吸烟与血液透析患者骨 gla 蛋白（BGP）水平降低有关。

Cigarette Smoking is Associated with Decreased Bone Gla-protein (BGP) Levels in Hemodialysis Patients.

机构信息

National Research Council (CNR), Institute of Clinical Physiology (IFC), Pisa Via G. Moruzzi 1, 56124, Pisa, PI, Italy.

Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, PD, Italy.

出版信息

Curr Vasc Pharmacol. 2018;16(6):603-609. doi: 10.2174/1570161115666170919182421.

DOI:10.2174/1570161115666170919182421

PMID:28933309

Abstract

BACKGROUND

Bone Gamma-carboxyglutamic acid (Gla)-protein (BGP or osteocalcin) is a vitamin K-dependent protein involved in the regulation of bone mineralization. Smoking is a risk factor for osteoporosis.

METHODS

We carried out a secondary analysis of the Vitamin K Italian (VIKI) study to investigate the association between cigarette smoking and BGP levels in patients with end stage renal disease. Data were collected in 370 haemodialysis patients, 37% (136) smokers (or ex-smokers) and 63% (234) nonsmokers. Vascular calcifications and vertebral fractures (quantitative morphometry) were identified on spine radiographs.

RESULTS

Smokers had significantly lower BGP levels (152 vs. 204 µg/L, p=0.003). Smokers had lower plasma phosphate levels (4.2 vs. 4.7 mg/dl, p<0.01). Lower BGP levels were associated with aortic calcification (p<0.001), iliac calcification (p=0.042) and vertebral fractures (p=0.023). In addition, the regression model showed that smoking is associated with a significant reduction of total BGP levels by about 18% (p=0.01).

CONCLUSION

This is the first clinical study in a haemodialysis population, which identifies cigarette smoking as a potential factor that can lower BGP levels, a protective agent in bone and vascular health.

摘要

背景

骨 γ-羧基谷氨酸蛋白（BGP 或骨钙素）是一种维生素 K 依赖性蛋白，参与骨矿化的调节。吸烟是骨质疏松的危险因素。

方法

我们对意大利维生素 K 研究（VIKI）进行了二次分析，以调查终末期肾病患者中吸烟与 BGP 水平之间的关系。数据采集于 370 名血液透析患者，其中 37%（136 名）为吸烟者（或曾经吸烟者），63%（234 名）为不吸烟者。通过脊柱 X 光片确定血管钙化和椎体骨折（定量形态计量学）。

结果

吸烟者的 BGP 水平明显较低（152 比 204 µg/L，p=0.003）。吸烟者的血浆磷酸盐水平较低（4.2 比 4.7 mg/dl，p<0.01）。较低的 BGP 水平与主动脉钙化（p<0.001）、髂骨钙化（p=0.042）和椎体骨折（p=0.023）相关。此外，回归模型显示，吸烟与总 BGP 水平显著降低约 18%相关（p=0.01）。