Zhou Si-Jia, Wang Xiao-Xiao, Tang Wen, Han Qing-Feng, He Lian, Zhang Ai-Hua
Department of Nephrology, Peking University Third Hospital, Beijing, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
Kidney Dis (Basel). 2021 May;7(3):219-226. doi: 10.1159/000512514. Epub 2021 Jan 15.
Vascular calcification (VC), with the mechanisms remaining unclear, is closely related with dialysis patients' cardiovascular mortality and all-cause mortality. Irisin is a newly identified myokine. This study aims to evaluate the serum irisin levels of peritoneal dialysis (PD) patients and their relationship with VC.
This cross-sectional study enrolled stable PD patients in Peking University Third Hospital who were followed for >6 months. We used plain X-ray films of abdomen to quantitatively evaluate VC of abdominal aorta. VC was evaluated by abdominal aortic calcification (AAC) scores, and PD patients were divided into the high AAC score group (AAC score ≥4) and the low AAC score group (AAC score <4). Demographic data and laboratory indexes were collected. Serum irisin concentrations were measured by enzyme-linked immunosorbent assay.
A total of 102 PD patients were enrolled in this study, and 52 patients (51.0%) were found to have a high AAC score of ≥4. Age, diabetic mellitus proportion, pulse pressure, hypercalcemia (corrected calcium >2.54 mmol/L) rate, serum ultrasensitive C reactive protein, and AAC scores were significantly higher in the high AAC score group than those of the low AAC score group ( < 0.05). The high AAC score group had lower diastolic blood pressure, serum albumin, and serum carbon dioxide combining power compared with the low AAC score group ( < 0.05). Serum irisin levels of PD patients with a high AAC score were significantly lower than those of PD patients with a low AAC score (109.7 ± 13.1 ng/mL vs. 115.9 ± 10.1 ng/mL, = 0.010). The multivariate logistic regression analyses showed that serum irisin, diabetic mellitus, serum ultrasensitive C reactive protein, and age were independent factors influencing the occurrence of VC in PD patients.
Our results are the first to provide a clinical evidence of the association between serum irisin and abdominal aortic calcification in PD patients. Lower irisin levels, diabetic mellitus, higher serum ultrasensitive C reactive protein, and older age could be potential predictive factors for VC in PD patients.
血管钙化(VC)机制尚不清楚,与透析患者的心血管死亡率和全因死亡率密切相关。鸢尾素是一种新发现的肌动蛋白。本研究旨在评估腹膜透析(PD)患者的血清鸢尾素水平及其与VC的关系。
本横断面研究纳入北京大学第三医院随访时间>6个月的稳定PD患者。我们使用腹部平片对腹主动脉的VC进行定量评估。通过腹主动脉钙化(AAC)评分评估VC,并将PD患者分为高AAC评分组(AAC评分≥4)和低AAC评分组(AAC评分<4)。收集人口统计学数据和实验室指标。采用酶联免疫吸附测定法测定血清鸢尾素浓度。
本研究共纳入102例PD患者,其中52例(51.0%)患者的AAC评分≥4,为高AAC评分组。高AAC评分组的年龄、糖尿病比例、脉压、高钙血症(校正钙>2.54 mmol/L)发生率、血清超敏C反应蛋白和AAC评分均显著高于低AAC评分组(<0.05)。与低AAC评分组相比,高AAC评分组的舒张压、血清白蛋白和血清二氧化碳结合力较低(<0.05)。高AAC评分的PD患者血清鸢尾素水平显著低于低AAC评分的PD患者(109.7±13.1 ng/mL对115.9±10.1 ng/mL,=0.010)。多因素逻辑回归分析显示,血清鸢尾素、糖尿病、血清超敏C反应蛋白和年龄是影响PD患者VC发生的独立因素。
我们的研究结果首次提供了血清鸢尾素与PD患者腹主动脉钙化之间关联的临床证据。较低的鸢尾素水平、糖尿病、较高的血清超敏C反应蛋白和较高的年龄可能是PD患者VC的潜在预测因素。