血清去磷酸化未羧化基质Gla蛋白和维生素K2水平与慢性肾脏病患者血管钙化相关性研究  

Correlation between serum dephosphorylated uncarboxylated matrix Gla protein(dp-ucMGP)and vitamin K2 levels and vascular calcification in patients with chronic kidney disease

作　　者：吴志茹 王梦慈 吴雪平[1] 陈卫东 WU Zhi-ru;WANG Meng-ci;WU Xue-ping;CHEN Wei-dong(Department of Nephrology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院肾病科,蚌埠233000

出　　处：《中国血液净化》2022年第4期253-257,共5页Chinese Journal of Blood Purification

基　　金：蚌埠医学院自然科学基金项目(BYKY1775)。

摘　　要：目的探讨血清去磷酸化未羧化基质Gla蛋白(dephosphorylated uncarboxylated matrix Gla protein,dp-ucMGP)和维生素K2水平与慢性肾脏病(chronic kidney disease,CKD)患者血管钙化(vascular calcification,VC)的相关性。方法选取CKD患者98例及健康人群70例为研究对象,用ELISA法测dp-ucMGP、维生素K2水平,彩色多普勒超声仪及腹部侧位X线检测VC,分析dp-ucMGP、维生素K2与VC的相关性。结果与对照组比较,试验组dp-ucMGP升高(Z=-7.767,P<0.001),维生素K2降低(t=16.006,P<0.001);CKD患者中,VC组甲状旁腺激素(PTH)、碱性磷酸酶(ALP)、dp-ucMGP及年龄较非VC组高(颈动脉VC组Z值分别为-2.231、-2.831、-5.739、-4.130,P值分别为0.026、0.005、<0.001、<0.001;腹主动脉VC组Z值分别为-2.299、-3.415、-4.637、-3.317,P值分别为0.022、0.001、<0.001、0.001),而维生素K2较非VC组低(颈动脉VC组Z=-3.936,腹主动脉VC组t=5.423,P均<0.001);Logistic回归分析示,年龄、dp-ucMGP及维生素K2是影响CKD患者VC的独立危险因素(颈动脉VC组OR值分别为1.080、4.777、0.160,95%CI分别为1.022~1.142、2.125~10.740、0.035~0.733,P值分别为0.006、<0.001、0.018;腹主动脉VC组OR值分别为1.066、2.259、0.104,95%CI分别为1.012~1.123、1.182~4.317、0.023~0.466,P值分别为0.016、0.014、0.003);相关分析示,CKD患者dp-ucMGP与PTH、ALP及年龄呈正相关(rs值分别为0.684、0.620、0.278,P值分别为<0.001、<0.001、0.006),与维生素K2呈负相关(rs=-0.271,P=0.007);重度VC组dp-ucMGP较轻、中度组升高,而维生素K2较轻度组降低(F值分别为12.378、4.478,P值分别为<0.001、0.017)。结论年龄、dp-ucMGP升高、维生素K2降低是影响CKD患者VC的独立危险因素。Objective To investigate the correlation between the levels of serum dephosphorylated uncarboxylated matrix Gla protein(dp-ucMGP)and vitamin K2 and the vascular calcification(VC)in patients with chronic kidney disease(CKD).Methods A total of 98 CKD patients and 70 healthy people were recruited as the research subjects.Serum dp-ucMGP and vitamin K2 were measured by ELISA,and VC was detected by color Doppler ultrasound and lateral abdominal X-ray examinations.The correlation between dp-uc-MGP and vitamin K2 levels and the VC was then analyzed.Results Serum dp-ucMGP increased(Z=-7.767,P<0.001)and vitamin K2 decreased(t=16.006,P<0.001)in CKD group as compared with those in control group.In CKD patients with VC,parathyroid hormone(PTH),alkaline phosphatase(ALP),dp-ucMGP and patients’age were higher(VC in carotid artery:Z=-2.231,-2.831,-5.739 and-4.130 respectively;P=0.026,0.005,<0.001 and<0.001 respectively.VC in abdominal aorta:Z=-2.299,-3.415,-4.637 and-3.317 respectively;P=0.022,0.001,<0.001 and 0.001 respectively),while serum vitamin K2 was lower,as compared with those in CKD patients without VC(VC in carotid artery:Z=-3.936,P<0.001;VC in abdominal aorta:t=5.423,P<0.001).Logistic regression analysis showed that age,dp-ucMGP and vitamin K2 were the independent risk factors for VC in CKD patients(VC in carotid artery:OR=1.080,4.777 and 0.160 respectively;95%CI=1.022~1.142,2.125~10.740 and 0.035~0.733 respectively;P=0.006,<0.001 and 0.018 respectively.VC in abdominal aorta:OR=1.066,2.259 and 0.104 respectively;95%CI=1.012~1.123,1.182~4.317 and 0.023~0.466 respectively;P=0.016,0.014 and 0.003 respectively).Correlation analysis showed that serum dp-ucMGP was positively correlated with PTH,ALP and age(rs=0.684,0.620 and 0.278 respectively,P<0.001,<0.001 and=0.006 respectively),and negatively correlated with serum vitamin K2(rs=-0.271,P=0.007).Serum dp-ucMGP was higher in the CKD patients with severe VC than in those with moderate and mild VC,while serum vitamin K2 was lower in the CKD patients with severe VC than in t

关 键 词：去磷酸化未羧化基质Gla蛋白 维生素K2 慢性肾脏病 血管钙化 

分 类 号：R692.5[医药卫生—泌尿科学]