维持性血液透析患者血清Irisin、BMP-7水平与血管钙化及钙磷代谢指标的相关性研究  

Clinical significance of serum Irisin and BMP-7 in vascular calcification and calcium/phosphorus metabolism in hemodialysis patients

作　　者：李大勇 袁新科 刘冠兰 吴运斗 郭宁 Da-yong Li;Xin-ke Yuan;Guan-lan Liu;Yun-dou Wu;Ning Guo(Department of Nephropathy and Rheumatology, The First Hospital of Changsha,Changsha, Hunan 410005, China)

机构地区：[1]长沙市第一医院肾病风湿科

出　　处：《中国现代医学杂志》2019年第15期41-46,共6页China Journal of Modern Medicine

基　　金：长沙市指导性科技计划项目(No:K150626-37)

摘　　要：目的探究维持性血液透析(MHD)患者中鸢尾素(Irisin)和骨形态发生蛋白7(BMP-7)水平与血管钙化(VC)及钙磷代谢指标的相关性。方法选取2017年1月-2018年2月长沙市第一医院治疗的MHD患者86例,纳入MHD组,同期选取健康志愿者86例作为对照组。检测血清中钙、镁、磷、钙磷乘积、血清白蛋白(ALB)、甲状旁腺激素(i PTH)、25羟基维生素D3[25-(OH)-Vit D3]、Irisin及BMP-7水平,采用腹部侧位X射线检查两组受试者VC情况。按照有无腹主动脉钙化发生将MHD患者分成钙化组44例和非钙化组42例。结果 MHD组患者血清中磷、钙磷乘积、i PTH、25-(OH)-Vit D3、腹主动脉钙化评分(AACS)及腹主动脉钙化率高于对照组(P<0.05)。MHD组患者血清中镁、BMP-7、ALB及Irisin水平低于对照组(P<0.05)。钙化组较非钙化组患者年龄更大,透析时间更长,血清中磷、钙磷乘积、iPTH水平更高(P<0.05),但钙化组的血镁、Irisin及BMP-7水平低于非钙化组(P<0.05)。Logistic回归分析表明iPTH、钙磷乘积、Irisin及BMP-7水平是MHD患者发生VC的影响因素(P<0.05)。Pearson相关分析显示,Irisin和BMP-7水平与年龄、透析时长、血清中磷、钙磷乘积、iPTH及AACS呈负相关(P<0.05),与血镁呈正相关(P<0.05)。结论 MHD患者中Irisin、BMP-7水平与VC、钙磷代谢及甲状旁腺激素水平呈负相关,Irisin、BMP-7升高可能是VC形成过程中的保护因素。Objective To investigate the correlation analysis of serum Irisin(Irisin) and Bone morphogenetic protein 7(BMP-7) levels with vascular calcification(VC) and calcium metabolism in maintenance hemodialysis(MHD) patients. Methods A total of 86 MHD patients who were admitted in our hospital from January 2017 to February 2018 and 86 healthy volunteers were selected in this study. Serum calcium, magnesium, phosphorus,calcium and phosphorus products, serum albumin(ALB), parathyroid hormone(iPTH), 25 hydroxyvitamin D3(25-(OH)-VitD3), Irisin and BMP-7 levels were detected. the VC status was examined by abdominal lateral X-ray. MHD patients were divided into calcification group and non-calcification group based on abdominal aortic calcification(n = 42). Results Levels of blood phosphorus, calcium and phosphorus products, iPTH, 25-(OH)-VitD3, abdominal aorta calcification score(AACS) and abdominal aorta calcification were increased while serum levels of magnesium, BMP-7, ALB and Irisin in MHD group were decreased in MHD group when compared with those in control group(P < 0.05). Patients in calcification group experienced increase in age, dialysis time, phosphorus,calcium, phosphorus products and iPTH while decrease in magnesium, Irisin and BMP-7 when compared with those in non-calcification group(P < 0.05). Logistic regression analysis showed that iPTH, calcium, phosphorus products, Irisin and BMP-7 levels were risk factors of VC(P < 0.05). Pearson correlation analysis showed that Irisin and BMP-7 levels were negatively correlated with age, duration of dialysis, phosphorus, calcium, phosphorus products, iPTH and AACS(P < 0.05) while were positively correlated with magnesium(P < 0.05). Conclusions Levels of Irisin and BMP-7 may be protective factors in the formation of VC in MHD patients.

关 键 词：维持性血液透析/透析 血管钙化/血管疾病 骨形态发生蛋白7 鸢尾素 钙磷代谢/代谢 

分 类 号：R473.5[医药卫生—护理学]