骨代谢标志物与老年腹膜透析患者主动脉钙化程度和心血管事件发生风险的相关性  

Correlation of bone metabolic markers with severity of aortic calcification and risk for cardiovascular events in elderly peritoneal dialysis patient

作　　者：程锦绣[1] 曹艳春[1] 刘圣君[1] 金玉杰 刘华[1] 王琳琳[1] 秦少强[2] Cheng Jinxiu;Cao Yanchun;Liu Shengjun;Jin Yujie;Liu Hua;Wang Linlin;Qin Shaoqiang(Department of Nephrology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei Province,China)

机构地区：[1]河北北方学院附属第一医院肾内科,张家口075000 [2]河北北方学院附属第一医院心内科,张家口075000

出　　处：《中华老年心脑血管病杂志》2025年第2期145-148,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河北省2019年度医学科学研究课题计划项目(20190917)。

摘　　要：目的探讨新型骨代谢标志物与老年腹膜透析患者主动脉钙化程度和心血管事件发生风险的相关性。方法采用前瞻性方法,选取2022年2月至2024年2月河北北方学院附属第一医院肾内科接受持续非卧床腹膜透析患者230例,根据透析治疗期间是否发生心血管事件分为心血管事件组92例和对照组138例。收集相关临床资料,检测患者主动脉钙化情况并用腹主动脉钙化(abdominal aortic calcification,AAC)评分进行主动脉钙化程度评价,检测血清骨代谢标志物水平,包括骨保护素、抗酒石酸酸性磷酸酶(tartrate resistant acid phosphatase,TRACP)、Ⅰ型前胶原氨基末端肽(procollagenⅠN-terminal propeptide,PINP)。结果心血管事件组血清骨保护素、TRACP及P1NP水平明显高于对照组,差异有统计学意义(P<0.01)。心血管事件组重度钙化和AAC评分明显高于对照组,差异有统计学意义(P<0.01)。重度钙化患者血清骨保护素、TRACP和P1NP水平明显高于轻度钙化和中度钙化患者,差异有统计学意义(P<0.01);中度钙化患者血清骨保护素、TRACP和P1NP水平明显高于轻度钙化患者,差异有统计学意义(P<0.01)。Spearman相关性分析显示,骨保护素、TRACP及P1NP与老年腹膜透析患者主动脉钙化程度呈正相关(r=0.465,P=0.000;r=0.396,P=0.000;r=0.434,P=0.000)。多因素logistic回归分析显示,骨保护素、TRACP及P1NP是老年腹膜透析患者心血管事件发生的危险因素(P<0.01)。结论骨代谢标志物在老年腹膜透析患者中与主动脉钙化程度和心血管事件风险存在显著相关性,监测这些标志物水平可能有助于心血管风险评估和管理。Objective To investigate the correlation between novel bone metabolism markers and the degree of aortic calcification as well as cardiovascular event risk in elderly patients treated by PD.Methods A prospective trial was conducted on 230elderly patients receiving continuous ambulatory PD in our department from February 2022to February 2024.According to the occurrence of cardiovascular events during dialysis treatment,they were divided into a cardiovascular event group(n=92)and a control group(n=138).Relevant clinical data were collected,aortic calcification was assessed using AAC scores,and serum levels of bone metabolism markers,including osteoprotegerin,TRACP,and PINP were measured.Results The serum levels of osteoprotegerin,TRACP and PINP were significantly higher in the cardiovascular event group than the control group(P<0.01).The cardiovascular event group had obviously severe calcification and higher AAC score than the control group(P<0.01).The serum levels of the three bone metabolism markers were notably higher in the patients with severe calcification than those with moderate calcification,followed by mild calcification in turn(P<0.01).Spearman correlation analysis indicated that the levels of the three indicators were positively correlated with the degree of aortic cal-cification in elderly PD patients(r=0.465,P=0.000;r=0.396,P=0.000;r=0.434,P=0.000).Multivariate logistic regression analysis showed that these three indicators were risk factors for cardiovascular events in elderly PD patients(P<0.01).Conclusion The three bone metabolism markers are significantly correlated with aortic calcification severity and cardiovascular event risk in elderly PD patients.Monitoring these marker levels may be helpful for the assessment and management of cardiovascular risk.

关 键 词：腹膜透析 血管钙化 数据相关性 logistic模型 

分 类 号：R73[医药卫生—肿瘤]