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血清鸢尾素水平降低与血液透析患者心血管和脑血管疾病死亡率的增加有关。

Lower serum irisin levels are associated with the increasing mortality of cardiovascular and cerebrovascular diseases in hemodialysis patients.

机构信息

Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China.

出版信息

Ann Palliat Med. 2021 Jun;10(6):6052-6061. doi: 10.21037/apm-21-406. Epub 2021 May 18.

Abstract

BACKGROUND

Irisin is a recently discovered myokine/adipokine and lower levels of irisin were proved to be associated with adverse outcomes of cardiovascular and cerebrovascular diseases (CCVD) in general population. A significant decrease of irisin concentrations were also detected in patients with chronic kidney disease (CKD). In the present study, we investigated whether the serum irisin levels were associated with cardiovascular and cerebrovascular mortality in hemodialysis (HD) patients.

METHODS

This retrospective cohort study enrolled 152 HD patients. Kaplan-Meier analysis was used to estimate the cumulative mortality of CCVD. The differences between the survival curves were compared by log-rank test. A multivariable Cox regression analysis was employed to identify the predictors of CCVD related deaths.

RESULTS

Among 152 HD patients, 55 patients died and 18 of them died of CCVD, 97 HD patients survived. Compared with the survival group, patients died of CCVD had significantly lower serum irisin levels [23.6 (2.2, 319.4) vs. 45.7 (2.1, 367.8) ng/mL, P<0.05]. The Kaplan-Meier survival curves showed that patients with lower levels of irisin had higher CCVD mortality. The Cox regression analysis indicated lower irisin level as an independent risk factor for CCVD mortality in HD patients but not for all-cause mortality.

CONCLUSIONS

Our results provided an association between lower irisin level and CCVD mortality in HD patients. Lower levels of irisin increased the mortality of CCVD in HD patients.

摘要

背景

鸢尾素是一种新发现的肌因子/脂肪因子,较低水平的鸢尾素与一般人群中心血管和脑血管疾病(CCVD)的不良结局相关。在慢性肾脏病(CKD)患者中也检测到鸢尾素浓度显著降低。在本研究中,我们研究了血清鸢尾素水平与血液透析(HD)患者心血管和脑血管死亡率之间是否存在相关性。

方法

这是一项回顾性队列研究,共纳入 152 名 HD 患者。Kaplan-Meier 分析用于估计 CCVD 的累积死亡率。通过对数秩检验比较生存曲线之间的差异。采用多变量 Cox 回归分析确定 CCVD 相关死亡的预测因素。

结果

在 152 名 HD 患者中,55 名患者死亡,其中 18 名死于 CCVD,97 名 HD 患者存活。与生存组相比,死于 CCVD 的患者血清鸢尾素水平显著降低[23.6(2.2,319.4)比 45.7(2.1,367.8)ng/mL,P<0.05]。Kaplan-Meier 生存曲线显示,鸢尾素水平较低的患者 CCVD 死亡率较高。Cox 回归分析表明,较低的鸢尾素水平是 HD 患者 CCVD 死亡率的独立危险因素,但不是全因死亡率的独立危险因素。

结论

我们的研究结果表明,较低的鸢尾素水平与 HD 患者 CCVD 死亡率之间存在关联。较低的鸢尾素水平增加了 HD 患者 CCVD 的死亡率。

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