Lin Lin, Lai Yu-Hsien, Chiu Liang-Te, Tsai Jen-Pi, Wang Chih-Hsien, Hsu Bang-Gee
Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Tzu Chi Med J. 2019 Apr-Jun;31(2):102-106. doi: 10.4103/tcmj.tcmj_90_18.
Sclerostin is a canonical Wingless (Wnt)/β-catenin signaling pathway inhibitor and had been associated with high arterial stiffness in patients with chronic kidney disease. The aortic augmentation index (AIx), a noninvasive method of assessing central hemodynamics/wave reflections, has been widely used as a clinical index of arterial stiffness. The aim of this study was to evaluate the relationship between fasting serum sclerostin levels and AIx values in peritoneal dialysis (PD) patients.
Fasting blood samples were obtained from 75 PD patients. The aortic AIx value was measured using a validated tonometry system (SphygmoCor, AtCor Medical, Sydney, New South Wales, Australia). Serum sclerostin and dickkopf-1 (DKK1) levels were quantified using commercial enzyme-linked immunosorbent assay kits.
Women PD patients had higher aortic AIx values than men ( = 0.039), while lower aortic AIx values were found in PD patients who used statins ( = 0.004). Univariate linear analysis of the aortic AIx values in PD patients showed that systolic blood pressure ( = 0.001), diastolic blood pressure ( = 0.018), and serum sclerostin levels ( = 0.001) were positively correlated, while height ( = 0.018), body weight ( = 0.001), body mass index ( = 0.043), and weekly total creatinine clearance ( = 0.015) were negatively correlated with aortic AIx values in PD patients. Multivariate linear regression analysis of the factors significantly associated with the aortic AIx values showed that serum sclerostin levels (adjusted = 0.057, = 0.011) and systolic blood pressure (adjusted = 0.125, = 0.004) were positively associated, while body weight (adjusted = 0.113, = 0.002) was inversely associated with aortic AIx values in PD patients.
In this study, the serum sclerostin level, but not DKK1, was positively associated with aortic AIx values in PD patients.
硬化蛋白是一种典型的无翅型（Wnt）/β-连环蛋白信号通路抑制剂，与慢性肾脏病患者的高动脉僵硬度有关。主动脉增强指数（AIx）是一种评估中心血流动力学/波反射的非侵入性方法，已被广泛用作动脉僵硬度的临床指标。本研究旨在评估腹膜透析（PD）患者空腹血清硬化蛋白水平与AIx值之间的关系。
采集75例PD患者的空腹血样。使用经过验证的眼压计系统（SphygmoCor，AtCor Medical，悉尼，新南威尔士州，澳大利亚）测量主动脉AIx值。使用商业酶联免疫吸附测定试剂盒对血清硬化蛋白和Dickkopf-1（DKK1）水平进行定量。
女性PD患者的主动脉AIx值高于男性（P = 0.039），而使用他汀类药物的PD患者主动脉AIx值较低（P = 0.004）。对PD患者主动脉AIx值进行单变量线性分析显示，收缩压（P = 0.001）、舒张压（P = 0.018）和血清硬化蛋白水平（P = 0.001）呈正相关，而身高（P = 0.018）、体重（P = 0.001）、体重指数（P = 0.043）和每周总肌酐清除率（P = 0.015）与PD患者的主动脉AIx值呈负相关。对与主动脉AIx值显著相关的因素进行多变量线性回归分析显示，血清硬化蛋白水平（校正β = 0.057，P = 0.011）和收缩压（校正β = 0.125，P = 0.004）呈正相关，而体重（校正β = 0.113，P = 0.002）与PD患者的主动脉AIx值呈负相关。
在本研究中，血清硬化蛋白水平而非DKK1水平与PD患者的主动脉AIx值呈正相关。
