He Lian, He Wan-Yu, A La-Ta, Yang Wen-Ling, Zhang Ai-Hua
Kidney Blood Press Res. 2018;43(1):287-295. doi: 10.1159/000487689. Epub 2018 Feb 22.
BACKGROUND/AIMS: Vascular calcification, which involves an active cellular transformation of vascular smooth muscle cells into bone forming cells, is prevalent and predicts mortality in dialysis patients. Its mechanisms are complex and unclear. We presume that irisin, a newly identified myokine also may play roles in vascular calcification in hemodialysis patients. This study aims to evaluate serum irisin levels and establish their relation to vascular calcification and other parameters in hemodialysis patients.
A total of 150 patients on maintenance hemodialysis treatment and 38 age- and sex-matched healthy controls were enrolled in this cross-sectional study. Serum irisin concentrations were measured by ELISA. Vascular calcification was evaluated by abdominal aortic calcification scores.
Serum irisin concentrations were significantly lower in hemodialysis patients than in controls [52.8 (22.0, 100.0) vs. 460.8 (434.8, 483.4) ng/ml, P<0.01]. In addition, irisin was negatively correlated with the parathyroid hormone level (P=0.01). The HD patients with vascular calcification showed significantly lower serum irisin concentrations [39.0 (21.7, 86.2) vs.79.0 (39.5, 130.2) ng/mL, P<0.01]. Compared with the group without vascular calcification multivariate logistic regression analyses revealed that serum irisin, HD vintage and age were significant independent determinant factors for vascular calcification in HD patients.
Our results are the first to provide a clinical evidence of the association between serum irisin and vascular calcification in HD patients. Lower irisin levels, long-term hemodialysis and old ages are independent risk factors in HD patients.
背景/目的:血管钙化涉及血管平滑肌细胞向成骨细胞的活跃细胞转化,在透析患者中普遍存在且可预测死亡率。其机制复杂且尚不清楚。我们推测,鸢尾素,一种新发现的肌动蛋白,可能在血液透析患者的血管钙化中也发挥作用。本研究旨在评估血液透析患者血清鸢尾素水平,并确定其与血管钙化及其他参数的关系。
本横断面研究共纳入150例维持性血液透析患者和38例年龄及性别匹配的健康对照。采用酶联免疫吸附测定法(ELISA)检测血清鸢尾素浓度。通过腹主动脉钙化评分评估血管钙化情况。
血液透析患者血清鸢尾素浓度显著低于对照组[52.8(22.0,100.0)对460.8(434.8,483.4)ng/ml,P<0.01]。此外,鸢尾素与甲状旁腺激素水平呈负相关(P=0.01)。有血管钙化的血液透析患者血清鸢尾素浓度显著更低[39.0(21.7,86.2)对79.0(39.5,130.2)ng/mL,P<0.01]。与无血管钙化组相比,多因素逻辑回归分析显示,血清鸢尾素、血液透析龄和年龄是血液透析患者血管钙化的重要独立决定因素。
我们的结果首次提供了血液透析患者血清鸢尾素与血管钙化之间关联的临床证据。较低的鸢尾素水平、长期血液透析和高龄是血液透析患者的独立危险因素。