透析患者25-羟维生素D水平与血管钙化的相关性研究  

Correlation between 25-hydroxyvitamin D level and vascular calcification in dialysis patients

作　　者：生玉平 马晓迎[1] 杨星梦 张浩然[1] 王娜[1] 徐海平[1] 孙福云[1] SHENG Yu-ping;MA Xiao-ying;YANG Xing-meng;ZHANG Hao-ran;WANG Na;XU Hai-ping;SUN Fu-yun(Department of Nephrology,Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院肾内科,沧州061000

出　　处：《中国血液净化》2022年第9期659-663,680,共6页Chinese Journal of Blood Purification

基　　金：河北省沧州市重点研发计划指导项目(204106081)。

摘　　要：目的观察透析患者25羟维生素D[25-hydroxyvitamin D,25(OH)D]及腹主动脉钙化(abdominal aortic calcification,AAC)情况,探讨25(OH)D与血管钙化(vascular calcification,VC)之间的关系。方法选取沧州市中心医院透析患者,收集其临床化验资料、腹部侧位X线,评估AAC情况,计算腹主动脉钙化积分(abdominal aortic calcification score,AACs)。Spearman相关法分析25(OH)D与ACCs的关系,Logistic回归法分析AAC的危险因素,受试者工作特征曲线(ROC)评价25(OH)D预测AAC的准确性。结果共纳入100例透析患者,维生素D缺乏发生率为61%,AAC发生率为72%,25(OH)D与AAC程度呈负相关(r=-0.605,P<0.001)。Logistic回归分析显示年龄、25(OH)D、透析方式为AAC发生的独立影响因素(OR值分别为1.067,0.889,0.977;95%CI分别为1.025~1.207,0.819~0.971,0.802~0.964;P值分别为0.013,0.011,0.038)。25(OH)D的ROC曲线下面积为0.721(95%CI:0.589~0.853,P=0.001),取25(OH)D浓度13.8ng/ml作为截点时,其预测AAC的敏感性为63.9%,特异性为60.7%,约登指数为0.246。结论透析患者25(OH)D与VC呈负相关,低水平25(OH)D是VC的独立危险因素。监测透析患者25(OH)D可预测其VC风险。Objective To observe 25-hydroxyvitamin D[25(OH)D]evel and abdominal aortic calcification(AAC)in dialysis patients,and to investigate the relationship between 25(OH)D level and vascular calcification(VC).Methods We enrolled 100 dialysis patients from Cangzhou Central Hospital in this study.Their clinical laboratory data were collected.Abdominal lateral radiographic image was performed to evaluate AAC and to calculate AAC score(AACs).Spearman correlation analysis was used to analyze the relationship between 25(OH)D level and AACs.Logistic regression was used to analyze the risk factors for AAC.Receiver operating curve(ROC)was used to evaluate the accuracy of 25(OH)D level for the prediction of AAC.Results Among the 100 dialysis patients,the incidence of vitamin D deficiency was 61%and the incidence of AAC was 72%.25(OH)D level was negatively correlated with the degree of AAC(r=-0.605,P<0.001).Logistic regression showed that age(OR=1.067,95%CI:1.025~1.207,P=0.013),25(OH)D level(OR=0.889,95%CI:0.819~0.971,P=0.011)and dialysis modality(OR=0.977,95%CI:0.802~0.964,P=0.038)were the independent influence factors for the occurrence of AAC.ROC showed that when the cut-off value of 25(OH)D level for the prediction of AAC was set at 13.8ng/ml,the curve under the area was 0.721(95%CI:0.589~0.853,P=0.001),with the sensitivity of 63.9%,the specificity of 60.7%,and Yoden index of 0.246.Conclusion 25(OH)D level is negatively correlated with VC in dialysis patients.Low 25(OH)D level is one of the independent risk factors for VC.Monitoring 25(OH)D level in dialysis patients may be useful for the prediction of VC risk.

关 键 词：血管钙化 25-羟维生素D 腹主动脉钙化 透析 

分 类 号：R692.5[医药卫生—泌尿科学]