Department of Nephrology, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, China.
Department of Nephrology, Xuanwu Hospital Capital Medical University, 45 Changchun Rd, Xicheng District, Beijing, 100053, China.
Int Urol Nephrol. 2022 Nov;54(11):3001-3007. doi: 10.1007/s11255-022-03240-2. Epub 2022 May 28.
Vascular calcification (VC), which is a pathological process of abnormal calcium and phosphorus deposition in blood vessels, valves, heart and other tissues, is highly prevalent and predicts mortality in dialysis patients. Its mechanisms are complex and unclear. We presume that intermedin (IMD), a kind of small molecule active peptide, may play roles in VC in hemodialysis (HD) patients. This study aims to evaluate serum IMD levels and establish their relation to VC and other parameters in HD patients.
A total of 116 patients on maintenance HD treatment and 52 age- and sex-matched healthy controls were enrolled in this study. Serum IMD levels were measured by radioimmunoassay (RIA). VC was evaluated by abdominal aortic calcification scores.
Serum IMD levels were significantly lower in HD patients than in controls [24.89 (13.55, 50.24) pg/ml vs. 137.79 (93.21, 201.64) pg/ml, P < 0.0001]. In addition, IMD was negatively correlated with the serum phosphate level (P = 0.036) in HD patients. However, compared with the group whose IMD levels were above the median, patients with IMD levels less than the median had a lower incidence of VC (P = 0.031). Multivariate logistic regression analyses revealed that serum IMD levels more than 24.89 pg/ml (P = 0.014, OR = 0.285), higher serum iPTH levels (P < 0.0001, OR = 1.093) and older age (P = 0.009, OR = 1.003) were significant independent determinant factors for VC in HD patients.
The serum IMD levels were significantly lower in HD patients than that in healthy group. In addition to higher PTH levels and older age, compensatory elevated IMD levels may be an independently determinant factor for VC in HD patients. This was the first study about IMD and VC in dialysis patients.
血管钙化（VC）是一种异常钙磷在血管、瓣膜、心脏和其他组织中沉积的病理过程，在透析患者中发病率高，预测死亡率。其机制复杂，尚不清楚。我们推测，中介素（IMD），一种小分子活性肽，可能在血液透析（HD）患者的 VC 中发挥作用。本研究旨在评估血清 IMD 水平，并建立其与 HD 患者 VC 及其他参数的关系。
本研究共纳入 116 名维持性 HD 治疗的患者和 52 名年龄和性别匹配的健康对照者。采用放射免疫法（RIA）测定血清 IMD 水平。采用腹主动脉钙化评分评估 VC。
HD 患者血清 IMD 水平明显低于对照组[24.89（13.55，50.24）pg/ml 比 137.79（93.21，201.64）pg/ml，P < 0.0001]。此外，HD 患者 IMD 与血清磷酸盐水平呈负相关（P = 0.036）。然而，与 IMD 水平高于中位数的组相比，IMD 水平低于中位数的患者 VC 发生率较低（P = 0.031）。多因素 logistic 回归分析显示，血清 IMD 水平大于 24.89 pg/ml（P = 0.014，OR = 0.285）、较高的血清 iPTH 水平（P < 0.0001，OR = 1.093）和年龄较大（P = 0.009，OR = 1.003）是 HD 患者 VC 的独立危险因素。
HD 患者血清 IMD 水平明显低于健康对照组。除了较高的 PTH 水平和年龄较大外，代偿性升高的 IMD 水平可能是 HD 患者 VC 的独立危险因素。这是关于透析患者 IMD 和 VC 的第一项研究。
