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血液透析患者抗热休克蛋白 70 抗体血清水平与营养不良-炎症评分的相关性。

Correlation of anti-heat shock protein 70 antibodies serum level with malnutrition-inflammation score in hemodialysis patients.

机构信息

Laparoscopy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Nutrition and Metabolic Diseases Research Center and Department of Nutrition, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Int Urol Nephrol. 2019 Oct;51(10):1849-1854. doi: 10.1007/s11255-019-02270-7. Epub 2019 Sep 4.

Abstract

BACKGROUND

Increased levels of circulating heat shock protein 70 antibodies (anti-Hsp70) have been reported in hemodialysis (HD) patients. Since the anti-Hsp70 correlates with inflammation, it may associate with the malnutrition-inflammation score (MIS). The aim of this study was to determine whether the increased MIS score in HD patients are related to circulating levels of anti-Hsp70.

METHOD

Ninety HD patients with an arteriovenous fistula, aged 30-65 years, who underwent three hemodialysis sessions a week for at least the past 3 months at a hemodialysis center were enrolled in this cross-sectional study. Patients were divided based on MIS score to two groups, and the clinical and biochemical variables were compared between them. MIS cutoff score of ≥ 5 indicated the presence of malnutrition. The association between categorized MIS and anti-Hsp70 was examined using regression models adjusted for diabetes mellitus, hemodialysis vintage, BMI, albumin, hs-CRP, IL6 and endotoxin levels as confounding factors.

RESULTS

The univariate regression analysis revealed a significant association between MIS ≥ 5 and hemodialysis vintage, uric acid, hs-CRP, IL-6, endotoxin and serum anti-Hsp70 level. After adjusting the confounders, the association between MIS ≥ 5 and serum anti-Hsp70 level remained significant.

CONCLUSION

These data support the role of serum anti-Hsp70 in the development of malnutrition in HD patients. However, further studies with body composition assessments and better generalizability are required to investigate the association between nutritional status and circulating anti-Hsp70 level in HD patients.

摘要

背景

已有研究报道,血液透析(HD)患者的循环热休克蛋白 70 抗体(抗-Hsp70)水平升高。由于抗-Hsp70 与炎症相关,它可能与营养不良-炎症评分(MIS)相关。本研究旨在确定 HD 患者中升高的 MIS 评分是否与循环抗-Hsp70 水平相关。

方法

本横断面研究纳入了 90 名年龄在 30-65 岁之间、在血液透析中心接受动静脉瘘血液透析治疗的患者,每周进行三次透析,至少持续了 3 个月。根据 MIS 评分将患者分为两组,并比较两组间的临床和生化变量。MIS 评分≥5 表示存在营养不良。使用回归模型,将糖尿病、血液透析年限、BMI、白蛋白、hs-CRP、IL6 和内毒素水平作为混杂因素进行调整,分析分类 MIS 与抗-Hsp70 的相关性。

结果

单因素回归分析显示,MIS≥5 与血液透析年限、尿酸、hs-CRP、IL-6、内毒素和血清抗-Hsp70水平显著相关。在调整混杂因素后,MIS≥5 与血清抗-Hsp70水平之间的相关性仍然显著。

结论

这些数据支持血清抗-Hsp70 在 HD 患者营养不良发展中的作用。然而,需要进一步研究,包括身体成分评估和更好的普遍性,以调查 HD 患者营养状况与循环抗-Hsp70 水平之间的关联。

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