to 1.26; P = 0.01) after controlling for age, race (black), diabetes mellitus, dialysis vintage, Charlson comorbidity score, history of previous cardiovascular disease, blood hemoglobin level, and serum concentrations of albumin, CRP, IL-6, and TNF-alpha. After dividing MPO values into 3 equal groups (tertiles), the death hazard ratio of the highest tertile (versus the middle tertile) was 1.82 (95% CI, 1.07 to 3.10; P = 0.03).
Serum MPO levels correlate with levels of markers of inflammation and prospective mortality risk in MHD patients.
在炎症过程中，髓过氧化物酶（MPO）会被释放出来，其在体循环中的测量值可作为白细胞活化和氧化应激的指标。在普通人群中，MPO水平与胸痛患者冠状动脉粥样硬化的血管造影证据及心血管事件相关。我们推测血清MPO水平与维持性血液透析（MHD）患者的不良临床结局有关。
在一项为期3年的队列研究开始时，测定了356例MHD患者血清样本中的MPO水平。
患者（46%为女性，28%为黑人，54%患有糖尿病）年龄为54.6±14.6（标准差）岁，接受MHD治疗的中位时间为26个月。测得的血清MPO水平为2005±1877 pmol/L（中位数为1444 pmol/L；四分位间距为861至2490 pmol/L）。全身脂肪较多的MHD患者MPO水平更高。MPO水平与血清C反应蛋白（CRP；r = +0.15）、白细胞介素6（IL-6；r = +0.23）、肿瘤坏死因子α（TNF-α；r = +0.21）及白细胞计数（r = +0.21）值具有统计学显著相关性（P < 0.01）且呈正相关。在控制了年龄、种族（黑人）、糖尿病、透析时间、Charlson合并症评分、既往心血管疾病史、血红蛋白水平以及血清白蛋白、CRP、IL-6和TNF-α浓度后，血清MPO水平每升高1000 pmol/L的死亡风险比为1.14（95%置信区间[CI]，1.03至1.26；P = 0.01）。将MPO值分为3个相等的组（三分位数）后，最高三分位数（相对于中间三分位数）的死亡风险比为1.82（95%CI，1.07至3.10；P = 0.03）。
血清MPO水平与MHD患者的炎症标志物水平及预期死亡风险相关。
