维持性血液透析患者血清SGK1水平与血管钙化的相关性研究

    The correlation between serum SGK1 and vascular calcification in maintenance hemodialysis patients

    • 摘要: 目的 探讨维持性血液透析(maintenance hemodialysis,MHD)患者血清和糖皮质激素诱导激酶1(serum and glucocorticoid induced protenin kinase 1,SGK1)水平与血管钙化的相关性,为探究MHD患者血管钙化的发生机制提供理论依据。方法 选取2019年1月至2019年12月山东第一医科大学附属青岛医院随访的MHD患者60例,采用胸部和腹部计算机断层扫描检测MHD患者血管钙化情况,根据胸主动脉、腹主动脉和冠状动脉存在的钙化或者斑块,分为血管钙化组和无血管钙化组,比较各组临床资料,包括性别、年龄、透析时间、体质量指数、既往基础疾病(高血压病等疾病)以及血磷、血钙、全段甲状旁腺素(intact parathyroid hormone,iPTH)、糖化血红蛋白、透析前后BUN、Scr和尿素氮下降率等实验室指标;采用酶联免疫吸附实验(ELISA法)测定MHD患者血清SGK1水平。结果 与无血管钙化组患者相比,血管钙化组患者年龄、透析时间、高血压病、吸烟史、C反应蛋白、糖化血红蛋白、血磷、iPTH、钙磷乘积和碱性磷酸酶显著增高,差异均有统计学意义(P<0.05)。血管钙化组患者血清SGK1浓度较无血管钙化对照组患者显著升高,差异有统计学意义(P<0.05)。血清SGK1水平与血磷、iPTH以及钙磷乘积有相关性(P<0.05)。Logistic回归分析结果显示,透析时间、血磷、iPTH、钙磷乘积和高水平SGK1为MHD患者发生血管钙化的独立危险因素(P<0.05)。结论 伴有血管钙化的MHD患者血清SGK1水平显著升高,且是MHD患者发生血管钙化的独立危险因素,SGK1可能在血管钙化发生中发挥重要的作用。

       

      Abstract: Objective To investigate the association between serum and glucocorticoid induced protein kinase 1(SGK1)level and vascular calcification in maintenance hemodialysis(MHD)patients,providing theoretical basis for exploration for pathogenesis of vascular calcificationin MHD patients. Methods A total of 60 patients with MHD who were followed up in Department of Nephrology of the Affiliated Qingdao Hospital of Shandong First Medical University were enrolled in the study between January 2019 and December 2019.Vascular calcification of the MHD patients was detected by thoracic and abdominal computed tomography.According to whether calcification or plaque exists in thoracic aorta,abdominal aorta and coronary artery,all the subjects were divided into vascular calcification group and non-vascular calcification group.Clinical data,including sex,age,dialysis age,BMI,previous medical history(hypertension,et al),serum phosphorus,serum calcium,parathyroid hormone,calcium-phosphorus product,glycosylated hemoglobin,blood creatinine and urea nitrogen before and after hemodialysis,urea reduction ratio(URR)and other indicators,were compared between groups.In addition,the serum SGK1 in patients with MHD was determined by enzyme Linked Immunosorbent Assay. Results The age,dialysis age,hypertension proportion,smoking history,values of C-reactive protein,glycosylated hemoglobin,serum phosphorus,intact parathyroid hormone,calcium-phosphorus product,and ALP levels were higher in the vascular calcification group,compared with those in the non-vascular calcification group,with all statistically significant differences(P<0.05).Compared with the non-vascular calcification group,the vascular calcification group showed an significant increase in serum SGK1 level(P<0.05).The level of serum SGK1 was associated with serum phosphorus,intact parathyroid hormone(iPTH)and calcium-phosphorus product(P<0.05).The Logistic regress analysis showed that dialysis age,serum phosphorus,iPTH,calcium-phosphorus product and the high SGK1 level were the independent risk factors for vascular calcification in maintenance hemodialysis patients(P<0.05). Conclusions The significant increase of serum SGK1 with vascular calcification is an independent risk factor for vascular calcificationin maintenance hemodialysis patients.SGK1 maybe plays a critical role in vascular calcification.

       

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