Oh Hyung Jung, Nam Bo Young, Lee Mi Jung, Kim Chan Ho, Koo Hyang Mo, Doh Fa Mee, Han Jae Hyun, Kim Eun Jin, Han Ji Suk, Park Jung Tak, Yoo Tae-Hyun, Kang Shin-Wook, Han Dae-Suk, Han Seung Hyeok
Division of Nephrology, Department of Internal Medicine, College of Medicine, Brain Korea 21, Severance Biomedical Science Institute, Yonsei University, Seoul, Korea.
Division of Nephrology, Department of Internal Medicine, College of Medicine, Brain Korea 21, Severance Biomedical Science Institute, Yonsei University, Seoul, Korea Division of Nephrology, Department of Internal Medicine, College of Medicine, Brain Korea 21, Severance Biomedical Science Institute, Yonsei University, Seoul, Korea.
Perit Dial Int. 2015 Jan-Feb;35(1):43-51. doi: 10.3747/pdi.2013.00150. Epub 2014 Feb 4.
It has been reported that klotho deficiency is associated with oxidative stress and inflammation in experimental kidney disease models. Patients with endstage renal disease (ESRD) are particularly characterized by increased oxidative stress and inflammation. However, little is known about the relationship between these features and klotho in patients with ESRD.
We conducted a single-center, cross-sectional study of 78 patients receiving peritoneal dialysis (PD). Serum concentrations of klotho, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and 8-isoprostane were measured by enzyme-linked immunosorbent assay. To define factors independently associated with klotho, we determined Spearman's correlation coefficients for between co-variates and conducted multiple linear regression analyses.
Patients were classified by median concentration of klotho. In patients with klotho levels > 329.6 pg/mL, serum 8-isoprostane and IL-6 levels were significantly higher than in those with klotho levels < 329.6 pg/mL. In correlation analyses, log 8-isoprostane (γ = -0.310, p = 0.006) and log IL-6 (γ = -0.343, p = 0.002) were inversely correlated with log klotho. After adjustment for age, gender, mean arterial pressure, log intact parathyroid hormone, and log IL-6, log 8-isoprostane was independently associated with log klotho (β = -0.158, p = 0.040). However, the significant relationship between klotho and IL-6 was not seen in an adjusted model.
This study showed that circulating klotho levels were significantly associated with 8-isoprostane levels in patients undergoing PD, suggesting a potential link between klotho deficiency and enhanced oxidative stress in ESRD patients.
据报道，在实验性肾脏疾病模型中，klotho缺乏与氧化应激和炎症相关。终末期肾病（ESRD）患者的特点尤其表现为氧化应激和炎症增加。然而，对于ESRD患者中这些特征与klotho之间的关系知之甚少。
我们对78例接受腹膜透析（PD）的患者进行了一项单中心横断面研究。通过酶联免疫吸附测定法测量血清中klotho、高敏C反应蛋白（hsCRP）、白细胞介素-6（IL-6）和8-异前列腺素的浓度。为了确定与klotho独立相关的因素，我们计算了协变量之间的Spearman相关系数，并进行了多元线性回归分析。
根据klotho的中位数浓度对患者进行分类。在klotho水平>329.6 pg/mL的患者中，血清8-异前列腺素和IL-6水平显著高于klotho水平<329.6 pg/mL的患者。在相关性分析中，log 8-异前列腺素（γ = -0.310，p = 0.006）和log IL-6（γ = -0.343，p = 0.002）与log klotho呈负相关。在调整年龄、性别、平均动脉压、log完整甲状旁腺激素和log IL-6后，log 8-异前列腺素与log klotho独立相关（β = -0.158，p = 0.040）。然而，在调整模型中未发现klotho与IL-6之间的显著关系。
本研究表明，接受PD治疗的患者循环klotho水平与8-异前列腺素水平显著相关，提示ESRD患者中klotho缺乏与氧化应激增强之间可能存在联系。
