血清Sortilin、TMAO与维持性血液透析患者炎症因子和腹主动脉钙化的关系研究  

Relationship between serum Sortilin,TMAO and inflammatory factors and abdominal aortic calcification in maintenance hemodialysis patients

作　　者：韦阳 高改琴 闫晓鹏 杨敏 WEI Yang;GAO Gaiqin;YAN Xiaopeng;YANG Min(Department of Nephrology,Tongchuan People′s Hospital,Tongchuan,Shaanxi 727000,China)

机构地区：[1]铜川市人民医院肾脏内科,陕西铜川727000

出　　处：《国际检验医学杂志》2024年第23期2856-2861,共6页International Journal of Laboratory Medicine

基　　金：国家卫生健康委医药卫生科技发展研究中心课题(W2021ZT527)。

摘　　要：目的 探讨血清分拣蛋白(Sortilin)、氧化三甲胺(TMAO)与维持性血液透析(MHD)患者炎症因子和腹主动脉钙化(AAC)的关系。方法 前瞻性选取2021年1月至2023年5月该院肾内科收治的MHD患者197例(MHD组)和同期150例体检健康者(对照组),根据AAC积分将MHD患者分为中重度AAC组(82例)和无或轻度AAC组(115例)。采用酶联免疫吸附试验检测血清Sortilin、TMAO和炎症因子[白细胞介素(IL)-1β、IL-6、肿瘤坏死因子-α(TNF-α)]水平。采用Spearman相关性分析MHD患者血清Sortilin、TMAO与炎症因子的相关性,采用多因素Logistic回归分析MHD患者中重度AAC的影响因素,绘制受试者工作特征曲线分析血清Sortilin、TMAO水平对MHD患者中重度AAC的预测价值。结果 中重度AAC组血清Sortilin、TMAO、IL-1β、IL-6、TNF-α水平高于无或轻度AAC组和对照组(均P<0.05)。MHD患者血清Sortilin、TMAO与IL-1β、IL-6、TNF-α水平呈正相关(均P<0.05)。透析龄延长(OR=1.034,95%CI:1.010~1.060)、IL-6(OR=1.092,95%CI:1.034~1.152)、Sortilin(OR=1.076,95%CI:1.043~1.110)、TMAO(OR=1.384,95%CI:1.150~1.664)升高为MHD患者中重度AAC的独立危险因素(均P<0.05)。血清Sortilin联合TMAO水平预测MHD患者中重度AAC的曲线下面积为0.885(95%CI:0.831~0.926),大于血清Sortilin、TMAO水平单独预测的0.785(95%CI:0.721~0.841)、0.797(95%CI:0.734~0.850;P<0.05)。结论 MHD患者血清Sortilin、TMAO水平升高,与炎症因子水平升高和AAC密切相关,血清Sortilin联合TMAO水平预测MHD患者中重度AAC有一定价值。Objective To investigate the relationship between serum sorting protein(Sortilin),trimethylamine oxide(TMAO) and inflammatory factors and abdominal aortic calcification(AAC) in maintenance hemodialysis(MHD) patients.Methods A total of 197 MHD patients(MHD group) admitted to Department of Nephrology in the hospital from January 2021 to May 2023 and 150 physically examined healthy individuals(control group) during the same period were prospectively selected,and the MHD patients were classified into the moderate and severe AAC group(82 patients) and no or mild AAC group(115 patients) according to the AAC score.The serum of serum Sortilin,TMAO and inflammatory factors [interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α)] were measured using enzyme-linked immunosorbent assay.The correlation between serum Sortilin,TMAO,and inflammatory factors in MHD patients was assessed using Spearman correlation analysis,and influencing factors associated with moderate and severe AAC in MHD patients were explored using multivariate Logistic regression analysis.The predictive value of serum Sortilin and TMAO levels for moderate and severe AAC in MHD patients was analyzed using receiver operating characteristic curve.Results The levels of serum Sortilin,TMAO,IL-1β,IL-6 and TNF-α in moderate and severe AAC group were higher than those in no or mild AAC group and control group(all P<0.05).Serum Sortilin and TMAO were positively correlated with IL-1β,IL-6 and TNF-α levels in MHD patients(all P<0.05).Prolonged dialysis age(OR=1.034,95%CI:1.010-1.060),increased levels of IL-6(OR=1.092,95%CI:1.034-1.152),Sortilin(OR=1.076,95%CI:1.043-1.110) and TMAO(OR=1.384,95%CI:1.150-1.664) were independent risk factors for moderate and severe AAC in MHD patients(P<0.05).The area under the curve of serum Sortilin combined with TMAO levels in predicting moderate and severe AAC in MHD patients was 0.885(95%CI:0.831-0.926),which was greater than 0.785(95%CI:0.721-0.841) and 0.797(95%CI:0.734-0.850) predicted by serum Sortilin and TMAO levels alone

关 键 词：维持性血液透析 分拣蛋白 氧化三甲胺 炎症 腹主动脉钙化 

分 类 号：R446.1[医药卫生—诊断学]