Zhang Minfang, Ni Zhaohui, Zhou Wenyan, Qian Jiaqi
Renal Division, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
J Biomed Sci. 2015 Sep 17;22(1):75. doi: 10.1186/s12929-015-0183-6.
Studies in recent years have shown that undercarboxylated osteocalcin (uOC) not only maintains bone mineralization, but is also involved in the regulation of atherosclerosis. However, a correlation between uOC and carotid atherosclerosis in non-dialysis patients with chronic kidney disease (CKD) has not been investigated. A total of 240 non-dialysis patients with CKD were included in the study. For these patients, the median estimated glomerular filtration rate (eGFR) was 20.05 (12.43-49.32) ml/min/1.73m(2). Serum uOC levels were measured using enzyme-linked immunosorbent assay (ELISA). Carotid ultrasonography was performed to assess carotid atherosclerotic plaques and intima-media thickness (IMT) in an attempt to analyze the relationship between uOC level and carotid atherosclerosis.
The uOC levels of non-dialysis patients with CKD were significantly lower than those of healthy controls [28.16 (21.40-45.85) ng/mL vs. 36.42 (28.05-49.28) ng/mL, P < 0.01]. The uOC levels gradually decreased as CKD progressed (P < 0.01). The uOC levels were significantly lower in patients with carotid plaques than in patients without carotid plaques [25.98 (20.14-31.35) ng/mL vs. 31.02 (25.86-36.40) ng/mL, P < 0.01]. uOC level showed significant negative correlation with IMT (r = -0.33, P < 0.01). Logistic regression analysis revealed that after adjustment for various confounding factors, decreased uOC levels were shown to indicate increased possibility of carotid atherosclerotic plaque development in non-dialysis patients with CKD (on every 1 SD decrease in the uOC level, odds ratio 1.70, 95 % confidence interval 1.24-2.98, P < 0.01). Multivariate stepwise regression analysis demonstrated that decreased uOC level (β = -0.163, P < 0.05) was an independent risk factor for increased carotid IMT in non-dialysis patients with CKD.
Serum uOC levels in non-dialysis patients with CKD are significantly lower than those in healthy individuals, and uOC is closely associated with subclinical atherosclerosis in CKD patients.
近年来的研究表明，未羧化骨钙素（uOC）不仅维持骨矿化，还参与动脉粥样硬化的调节。然而，尚未研究非透析慢性肾脏病（CKD）患者中uOC与颈动脉粥样硬化之间的相关性。本研究共纳入240例非透析CKD患者。这些患者的估算肾小球滤过率（eGFR）中位数为20.05（12.43 - 49.32）ml/min/1.73m²。采用酶联免疫吸附测定（ELISA）法检测血清uOC水平。进行颈动脉超声检查以评估颈动脉粥样硬化斑块和内膜中层厚度（IMT），试图分析uOC水平与颈动脉粥样硬化之间的关系。
非透析CKD患者的uOC水平显著低于健康对照者[28.16（21.40 - 45.85）ng/mL对36.42（28.05 - 49.28）ng/mL，P < 0.01]。随着CKD进展，uOC水平逐渐降低（P < 0.01）。有颈动脉斑块的患者uOC水平显著低于无颈动脉斑块的患者[25.98（20.14 - 31.35）ng/mL对31.02（25.86 - 36.40）ng/mL，P < 0.01]。uOC水平与IMT呈显著负相关（r = -0.33，P < 0.01）。Logistic回归分析显示，在调整各种混杂因素后，非透析CKD患者中uOC水平降低表明颈动脉粥样硬化斑块形成的可能性增加（uOC水平每降低1个标准差，比值比为1.70，95%置信区间为1.24 - 2.98，P < 0.01）。多因素逐步回归分析表明，uOC水平降低（β = -0.163，P < 0.05）是非透析CKD患者颈动脉IMT增加的独立危险因素。
非透析CKD患者的血清uOC水平显著低于健康个体，且uOC与CKD患者的亚临床动脉粥样硬化密切相关。
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