腹膜透析患者血清鸢尾素水平、全因死亡率和心血管死亡率的关系。

IF 2.3 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Kidney & blood pressure research Pub Date : 2024-01-01 Epub Date: 2023-12-02 DOI:10.1159/000535582

Sijia Zhou, Wen Tang, Xiaoxiao Wang, Qingfeng Han, Qiong Bai, Aihua Zhang

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引用次数: 0

摘要

简介:本研究旨在探讨血清鸢尾素-一种新型脂肪肌因子-在腹膜透析(PD)患者全因死亡率和心血管(CV)死亡率中的前瞻性作用。方法:对154例PD患者进行前瞻性观察研究。从医疗记录中收集基线临床数据。采用酶联免疫吸附法测定血清鸢尾素浓度。根据血清鸢尾素中位数分为高鸢尾素组(血清鸢尾素≥113.5ng/mL)和低鸢尾素组(血清鸢尾素< 113.5ng/mL)。使用体成分监测仪监测体成分。采用Cox回归分析寻找PD患者全因死亡率和CV死亡率的独立危险因素。结果:血清中位鸢尾素浓度为113.5 ng/mL(四分位数范围为106.2 ~ 119.8 ng/mL)。高鸢尾素组患者肌肉量和二氧化碳结合力(CO2CP)显著高于低鸢尾素组(p < 0.05)。血清鸢尾素与脉压、CO2CP、肌肉质量呈正相关，与体脂率呈负相关(p < 0.05)。在中位随访60.0个月期间，有55例全因死亡和26例CV死亡。高鸢尾素组患者的CV生存率高于低鸢尾素组(p = 0.016)。多因素Cox回归分析显示，鸢尾素水平高[危险比(HR)， 0.341;95%置信区间(CI) 0.135-0.858;p = 0.022]、年龄和糖尿病与PD患者CV死亡率独立相关。然而，血清鸢尾素水平未能证明与全因死亡率有统计学意义的关系。结论:基线时血清鸢尾素水平低可独立预测PD患者的CV死亡率，但不能预测全因死亡率。因此，血清鸢尾素可能是监测PD患者CV结果的潜在靶点。

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Relationship between Serum Irisin Level, All-Cause Mortality, and Cardiovascular Mortality in Peritoneal Dialysis Patients.

Introduction: This study aimed to investigate the prospective role of serum irisin - a novel adipo-myokine - in all-cause mortality and cardiovascular (CV) mortality in patients on peritoneal dialysis (PD).

Methods: A prospectively observational study was conducted with 154 PD patients. Baseline clinical data were collected from the medical records. Serum irisin concentrations were determined using enzyme-linked immunosorbent assay. Patients were divided into the high irisin group (serum irisin ≥113.5 ng/mL) and the low irisin group (serum irisin <113.5 ng/mL) based on the median value of serum irisin. A body composition monitor was used to monitor body composition. Cox regression analysis was utilized to find the independent risk factors of all-cause and CV mortality in PD patients.

Results: The median serum irisin concentration was 113.5 ng/mL (interquartile range, 106.2-119.8 ng/mL). Patients in the high irisin group had significantly higher muscle mass and carbon dioxide combining power (CO2CP) than those in the low irisin group (p < 0.05). Serum irisin was positively correlated with pulse pressure, CO2CP, and muscle mass, while negatively correlated with body fat percentage (p < 0.05). During a median of follow-up for 60.0 months, there were 55 all-cause deaths and 26 CV deaths. Patients in the high irisin group demonstrated a higher CV survival rate than those in the low irisin group (p = 0.016). Multivariate Cox regression analysis showed that high irisin level (hazard ratio [HR], 0.341; 95% confidence interval [CI], 0.135-0.858; p = 0.022), age, and diabetic mellitus were independently associated with CV mortality in PD patients. However, serum irisin level failed to demonstrate a statistically significant relationship with all-cause mortality.

Conclusion: Low serum irisin levels at baseline were independently predictive of CV mortality but not all-cause mortality in PD patients. Therefore, serum irisin could be a potential target for monitoring CV outcomes in PD patients.

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来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.