维持性血液透析患者中合并和不合并糖尿病者血浆中性粒细胞明胶酶相关载脂蛋白与胸主动脉钙化的相关性。
Association of plasma neutrophil gelatinase-associated lipocalin and thoracic aorta calcification in maintenance hemodialysis patients with and without diabetes.
机构信息
Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), No.16766, Jingshi Road, Jinan, 250014, China.
Shandong Provincial Insititute of Nephrology, Jinan, China.
出版信息
BMC Nephrol. 2022 Apr 22;23(1):156. doi: 10.1186/s12882-022-02773-z.
BACKGROUND
Neutrophil gelatinase-associated lipocalin (NGAL) is not only a bone-derived factor involved in metabolism, but also a biomarker of kidney disease and cardiovascular pathophysiology. We conducted this cross-sectional observational study to explore relationships between plasma NGAL and thoracic aorta calcification (TAC) in maintenance hemodialysis (MHD) patients with and without diabetes.
METHODS
Plasma NGAL was measured by ELISA, TAC was evaluated via computed tomography scan using a 3D quantification method or chest radiography aortic arch calcification score. Spearman correlation, Logistic regression and Partial correlation analysis were used to describe the correlations between NGAL and TAC.
RESULTS
Plasma NGAL levels were lower in MHD patients with diabetes compared to those without diabetes (49.33(42.37, 55.48) vs 56.78(44.37, 674.13) ng/mL, P = 0.026). In MHD patients without diabetes, lg (NGAL) was positively correlated with ARC value(R = 0.612, P = 0.003) analyzed by Spearman correlation; for partial correlation analysis, lg (NGAL) was positively correlated with ARC value, after adjusting for age and sex (R = 0.550, P = 0.015), adjusting for age, sex and CHD (R = 0.565, P = 0.015), adjusting for age, sex, CHD and Alb (R = 0.536, P = 0.027), or adjusting for age, sex, CHD, Alb, and dialyzer membrane (polysulfone) (R = 0.590, P = 0.016); however, when adjusting for age, sex, CHD, Alb and Ca, the correlation between lg (NGAL) and ARC value disappeared. Positive correlation were found between NGAL and Ca (R = 0.644, P < 0.001), Ca and ACR (R = 0.534, P = 0.013) in Spearman coefficient analysis.
CONCLUSION
There were positive correlations among plasma NGAL, serum Ca and ARC in MHD patients without diabetes; which suggests that NGAL is possibly a participant in cardiovascular calcification, in non-diabetic MHD.
背景
中性粒细胞明胶酶相关载脂蛋白（NGAL）不仅是一种参与代谢的骨源性因子，也是肾脏疾病和心血管病理生理学的生物标志物。我们进行了这项横断面观察性研究，以探讨维持性血液透析（MHD）患者中有无糖尿病时，血浆 NGAL 与胸主动脉钙化（TAC）之间的关系。
方法
通过 ELISA 法测定血浆 NGAL，通过 CT 扫描采用三维定量方法或胸部 X 线片主动脉弓钙化评分评估 TAC。采用 Spearman 相关分析、Logistic 回归和偏相关分析描述 NGAL 与 TAC 之间的相关性。
结果
与无糖尿病的 MHD 患者相比，糖尿病患者的血浆 NGAL 水平较低（49.33（42.37，55.48） vs 56.78（44.37，674.13）ng/mL，P=0.026）。在无糖尿病的 MHD 患者中，Spearman 相关分析显示 lg（NGAL）与 ARC 值呈正相关（R=0.612，P=0.003）；偏相关分析显示，在调整年龄和性别后，lg（NGAL）与 ARC 值呈正相关（R=0.550，P=0.015），调整年龄、性别、CHD 后（R=0.565，P=0.015），调整年龄、性别、CHD 和 Alb 后（R=0.536，P=0.027），或调整年龄、性别、CHD、Alb 和透析器膜（聚砜）后（R=0.590，P=0.016）；然而，当调整年龄、性别、CHD、Alb 和 Ca 后，lg（NGAL）与 ARC 值之间的相关性消失。在 Spearman 系数分析中，NGAL 与 Ca（R=0.644，P<0.001）和 Ca 与 ACR（R=0.534，P=0.013）之间存在正相关。
结论
在无糖尿病的 MHD 患者中，血浆 NGAL、血清 Ca 和 ARC 之间存在正相关；这表明 NGAL 可能是糖尿病非 MHD 患者心血管钙化的参与者。
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