Division of Nephrology, Department of Medicine, Hualien Armed Forces General Hospital, Hualien 97144, Taiwan.
Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan.
Medicina (Kaunas). 2024 Jun 14;60(6):984. doi: 10.3390/medicina60060984.
: Endocan, secreted from the activated endothelium, is a key player in inflammation, endothelial dysfunction, proliferation of vascular smooth muscle cells, and angiogenesis. We aimed to investigate the link between endocan and aortic stiffness in maintenance hemodialysis (HD) patients. : After recruiting HD patients from a medical center, their baseline characteristics, blood sample, and anthropometry were assessed and recorded. The serum endocan level was determined using an enzyme immunoassay kit, and carotid-femoral pulse wave velocity (cfPWV) measurement was used to evaluate aortic stiffness. : A total of 122 HD patients were enrolled. Aortic stiffness was diagnosed in 53 patients (43.4%), who were found to be older ( = 0.007) and have a higher prevalence of diabetes ( < 0.001) and hypertension ( = 0.030), higher systolic blood pressure ( = 0.011), and higher endocan levels ( < 0.001), when compared with their counterparts. On the multivariate logistic regression model, the development of aortic stiffness in patients on chronic HD was found to be associated with endocan [odds ratio (OR): 1.566, 95% confidence interval (CI): 1.224-2.002, < 0.001], age (OR: 1.040, 95% CI: 1.001-1.080, = 0.045), and diabetes (OR: 4.067, 95% CI: 1.532-10.798, = 0.005), after proper adjustment for confounders (adopting diabetes, hypertension, age, systolic blood pressure, and endocan). The area under the receiver operating characteristic curve was 0.713 (95% CI: 0.620-0.806, < 0.001) for predicting aortic stiffness by the serum endocan level, at an optimal cutoff value of 2.68 ng/mL (64.15% sensitivity, 69.57% specificity). Upon multivariate linear regression analysis, logarithmically transformed endocan was proven as an independent predictor of cfPWV (β = 0.405, adjusted R change = 0.152; < 0.001). : The serum endocan level positively correlated with cfPWV and was an independent predictor of aortic stiffness in chronic HD patients.
内脂素是一种由活化的内皮细胞分泌的物质,它是炎症、内皮功能障碍、血管平滑肌细胞增殖和血管生成的关键因子。本研究旨在探讨维持性血液透析(HD)患者中内脂素与主动脉僵硬之间的关系。
从一家医疗中心招募 HD 患者后,评估并记录其基线特征、血液样本和人体测量数据。使用酶联免疫吸附试验试剂盒测定血清内脂素水平,通过颈股脉搏波速度(cfPWV)测量评估主动脉僵硬。
共纳入 122 例 HD 患者。53 例(43.4%)患者被诊断为主动脉僵硬,与无主动脉僵硬的患者相比,这些患者年龄更大(=0.007),糖尿病患病率更高(<0.001)、高血压患病率更高(=0.030)、收缩压更高(=0.011)、内脂素水平更高(<0.001)。多变量 logistic 回归模型显示,慢性 HD 患者主动脉僵硬的发生与内脂素有相关性[比值比(OR):1.566,95%置信区间(CI):1.224-2.002,<0.001],与年龄(OR:1.040,95%CI:1.001-1.080,=0.045)和糖尿病(OR:4.067,95%CI:1.532-10.798,=0.005)有关,在调整混杂因素(糖尿病、高血压、年龄、收缩压和内脂素)后。血清内脂素水平预测主动脉僵硬的受试者工作特征曲线下面积为 0.713(95%CI:0.620-0.806,<0.001),最佳截断值为 2.68ng/mL(64.15%的敏感性,69.57%的特异性)。多元线性回归分析表明,对数转换后的内脂素是 cfPWV 的独立预测因子(β=0.405,调整后的 R 变化=0.152;<0.001)。
综上所述,血清内脂素水平与 cfPWV 呈正相关,是慢性 HD 患者主动脉僵硬的独立预测因子。