Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany,
Department of Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany,
Cardiorenal Med. 2024;14(1):407-415. doi: 10.1159/000539765. Epub 2024 Jul 18.
Periostin is a matricellular protein. Elevated serum concentrations of periostin have been reported in patients with various cardiovascular diseases, including heart failure. Patients with end-stage renal disease have a substantially increased risk for cardiovascular diseases. However, there is a lack of clinical studies to clarify the prognostic significance of systemic periostin on all-cause mortality in patients with end-stage renal disease on hemodialysis.
313 stable end-stage renal disease patients were recruited and followed for 5 years concerning all-cause mortality. At baseline, we collected blood samples and clinical data. Serum periostin concentrations were measured using a certified ELISA.
The optimal cut-off value for serum periostin regarding all-cause mortality, calculated through receiver operating characteristic analysis, was 777.5 pmol/L. Kaplan-Meier survival analysis using this cut-off value demonstrated that higher periostin concentrations are linked to higher all-cause mortality (log-rank test: p = 0.002). Subgroup analysis revealed that serum periostin concentrations only affected all-cause mortality in male but not in female patients (p = 0.002 in male patients and p = 0.474 in female patients). Multivariate Cox regression analyses, adjusted for confounding factors, likewise showed that elevated serum periostin concentrations were positively associated with all-cause mortality in male (p = 0.028) but not in female patients on hemodialysis (p = 0.313).
Baseline serum periostin is an independent risk factor for all-cause mortality in male patients with chronic renal disease on hemodialysis.
骨膜蛋白是一种基质细胞蛋白。已有研究报道，多种心血管疾病患者的血清骨膜蛋白浓度升高，包括心力衰竭。终末期肾病患者发生心血管疾病的风险显著增加。然而，目前缺乏临床研究来阐明系统性骨膜蛋白对血液透析的终末期肾病患者全因死亡率的预后意义。
纳入 313 例稳定的终末期肾病患者，随访 5 年以观察全因死亡率。在基线时，我们收集了血液样本和临床数据。使用经过认证的 ELISA 法测量血清骨膜蛋白浓度。
通过接收者操作特征分析计算得出，血清骨膜蛋白浓度的最佳截断值为 777.5 pmol/L，用于预测全因死亡率。使用该截断值的 Kaplan-Meier 生存分析表明，较高的骨膜蛋白浓度与较高的全因死亡率相关（对数秩检验：p = 0.002）。亚组分析表明，血清骨膜蛋白浓度仅影响男性患者的全因死亡率，而不影响女性患者（男性患者中 p = 0.002，女性患者中 p = 0.474）。调整混杂因素的多变量 Cox 回归分析同样表明，在男性血液透析的慢性肾病患者中，升高的血清骨膜蛋白浓度与全因死亡率呈正相关（p = 0.028），而在女性患者中则无相关性（p = 0.313）。
基线血清骨膜蛋白是男性慢性肾脏病血液透析患者全因死亡率的独立危险因素。
