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血清内皮细胞蛋白聚糖是维持性血液透析患者主动脉僵硬的危险因素。

Serum Endocan Is a Risk Factor for Aortic Stiffness in Patients Undergoing Maintenance Hemodialysis.

机构信息

Division of Nephrology, Department of Medicine, Hualien Armed Forces General Hospital, Hualien 97144, Taiwan.

Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan.

出版信息

Medicina (Kaunas). 2024 Jun 14;60(6):984. doi: 10.3390/medicina60060984.

Abstract

: 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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e30e/11205908/a52a2bd0863d/medicina-60-00984-g001.jpg

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