慢性肾脏病患者血清Klotho蛋白水平与炎症因子的相关性分析  

Relationship between serum Klotho protein and inflammatory factors in patients with chronic kidney disease

作　　者：郑昌玲[1] 杨可[1] 余彦霖[1] 何婷[1] 徐新丽[1] 赵景宏[1] 

机构地区：[1]第三军医大学新桥医院肾内科 全军肾脏病中心,重庆400037

出　　处：《第三军医大学学报》2016年第24期2606-2610,共5页Journal of Third Military Medical University

基　　金：国家自然科学基金面上项目(81270290);重庆市自然科学基金重点项目(CSTC2015jcyjB X0028)~~

摘　　要：目的 分析慢性肾脏病（chronic kidney disease,CKD）患者血清Klotho蛋白水平与炎症因子的相关性,评价CKD患者Klotho与微炎症状态的关系。方法 采用ELISA检测314例CKD 1-5期患者血清中Klotho蛋白、C反应蛋白（C-reaction protein,CRP）、白介素6（interleukin 6,IL-6）、肿瘤坏死因子α（tumor necrosis factor alpha,TNF-α）水平。生化检测血清白蛋白（albumin,ALB）、血磷（serum phosphorus,P）、血肌酐、尿酸（uric acid,UA）、胱抑素,记录患者年龄、性别、身高等指标,通过CKD-EPI公式估算肾小球滤过率（estimated glomerular filtration rate,e GFR）。单因素方差分析比较CKD不同分期血清中炎症因子水平,炎症因子与ALB、e GFR、UA、Klotho、P相关性采用等级相关（Spearman）分析,影响CKD患者炎症因子的因素采用多元线性回归分析。结果 1单因素方差分析结果显示CKD 1-5期患者血清TNF-α含量逐渐升高（P〈0.05）,CRP、IL-6差异无统计学意义（P〉0.05）,Klotho蛋白水平逐渐降低（P〈0.01）。2Spearman相关分析结果显示,CKD患者血清TNF-α水平与e GFR呈负相关（r=-0.550,P〈0.01）;CKD患者血清TNF-α与Klotho呈负相关（r=-0.753,P〈0.01）;Klotho与e GFR呈正相关（r=0.643,P〈0.01）。3多元线性回归分析结果显示,CKD患者血清TNF-α水平与Klotho、e GFR关系密切。结论 CKD患者随着e GFR的降低,血清Klotho水平逐渐下降,炎症因子TNF-α水平逐渐升高,两者之间具有明显的相关性,提示Klotho蛋白降低与CKD微炎症状态的发生和发展有着密切关联。Objective To analyze the correlation between serum Klotho protein level and inflammatory factors in the patients with chronic kidney disease （CKD） for assessment of Klotbo protein associated micro-inflammatory state. Methods ELISA was used to measure the levels of serum Klotho protein, C-reactive protein （CRP）, interleukin-6 （IL-6） and tumor necrosis factor ct （TNF-α） in 314 patients with stages 1 - 5 CKD. Serum albumin （ALB）, blood phosphorus （P）, serum creatinine （ Scr）, uric acid （UA） and cystatin （Cys-c） were examined by bioanalysis. Patients＇ age, sex, height, weight and other indicators were recorded. Estimated glomerular filtration rate （eGFR） was calculated according to CKD- EPI equation. The serum levels of inflammatory factors in different stages of CKD were compared by single factor analysis of variance （ANOVA）. The correlation of inflammatory factors with ALB, eGFR, UA, Klotho and P was analyzed by Spearman＇ s rank correlation. The parameters influencing the inflammatory factors in the CKD patients were analyzed by multiple linear regression analysis. Results （1） ANOVA analysis showed that in the patients with stages 1 -5 CKD, serum TNF-α was increased gradually （P 〈 0.01 ）, CRP and IL-6 had no significant difference; Klotho protein level was reduced along with the CKD stages （P 〈 0. 01 ）. （2） Correlation analysis indicated that serum TNF-α levels in patients with CKD was negatively correlated with eGFR （r = - 0. 550, P 〈 0.01 ） and Klotho （ r = - 0. 753, P 〈 0. 01 ）, respectively, whereas Klotho protein and eGFR were positively correlated （r = 0. 643, P 〈 0. 01 ） （3） Multiple linear regression analysis demonstrated a strong relationship of serum TNF-α with both Klotho and eGFR in CKD patients. Conclusion Our data showed significantly decreased level of serum Klotho and increased level of inflammatory cytokine TNF-α in CKD patients with decreasing eGFR. The strong correlation between Klotho protein and infl

关 键 词：慢性肾脏病 炎症 肿瘤坏死因子Α KLOTHO蛋白 

分 类 号：R392.32[医药卫生—免疫学] R446.11[医药卫生—基础医学]