血清iPTH、SOST和HDL3-C水平检测对糖尿病肾病维持性血液透析患者血管钙化的预测价值  

The predictive value of combined detection of serum iPTH,SOST,and HDL3-C levels for vascular calcification in patients with diabetic nephropathy undergoing maintenance hemodialysis

作　　者：邢晓妍 牛培元 李林淋 Xing Xiaoyan;Niu Peiyuan;Li Linlin(Department of Nephrology,Henan Shenhuo Group General Hospital,Yongcheng,Henan 476600,China;Department of Nephrology,Henan Provincial People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]河南神火集团总医院肾内科,河南永城476600 [2]河南省人民医院肾内科,河南郑州450000

出　　处：《感染、炎症、修复》2025年第1期44-48,共5页Infection Inflammation Repair

摘　　要：目的:探讨血清全段甲状旁腺激素(i PTH)、骨硬化蛋白(SOST)、高密度脂蛋白亚组份3(HDL3-C)水平联合检测对糖尿病肾病(DN)维持性血液透析(MHD)患者血管钙化的预测价值。方法:选取河南神火集团总医院2021年6月至2024年2月收治的80例接受MHD治疗的DN患者为研究对象,按照胸部X线片主动脉弓钙化情况,分为钙化组和无钙化组,比较两组临床一般资料和入院时血清i PTH、SOST、HDL3-C水平,采用单因素分析和Logistic回归分析方法分析DN患者并发血管钙化的影响因素及上述指标的预测价值。结果:钙化组入院时血清i PTH、HDL3-C水平显著高于无钙化组,血清SOST显著低于无钙化组(P<0.05);入院时血清iPTH、HDL3-C是DN患者发生血管钙化的危险因素,血清SOSTs是DN患者发生血管钙化的保护因素(P<0.05)。入院时血清iPTH、SOST、HDL3-C水平单独及联合预测DN患者血管钙化的受试者工作特征曲线下面积(AUC)分别为0.777、0.780、0.810、0.936。结论:血清iPTH、SOST、HDL3-C水平与血管钙化的发生有关,是接受MHD治疗的DN患者血管钙化发生的影响因素,3项指标联合检测对DN患者血管钙化具有较高的预测价值。Objective:To explore the predictive value of combined detection of serum intact parathyroid hormone(iPTH),sclerostin(SOST),and high-density lipoprotein subfraction 3(HDL3-C)levels for vascular calcification(VC)in maintenance hemodialysis(MHD)patients with diabetic nephropathy(DN).Methods:Eighty DN patients treated with MHD admitted to Henan Shenhuo Group General Hospital from June 2021 to February 2024 were selected as the study objects.They were divided into the calcification group and the non-calcification group according to the calcification of the aortic arch on chest X-ray.The clinical general data,and the serum iPTH,SOST,and HDL3-C levels at admission were compared between the two groups.Univariate analysis and Logistic regression analysis were used to analyze the influencing factors of vascular calcification complicated by DN patients and the predictive value of the above indicators.Results:The levels of serum iPTH and HDL3-C in the calcification group were significantly higher than those in the non-calcification group at admission,while the level of serum SOST was significantly lower than that in the non-calcification group(P<0.05).The serum iPTH,HDL3-C at admission were risk factors for VC in patients with DN,while serum SOSTs were protective factors for VC in patients with DN(P<0.05).The area under the curve(AUC)of serum iPTH,SOST,HDL3-C levels alone and in combination for predicting VC in patients upon admission were 0.777,0.780,0.810,and 0.936,respectively.Conclusions:Serum iPTH,SOST and HDL3-C levels are related to the occurrence of vascular calcification.As the influencing factors for the occurrence of vascular calcification in DN patients treated with MHD.The combined detection has high application value in predicting the occurrence of VC in DN patients.

关 键 词：全段甲状旁腺激素 骨硬化蛋白 高密度脂蛋白亚组份3 糖尿病肾病 血管钙化 

分 类 号：R587.2[医药卫生—内分泌]