腹膜透析患者中，脂蛋白（a）水平升高与通过心踝血管指数测量的动脉僵硬度相关。
Elevated Lipoprotein(a) Levels are Associated with Arterial Stiffness Measured by Cardio-Ankle Vascular Index in Patients Undergoing Peritoneal Dialysis.
作者信息
Huang Po-Yu, Hsu Bang-Gee, Lin Huei-Jhen, Lin Yu-Li, Wang Chih-Hsien, Tsai Jen-Pi
机构信息
Division of Nephrology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 62247 Chiayi, Taiwan.
School of Medicine, Tzu Chi University, 97004 Hualien, Taiwan.
出版信息
Rev Cardiovasc Med. 2023 Nov 23;24(11):322. doi: 10.31083/j.rcm2411322. eCollection 2023 Nov.
BACKGROUND
Arterial stiffness (AS) can be used to predict future cardiovascular diseases. High lipoprotein(a) (Lp(a)) levels were independently correlated with cardiovascular (CV) morbidity and death in patients with chronic renal insufficiency. The cardio-ankle vascular index (CAVI) is a useful biomarker of arteriosclerotic disorders and has a close relationship with a variety of CV events. This study aimed to investigate the correlation between serum Lp(a) levels and AS in patients on peritoneal dialysis (PD) using the CAVI.
METHODS
A total of 86 adult patients who were on regular PD for at least 3 months were recruited in this study. The CAVI values were determined using the waveform device (VaSera VS-1000). A CAVI value of 9.0 on either side was defined as high. Serum Lp(a) levels were measured by an enzyme-linked immunosorbent assay.
RESULTS
Among these participants, 35 of 86 (40.7%) belonged to the high CAVI group. In contrast to those with a normal CAVI, PD recipients in the high CAVI group had higher serum levels of total cholesterol ( = 0.003), triglycerides ( = 0.044), C-reactive protein ( 0.001), and Lp(a) ( 0.001), whereas their albumin levels were significantly lower ( = 0.026). Based on multivariable logistic regression analysis, serum Lp(a) (odds ratio [OR] 1.025, 95% confidence interval [CI] 1.010-1.040, = 0.001), total cholesterol (OR 1.042, 95% CI 1.005-1.081, = 0.027), and C-reactive protein (each increase 0.1 mg/dL, OR 1.217, 95% CI 1.008-1.469, = 0.041) levels were found as the parameters that could independently predict AS in patients on PD. Further, using Spearman's correlation analysis, both the left and right CAVIs revealed a significantly positive correlation with log-transformed Lp(a) levels ( = 0.588, 0.001; = 0.639, 0.001, respectively).
CONCLUSIONS
Serum Lp(a) levels were postulated to participate in the pathogenic processes of AS in adult patients undergoing PD.
背景
动脉僵硬度（AS）可用于预测未来心血管疾病。高脂蛋白（a）[Lp（a）]水平与慢性肾功能不全患者的心血管（CV）发病率和死亡率独立相关。心-踝血管指数（CAVI）是动脉粥样硬化疾病的一种有用生物标志物，与多种CV事件密切相关。本研究旨在使用CAVI调查腹膜透析（PD）患者血清Lp（a）水平与AS之间的相关性。
方法
本研究共纳入86例接受规律PD至少3个月的成年患者。使用波形装置（VaSera VS-1000）测定CAVI值。两侧CAVI值≥9.0定义为升高。采用酶联免疫吸附测定法测量血清Lp（a）水平。
结果
在这些参与者中，86例中有35例（40.7%）属于高CAVI组。与CAVI正常者相比，高CAVI组的PD患者血清总胆固醇（P = 0.003）、甘油三酯（P = 0.044）、C反应蛋白（P<0.001）和Lp（a）（P<0.001）水平更高，而其白蛋白水平显著更低（P = 0.026）。基于多变量逻辑回归分析，血清Lp（a）[比值比（OR）1.025，95%置信区间（CI）1.010 - 1.040，P = 0.001]、总胆固醇（OR 1.042，95%CI 1.005 - 1.081，P = 0.027）和C反应蛋白（每增加0.1mg/dL，OR 1.217，95%CI 1.008 - 1.469，P = 0.041）水平被发现是可独立预测PD患者AS的参数。此外，使用Spearman相关性分析，左右两侧CAVI均与对数转换后的Lp（a）水平呈显著正相关（分别为r = 0.588，P<0.001；r = 0.639，P<0.001）。
结论
推测血清Lp（a）水平参与了接受PD的成年患者AS的发病过程。
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