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[肾移植受者血清镁水平低与腹主动脉钙化程度之间的关联]

[Association between low serum magnesium levels and the extent of abdominal aortic calcification in renal transplant recipients].

作者信息

Massimetti Carlo, Cardello Paolo, Brescia Franco, Imperato Gea, Feriozzi Sandro

机构信息

Centro di Riferimento di Nefrologia e Dialisi, Ospedale Belcolle, Viterbo.

Radiologia, Ospedale Belcolle, Viterbo.

出版信息

G Ital Nefrol. 2020 Feb 12;37(1):2020-vol1.

Abstract

In renal transplant recipients (RTRs) vascular calcifications has been associated with an increased risk of cardiovascular as well as all-cause mortality. Recent experimental and clinical studies showed that magnesium (Mg) deficiency may be related to the progression of vascular calcification. Aim of this study was to determine the hypothetical association between Mg and vascular calcifications in RTRs. Seventy-one RTRs underwent a lateral X-ray of the lumbar spine to assess the presence of calcification of the abdominal aorta. Abdominal aortic calcium (AAC) content was graded with a score ranging from 0 to 24 points. At the same time were evaluated: carotid artery intima-media thickness (IMT); left ventricular mass index (LVMi); sCa, sPO4, sMg, uMg, PTH, HDL, LDL, blood pressure (BP). AAC was correlated with: age (r=0.601; P<0.001), dialysis vintage (r=0.314; P<0.01), sMg (r=-0.438; P<0.001), PTH (r=0.322; P<0.01), SBP (r=0.539; P<0.001), IMT (r=0.706; P<0.001), LVMi (r=0.326; P<0.01). Serum Mg was correlated with PTH (r= -0.304; P<0.01). IMT was correlated with LVMi and SBP (r=0.330, P<0.01; r=0.494, P <0.0001; respectively). Stepwise multiple regression analysis showed that the final model contained six predictor variables for AAC (IMT, sMg, age, SBP, proteinuria, and dialysis vintage; F5,64=31.7, P<0.001; Adjusted R2 =0.718). Patients in higher AAC thirtile (8-24) were older, with longer dialysis vintage, lower sMg, higher PTH, and higher IMT values. Our results suggest a hypothetical interrelationship between sMg and ACC, and IMT in RTRs.

摘要

在肾移植受者(RTRs)中,血管钙化与心血管疾病风险以及全因死亡率增加相关。近期的实验和临床研究表明,镁(Mg)缺乏可能与血管钙化的进展有关。本研究的目的是确定RTRs中镁与血管钙化之间的假设关联。71名RTRs接受了腰椎侧位X线检查,以评估腹主动脉钙化的存在情况。腹主动脉钙(AAC)含量采用0至24分的评分进行分级。同时评估了:颈动脉内膜中层厚度(IMT);左心室质量指数(LVMi);血清钙(sCa)、血清磷(sPO4)、血清镁(sMg)、尿镁(uMg)、甲状旁腺激素(PTH)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血压(BP)。AAC与以下因素相关:年龄(r = 0.601;P < 0.001)、透析龄(r = 0.314;P < 0.01)、sMg(r = -0.438;P < 0.001)、PTH(r = 0.322;P < 0.01)、收缩压(SBP)(r = 0.539;P < 0.001)、IMT(r = 0.706;P < 0.001)、LVMi(r = 0.326;P < 0.01)。血清镁与PTH相关(r = -0.304;P < 0.01)。IMT与LVMi和SBP相关(分别为r = 0.330,P < 0.01;r = 0.494,P < 0.0001)。逐步多元回归分析表明,最终模型包含六个预测AAC的变量(IMT、sMg、年龄、SBP、蛋白尿和透析龄;F5,64 = 31.7,P < 0.001;调整后R2 = 0.718)。AAC处于较高三分位数(8 - 24)的患者年龄更大,透析龄更长,sMg更低,PTH更高,IMT值更高。我们的结果表明RTRs中sMg与ACC以及IMT之间存在假设的相互关系。

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