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探讨晚期颈动脉粥样硬化患者血浆护骨素(OPG)和核因子κB 受体激活剂配体(RANKL)水平与临床危险因素的相关性。

Correlation of plasma osteoprotegerin (OPG) and receptor activator of the nuclear factor κB ligand (RANKL) levels with clinical risk factors in patients with advanced carotid atherosclerosis.

机构信息

Department of Forensic Medicine and Toxicology, Medical School, University of Athens, Athens, Greece.

出版信息

Med Sci Monit. 2012 Oct;18(10):CR597-604. doi: 10.12659/msm.883485.

Abstract

BACKGROUND

Osteoprotegerin (OPG) is considered to be a crucial regulatory mediator of bone metabolism by acting as a decoy receptor of the receptor activator of nuclear factor κB ligand (RANKL). OPG and RANKL have further become the subject of intense interest for their potential role in cardiovascular disease. The present study aimed to assess the clinical implication of plasma OPG and RANKL levels in patients with advanced carotid atherosclerosis.

MATERIAL/METHODS: Plasma OPG and RANKL concentrations measured by solid-phase enzyme-linked immunosorbent assay (ELISA) were correlated with medical history, risk factors and medication intake in 131 patients who underwent carotid endarterectomy for vascular repair.

RESULTS

Plasma OPG concentrations were associated with patients' age (p=0.0258), homocysteine levels (p<0.00001), eGFR (p=0.0254), history of diabetes (p=0.0324), statins therapy (p=0.0044), hyperlipidemia (p=0.0407), smoking (p=0.0226) and CAD (p=0.0377). Plasma RANKL concentrations were associated with patients' age (p=0.0191), homocysteine levels (p<0.00001), history of smoking (p=0.0185) and statins therapy (p=0.0004). Diabetes, CAD, smoking status, statins therapy and homocysteine were identified as independent predictors of OPG concentrations (p=0.0157, p=0.0030, p=0.0249, p=0.0047 and p=0.0072, respectively), whereas smoking showed an independent effect for RANKL (p=0.0010).

CONCLUSIONS

The present data reinforce the clinical utility of OPG in carotid atherosclerosis, whereas the clinical implication of RANKL seems uncertain.

摘要

背景

骨保护素(OPG)被认为是核因子κB 配体受体激活剂(RANKL)的诱饵受体,通过充当其调节剂在骨代谢中起着关键作用。OPG 和 RANKL 因其在心血管疾病中的潜在作用而成为研究热点。本研究旨在评估晚期颈动脉粥样硬化患者血浆 OPG 和 RANKL 水平的临床意义。

材料/方法:通过固相酶联免疫吸附试验(ELISA)测量 131 例接受颈动脉内膜切除术进行血管修复的患者的血浆 OPG 和 RANKL 浓度,并将其与病史、危险因素和药物摄入相关联。

结果

血浆 OPG 浓度与患者年龄(p=0.0258)、同型半胱氨酸水平(p<0.00001)、eGFR(p=0.0254)、糖尿病史(p=0.0324)、他汀类药物治疗(p=0.0044)、高脂血症(p=0.0407)、吸烟史(p=0.0226)和 CAD(p=0.0377)相关。血浆 RANKL 浓度与患者年龄(p=0.0191)、同型半胱氨酸水平(p<0.00001)、吸烟史(p=0.0185)和他汀类药物治疗(p=0.0004)相关。糖尿病、CAD、吸烟状态、他汀类药物治疗和同型半胱氨酸被确定为 OPG 浓度的独立预测因子(p=0.0157、p=0.0030、p=0.0249、p=0.0047 和 p=0.0072),而吸烟对 RANKL 具有独立影响(p=0.0010)。

结论

本研究数据进一步证实了 OPG 在颈动脉粥样硬化中的临床应用价值,而 RANKL 的临床意义尚不确定。

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