贾凤玉, 卢文婷, 张洪彬, 秦瑜, 荣鹏, 任梦, 苏曰龙, 刘文渊, 王素霞, 孙钢. 维持性血液透析患者骨钙素和矿物质与骨代谢紊乱指标的相关性分析[J]. 临床肾脏病杂志, 2017, 17(7): 395-398. DOI: 10.3969/j.issn.1671-2390.2017.07.003
    引用本文: 贾凤玉, 卢文婷, 张洪彬, 秦瑜, 荣鹏, 任梦, 苏曰龙, 刘文渊, 王素霞, 孙钢. 维持性血液透析患者骨钙素和矿物质与骨代谢紊乱指标的相关性分析[J]. 临床肾脏病杂志, 2017, 17(7): 395-398. DOI: 10.3969/j.issn.1671-2390.2017.07.003
    JIA Feng-yu, LU Wen-ting, ZHANG Hong-bin, QIN Yu, RONG Peng, REN Meng, SU Yue-long, LIU Wen-yuan, WANG Su-xia, SUN Gang. Correlation of serum osteocalcin with bone metabolism and mineral markers in maintenance hemodialysis patients[J]. Journal of Clinical Nephrology, 2017, 17(7): 395-398. DOI: 10.3969/j.issn.1671-2390.2017.07.003
    Citation: JIA Feng-yu, LU Wen-ting, ZHANG Hong-bin, QIN Yu, RONG Peng, REN Meng, SU Yue-long, LIU Wen-yuan, WANG Su-xia, SUN Gang. Correlation of serum osteocalcin with bone metabolism and mineral markers in maintenance hemodialysis patients[J]. Journal of Clinical Nephrology, 2017, 17(7): 395-398. DOI: 10.3969/j.issn.1671-2390.2017.07.003

    维持性血液透析患者骨钙素和矿物质与骨代谢紊乱指标的相关性分析

    Correlation of serum osteocalcin with bone metabolism and mineral markers in maintenance hemodialysis patients

    • 摘要: 目的 探讨维持性血液透析(maintenance hemodialysis,MHD)患者骨钙素(bone glaprotein,BGP)水平和矿物质与骨代谢紊乱指标的相关性。方法 选择2015年2月至2015年5月在济南军区总医院血液净化中心并发慢性肾脏病-矿物质与骨代谢紊乱(chronic kidney disease mineral and bone disorder,CKD-MBD)的MHD患者36例,抽取透析前空腹血进行常规实验室检查,同时检测血钙、血磷、总碱性磷酸酶。用化学发光法检测全段甲状旁腺素(immunoreactive parathyroid hormone,iPTH),酶联免疫法检测成纤维细胞生长因子23(fibroblast growth factor23,FGF23)、BGP。用Pearson相关及Logistic回归分析相关研究数据。结果 36例MHD患者BGP平均水平为(193.59±87.38)μg/L,与血磷(r=0.529)、FGF23(r=0.492)、iPTH(r=0.601)正相关;与年龄(r=-0.346)负相关;与血钙(r=0.003)、总碱性磷酸酶(r=0.170)、患者透析时间(r=0.097)不相关。根据iPTH水平将患者分为低iPTH组、iPTH达标组和高iPTH组,统计分析发现组间BGP(F=21.365,P=0.0001)、FGF23(F=5.824,P=0.007)、血磷(F=7.739,P=0.002)存在差异,而血清钙、总碱性磷酸酶、年龄和透析时间之间无显著性差异。根据BGP水平将患者分为高于均值组和低于均值组,进行多因素Logistics回归分析,发现高iPTH(OR=3.49,P=0.042)、高FGF23(OR=3.221,P=0.043)、高血磷(OR=3.103,P=0.038)是BGP高于均值的独立危险因素。结论 BGP在MHD患者中明显升高,且与iPTH、血磷和FGF23正相关。

       

      Abstract: Objective To investigate the level of osteocalcin (bone glaprotein, BGP) in maintenance hemodialysis patients (MHD) and its correlation with bone metabolism and mineral metabolism indexes.Methods We enrolled 36 adult MHD patients from February 2014 to May 2014 in Blood Purification Center, General Hospital of Jinan Military Command. Fasting blood routine laboratory examination was carried out before dialysis extraction. Serum calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone (iPTH, chemiluminescence), fibroblast growth factor 23 (FGF23, ELISA), and osteocalcin (BGP, ELISA) were detected. Pearson correlation and Logistic regression were used to analyze related data.Results The BGP level in 36 patients was (193.59±87.38) g/L, positively correlated with serum phosphorus (r=0.529), FGF23 (r=0.492), and iPTH (r=0.601), negatively correlated with age (r=-0.346), but not with serum calcium (r=0.003), total alkaline phosphatase (r=0.170), and dialysis vintage (r=0.097). According to the level of iPTH, patients were divided into low iPTH group, iPTH control group and high iPTH group, and the statistical analysis showed significant difference in BGP (F=21.365, P=0.0001), FGF23 (F=5.824, P=0.007), serum phosphorus (F=7.739, P=0.002) among the groups, but no significant difference existed in the serum calcium, alkaline phosphatase, and the dialysis vintage among the groups. According to the level of BGP, patients were divided into higher than average level group and below average level group, and Logistics regression analysis revealed that high iPTH (OR=3.49, P=0.042), high FGF23 (OR=3.221, P=0.043) and high phosphorus (OR=3.103, P=0.038) were independent risk factors of BGP higher than average level.Conclusions BGP was significantly elevated in MHD patients, and positively correlated with iPTH, serum phosphorus and FGF23.

       

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