Ulu Sena Memnune, Yuksel Seref, Altuntaş Atila, Kacar Emre, Ahsen Ahmet, Altug Abdullah, Celik Sefa, Sezer M Tugrul
Department of Nephrology, Faculty of Medicine, Afyon Kocatepe University, 03200, Afyonkarahisar, Turkey,
Int Urol Nephrol. 2014 Dec;46(12):2409-14. doi: 10.1007/s11255-014-0753-7. Epub 2014 Jun 8.
Patients on continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis have accelerated atherosclerosis associated with an increase in cardiovascular morbidity and mortality. Atherosclerosis is associated with increased arterial stiffness (AS), endothelial dysfunction and elevated oxidative stress (OS) and inflammation. We aimed to investigate the relationship between oxidative stress status, arterial stiffness, hepcidin and fibroblast growth factor-21 (FGF-21) levels in CAPD patients.
As a prospective observational study, we analyzed 56 CAPD patients, aged between 30 and 63 years. Serum hepcidin, FGF-21 levels, OS status and AS were determined. Arterial stiffness was measured by flow-mediated dilatation (FMD). Oxidative stress status was determined by total antioxidant status, total oxidant status (TOS) and oxidative stress index (OSI).
FMD was negatively correlated with TOS, OSI, hepcidin and FGF-21 (r: -0.313, p: 0.020; r: -0.0331, p: 0.014; r: -0.498, p < 0.001; r: -0.403, p: 0.002, respectively). OSI was positively correlated with hepcidin, parathormone and negatively correlated with FMD (r: 0.278, p: 0.040; r: 0.462, p < 0.001; r: -0.0331, p: 0.014, respectively).
There are many factors affecting arterial stiffness in CAPD patients. In our study, higher levels of OS status, hepcidin and FGF-21 were independent determinants of arterial stiffness in PD patients. Therefore, definition and improvement of these new parameters will be helpful to reduce the cardiovascular disease risk and mortality in CAPD patients.
持续非卧床腹膜透析(CAPD)和血液透析患者存在动脉粥样硬化加速的情况,这与心血管发病率和死亡率增加相关。动脉粥样硬化与动脉僵硬度(AS)增加、内皮功能障碍以及氧化应激(OS)和炎症升高有关。我们旨在研究CAPD患者氧化应激状态、动脉僵硬度、铁调素和成纤维细胞生长因子-21(FGF-21)水平之间的关系。
作为一项前瞻性观察性研究,我们分析了56例年龄在30至63岁之间的CAPD患者。测定血清铁调素、FGF-21水平、OS状态和AS。通过血流介导的血管舒张(FMD)测量动脉僵硬度。通过总抗氧化状态、总氧化状态(TOS)和氧化应激指数(OSI)确定氧化应激状态。
FMD与TOS、OSI、铁调素和FGF-21呈负相关(r分别为-0.313,p为0.020;r为-0.0331,p为0.014;r为-0.498,p<0.001;r为-0.403,p为0.002)。OSI与铁调素、甲状旁腺激素呈正相关,与FMD呈负相关(r分别为0.278,p为0.040;r为0.462,p<0.001;r为-0.0331,p为0.014)。
CAPD患者中存在许多影响动脉僵硬度的因素。在我们的研究中,较高水平的OS状态、铁调素和FGF-21是PD患者动脉僵硬度的独立决定因素。因此,明确和改善这些新参数将有助于降低CAPD患者的心血管疾病风险和死亡率。