摘要
目的 评价血液透析(hemodialysis,HD)患者血25羟维生素D[25-hydroxyvitamin D,25 (OH)D]和α-Klotho的相关性及二者在血管钙化中的角色.方法 选择北京友谊医院血液净化中心中心HD患者152例;周中透析日抽取透析前空腹血,采用全自动电化学发光免疫分析仪检测血清25 (OH)D及全段甲状旁腺激素(intact parathormone,iPTH)水平;夹心酶联免疫吸附法测定血清α-K]otho水平.后前位胸部X线摄片评估主动脉弓钙化程度.结果 患者血清25 (OH)D的平均水平为(19.97±8.30) ng/ml;维生素D缺乏的罹患率为69.7%(n=106).血清α-Klotho的平均浓度为(421.69±185.28)pg/ml.89例患者(58.6%)存在主动脉弓钙化.维生素D缺乏组患者女性更多、血清α-Klotho水平更低(x2/t值分别为9.660,-2.308;P值分别为0.006,0.022);主动脉弓钙化罹患率趋向于更高,但未达统计学差异(x2=3.127,P=0.077).多元逐步回归分析显示血清25 (OH)D与α-Klotho水平独立相关(P=-0.022).Logistic回归分析显示年龄和血清25 (OH)D是主动脉弓钙化的独立危险因素(95% CI值分别为1.069~1.163,0.901~0.998;0R值分别为1.115,0.948;P值分别为<0.001,0.041).结论 维生素D缺乏在HD患者中非常多见,是循环α-Klotho及主动脉弓钙化的独立危险因素.
Objectives To evaluate the relationship between serum 25(OH)D level and the changes of serum soluble a-Klotho and aortic arch calcification in hemodialysis(HD)patients.Methods This was a crosssectional study enrolled in 152 HD patients from the Dialysis Center of Beijing Friendship Hospital.Fasting blood samples were collected prior to hemodialysis at the second hemodialysis session in a week.Serum 25(OH)D and intact parathyroid hormone(iPTH)were assayed by an automatic electrochemiluminescence immunoassay instrument.Serum a-Klotho was determined using a sandwich enzyme-linked immunosorbent assay(ELISA)kit.Posterior-anterior chest X-ray examination was used to assess aortic arch calcification.Results The average serum 25(OH)D level was 19.97±8.30 ng/ml in the HD patients,in which vitamin D deficiency was found in 106 patients(69.7%).The average serum a-Klotho level was 421.69±185.28 pg/ml.Aortic arch calcification was found in 89 patients(58.6%).In patients with vitamin D deficiency,females were more than males(54.7%vs.28.3%,χ~2=9.660,P=0.006);serum a-Klotho levels were lower(399.16±179.62 pg/ml vs.473.61±189.62 pg/ml,t=2.308,P=0.022);and the prevalence of aortic arch calcification was higher but without statistical significance(63.2%vs.47.8%,χ~2=3.127,P=0.077).Linear stepwise regression analysis showed that serum 25(OH)D level was independently correlated with serum a-Klotho level(P=0.022).Binary logistic regression analysis confirmed that age(OR=1.115,95%CI=1.069-1.163,P<0.001)and serum 25(OH)D(OR=0.948,95%CI=0.901-0.998,P=0.041)were the independent risk factors for aortic arch calcification.Conclusions Vitamin D deficiency was prevalent in HD patients.Serum 25(OH)D was the independent risk factor for both circulating a-Klotho and aortic arch calcification.Therefore,serum 25(OH)D assay for HD patients is clinically valuable.
作者
张爱华
郭维康
于玲
刘文虎
ZHANG Ai-hua;GUO Wei-kang;YU Ling;LIU Wen-hu(Department of Nephrology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Blood Purifi—eatfon Center,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China.)
出处
《中国血液净化》
CSCD
2019年第8期535-538,共4页
Chinese Journal of Blood Purification
基金
北京市医院管理局临床医学发展专项经费资助(ZYLX201824)
作者简介
通讯作者:刘文虎,Email:wenhuliu@mail.ccmu.edu.cn
