Laboratoire de Biochimie, CHRU Montpellier, Univ Montpellier 1, Montpellier, France.
PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier Cedex 5, France.
J Nephrol. 2015 Dec;28(6):765-72. doi: 10.1007/s40620-015-0201-5. Epub 2015 Apr 29.
Bone-vessel interaction in chronic renal failure remains poorly understood and could be driven by bone remodeling factors including osteoprotegerin (OPG), fibroblast growth factor 23 (FGF23), parathormone and vitamin D. Only few data are available in renal transplantation. The aim of this study was to investigate the relationship between bone remodeling factors and large artery function in renal transplant patients.
89 renal transplant patients were enrolled in this cross-sectional study. Carotid to femoral pulse wave velocity (PWV) and central augmentation index (AIx) were determined as an estimation of large artery function. Blood samples were collected for measurement of vascular risk markers. Independent predictors were identified by multivariate linear regression through backward feature selection using Akaike's information criteria.
At multivariate analysis, age (p < 0.001) and systolic arterial pressure (p = 0.003) were significantly associated with PWV but not AIx. In addition, both elevated blood concentrations of 1.25(OH)2 vitamin D (p = 0.013) and OPG (p = 0.047) were still significantly related to high PWV.
These results underline that age and mean arterial pressure are the main determinants of PWV following renal transplantation. Among bone remodeling biomarkers, plasma OPG and active vitamin D were the strongest determinants of arterial stiffness.
慢性肾衰竭中骨血管相互作用仍知之甚少,可能受骨重塑因子驱动,包括护骨素(OPG)、成纤维细胞生长因子 23(FGF23)、甲状旁腺素和维生素 D。在肾移植中仅有少量数据可用。本研究旨在探讨肾移植患者骨重塑因子与大动脉功能之间的关系。
本横断面研究纳入 89 例肾移植患者。通过颈动脉-股动脉脉搏波速度(PWV)和中心增强指数(AIx)评估大动脉功能。采集血样以测量血管风险标志物。通过向后特征选择的 Akaike 信息准则进行多元线性回归,确定独立预测因子。
在多元分析中,年龄(p<0.001)和收缩压(p=0.003)与 PWV 显著相关,但与 AIx 不相关。此外,1.25(OH)2 维生素 D(p=0.013)和 OPG(p=0.047)的血液浓度升高均与 PWV 升高显著相关。
这些结果表明,年龄和平均动脉压是肾移植后 PWV 的主要决定因素。在骨重塑生物标志物中,OPG 和活性维生素 D 是动脉僵硬的最强决定因素。