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肾移植后血清骨桥蛋白与首次住院及全因死亡率的关联。

Association of serum osteopontin with first hospitalization and all-cause mortality after kidney transplantation.

作者信息

Yang Hsiao-Hui, Hsu Bang-Gee, Ho Ching-Chun, Lee Ming-Che

机构信息

Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

出版信息

Tzu Chi Med J. 2021 Apr 1;34(2):200-206. doi: 10.4103/tcmj.tcmj_269_20. eCollection 2022 Apr-Jun.

Abstract

OBJECTIVE

Osteopontin (OPN) is involved in vascular calcification and atherosclerosis. We evaluated the association between serum OPN levels and the first postoperative hospitalization and all-cause mortality in patients who received kidney transplantation (KT).

MATERIALS AND METHODS

Seventy KT recipients were enrolled in this study from January to April 2012. The primary end point was first postoperative hospitalization or death. All patients were monitored in the outpatient clinics until June 30, 2017. Serum OPN level was measured by enzyme-linked immunosorbent assay.

RESULTS

During follow-up (median length, 65 months), 47 first postoperative hospitalizations and 8 deaths occurred. In comparison with serum median OPN levels, serum OPN level was positively associated with KT duration ( = 0.048), serum blood urea nitrogen (BUN; P = 0.043), and serum creatinine levels ( = 0.045) but negatively associated with estimated glomerular filtration rate (eGFR; = 0.049). Hospitalized KT recipients had a higher prevalence of diabetes mellitus (DM) ( = 0.032), BUN ( = 0.002), and serum OPN level ( = 0.001) but lower eGFR ( = 0.030) than did patients not hospitalized. KT recipients who died had higher serum level of creatinine ( = 0.009) and OPN ( = 0.001) but lower eGFR ( = 0.036) than did surviving patients. Multivariate Cox analysis adjusted for age, gender, DM, hypertension, eGFR, KT duration, and steroid used showed that serum OPN level was associated with both first postoperative hospitalization ( = 0.049) and all-cause mortality ( = 0.017).

CONCLUSIONS

Serum OPN level is a potential biomarker for first postoperative hospitalization and all-cause mortality in KT recipients.

摘要

目的

骨桥蛋白(OPN)与血管钙化和动脉粥样硬化有关。我们评估了接受肾移植(KT)患者的血清OPN水平与首次术后住院及全因死亡率之间的关联。

材料与方法

2012年1月至4月,70例KT受者纳入本研究。主要终点为首次术后住院或死亡。所有患者在门诊接受监测直至2017年6月30日。采用酶联免疫吸附测定法检测血清OPN水平。

结果

随访期间(中位时长65个月),发生47次首次术后住院和8例死亡。与血清OPN水平中位数相比,血清OPN水平与KT时长(P = 0.048)、血清尿素氮(BUN;P = 0.043)及血清肌酐水平(P = 0.045)呈正相关,但与估计肾小球滤过率(eGFR;P = 0.049)呈负相关。与未住院患者相比,住院的KT受者糖尿病(DM)患病率更高(P = 0.032)、BUN水平更高(P = 0.002)、血清OPN水平更高(P = 0.001),但eGFR更低(P = 0.030)。死亡的KT受者血清肌酐水平(P = 0.009)和OPN水平(P = 0.001)更高,但eGFR更低(P = 0.036)。经年龄、性别、DM、高血压、eGFR、KT时长及使用的类固醇进行多因素Cox分析显示,血清OPN水平与首次术后住院(P = 0.049)及全因死亡率(P = 0.017)均相关。

结论

血清OPN水平是KT受者首次术后住院和全因死亡率的潜在生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/809c/9020252/b5e775f9942a/TCMJ-34-200-g001.jpg

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