Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Ren Fail. 2020 Nov;42(1):131-136. doi: 10.1080/0886022X.2020.1714654.
Osteoprotegerin (OPG) is a potential biomarker of cardiovascular disease complications and severity. Peripheral arterial disease (PAD) is associated with an increased risk of death in patients on peritoneal dialysis (PD). Therefore, this study aimed to evaluate the relationship between serum OPG levels and PAD by measuring the ankle-brachial index (ABI) of patients on PD. A commercial enzyme-linked immunosorbent assay kit was used to measure OPG values. Left or right ABI values of <0.9 were categorized as the low ABI group. Among 70 patients on PD, 13 (18.6%) were categorized in the low ABI group. Patients in the low ABI group had higher prevalence of diabetes mellitus ( = .044) and higher serum C-reactive protein (CRP) ( < .001) and OPG levels ( < .001) but lower creatinine ( = .013) and peritoneal Kt/V ( = .048) levels than those in the normal ABI group. Results of multivariable logistic regression analysis revealed that OPG [adjusted odds ratio (aOR) 1.027, 95% confidence interval (CI) 1.010-1.045, = .002] and CRP (aOR 1.102, 95% CI 1.006-1.207, = .037) levels were independent predictors of PAD in patients on PD. OPG can also be used to predict PAD development with the area under the receiver operating characteristic curve of 0.823 (95% CI: 0.714-0.904, < .001) in patients on PD. Therefore, serum OPG and CRP levels can be considered as risk factors for PAD development in patients on PD.
骨保护素 (OPG) 是心血管疾病并发症和严重程度的潜在生物标志物。周围动脉疾病 (PAD) 与腹膜透析 (PD) 患者的死亡风险增加有关。因此，本研究旨在通过测量 PD 患者的踝臂指数 (ABI) 来评估血清 OPG 水平与 PAD 之间的关系。使用商业酶联免疫吸附测定试剂盒测量 OPG 值。ABI 值 <0.9 的左或右 ABI 被归类为低 ABI 组。在 70 名 PD 患者中，有 13 名 (18.6%) 被归类为低 ABI 组。低 ABI 组患者糖尿病患病率更高（ = .044），血清 C 反应蛋白 (CRP)（ < .001）和 OPG 水平（ < .001）更高，但肌酐（ = .013）和腹膜 Kt/V（ = .048）水平更低与正常 ABI 组相比。多变量逻辑回归分析结果显示，OPG [调整优势比 (aOR) 1.027，95%置信区间 (CI) 1.010-1.045， = .002] 和 CRP (aOR 1.102，95% CI 1.006-1.207， = .037) 水平是 PD 患者 PAD 的独立预测因素。OPG 也可用于预测 PD 患者 PAD 发展，曲线下面积为 0.823（95% CI：0.714-0.904， < .001）。因此，血清 OPG 和 CRP 水平可被视为 PD 患者 PAD 发展的危险因素。
