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骨钙素、骨保护素和骨桥蛋白对血液透析慢性肾衰竭患者动脉僵硬度的影响。

The Impact of Osteocalcin, Osteoprotegerin and Osteopontin on Arterial Stiffness in Chronic Renal Failure Patients on Hemodialysis.

机构信息

FMC Dialysis Center Pécs, Pécs, Hungary.

Nephrological Center and 2nd Department of Medicine, Faculty of Medicine, University of Pécs, Pécs, Hungary.

出版信息

Kidney Blood Press Res. 2017;42(6):1312-1321. doi: 10.1159/000486114. Epub 2017 Dec 15.

Abstract

BACKGROUND/AIMS: This cross-sectional study was designed to assess the relationship between vascular stiffness (VS) and bone-related proteins involved in the development of arteriosclerosis in patients on regular hemodialysis (HD).

METHODS

68 consecutive patients in stable clinical condition who received regular HD in the FMC Dialysis Center, Pécs were included. VS parameters (carotid-femoral pulse wave velocity - PWV, aortic augmentation index - AIx) were determined by applanation tonometry (SphygmoCor, AtCor Medical, Sidney) and the routine latoratory test were completed with measurements of osteocalcin (OC), osteopontin (OP) and osteoprotegerin (OPG) by using commercially available ELISA kits. 35 heathcare workers served as controls.

RESULTS

In patients on regular HD PWV markedly increased and there was several-fold elevation in the interrelated bone-specific proteins (OC, OP, OPG). PWV was found to be independently associated only with OC (β:-0.25, p<0.029) and age (r=0.411,p<0.000), but risk factors for arterial calcification had significant impact on OC (systolic blood pressure, hsCRP, BMI), OPG (age, BMI) and OP (LDL-cholesterol).

CONCLUSION

Except for OC, our results failed to document direct association of vascular lesion with OP and OPG, therefore their high circulating levels may be an epiphenomenon or they may have counter-regulatory role to attenuate the uremic calcification process.

摘要

背景/目的:本横断面研究旨在评估在接受常规血液透析(HD)的患者中,血管僵硬(VS)与参与动脉硬化发展的骨相关蛋白之间的关系。

方法

纳入了在佩奇 FMC 透析中心接受常规 HD 的 68 例稳定临床状态的患者。通过平板张力计(SphygmoCor,AtCor Medical,悉尼)测定 VS 参数(颈股脉搏波速度 - PWV、主动脉增强指数 - AIx),并通过商用 ELISA 试剂盒测定骨钙素(OC)、骨桥蛋白(OP)和护骨素(OPG)的常规实验室检测。35 名医护人员作为对照。

结果

在接受常规 HD 的患者中,PWV 明显增加,相关骨特异性蛋白(OC、OP、OPG)也呈数倍升高。PWV 仅与 OC(β:-0.25,p<0.029)和年龄(r=0.411,p<0.000)独立相关,但动脉钙化的危险因素对 OC(收缩压、hsCRP、BMI)、OPG(年龄、BMI)和 OP(LDL-胆固醇)有显著影响。

结论

除了 OC 之外,我们的结果未能证明血管病变与 OP 和 OPG 之间存在直接关联,因此它们的高循环水平可能是一种表象,或者它们可能具有代偿性作用,以减轻尿毒症钙化过程。

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