慢性肾衰竭血液透析患者血清促肾上腺素和聚簇素的临床意义

IF 3.2 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinica Chimica Acta Pub Date : 2025-04-09 DOI:10.1016/j.cca.2025.120287

Feng Gu , Yanfeng Wu , Jingyuan Lu , Penghui Zhang , Hualin Qi

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引用次数: 0

摘要

背景Adropin和Clusterin均与心脑血管疾病有关。不幸的是，它们在慢性肾衰竭（CRF）人群中的临床意义在很大程度上仍不清楚。方法纳入356例接受血液透析的CRF患者。ELISA法测定血清Adropin和Clusterin浓度。通过受试者工作特征（ROC）曲线分析确定Adropin或Clusterin对心脑血管并发症/死亡的最佳临界值。采用Kaplan-Meier生存曲线、log-rank检验和Cox比例风险模型评估Adropin和Clusterin的预后价值。结果在血液透析过程中伴有心脑血管病变的CRF患者，基线血清Adropin显著降低，而血清Clusterin升高。基线血清Adropin的降低和血清Clusterin的升高都显示了预测CRF患者血液透析过程中心脑血管影响的潜力。基线血清Adropin降低表明血液透析期间CRF患者预后不良，而基线血清Clusterin升高表明血液透析期间CRF患者预后不良。结合基线血清Adropin和Clusterin检测预测CRF患者预后效果较好。结论Adropin的降低或Clusterin的升高可能是预测心脑血管并发症和总生存率的一种新颖而有用的工具。重要的是，Adropin和Clusterin联合检测可能有助于构建新的CRF患者管理体系，有效改善其预后。

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Clinical implications of serum adropin and clusterin in chronic renal failure patients who received hemodialysis

Background

Both Adropin and Clusterin are associated with cardiovascular and cerebrovascular diseases. Unfortunately, the clinical implications of them in Chronic renal failure (CRF) population remains largely unclear.

Methods

We included 356 CRF patients received hemodialysis. Determination of serum concentrations of Adropin and Clusterin were performed by ELISA.The optimal cutoff values of Adropin or Clusterin for cardiovascular and cerebrovascular complications/death were determined by receiver operating characteristics (ROC) curve analysis. The prognostic value of Adropin and Clusterin was evaluated using Kaplan–Meier survival curves, log-rank tests, and Cox proportional hazards models.

Results

Baseline serum Adropin significantly decreased, while serum Clusterin elevated in CRF patients who suffered cardiovascular or cerebrovascular implications during hemodialysis. Both decreased baseline serum Adropin and increased serum Clusterin showed potentials for predicting cardiovascular/cerebrovascular implications during hemodialysis in CRF patients. Reduced baseline serum Adropin indicated poor prognosis in CRF patient during hemodialysis, whereas increased baseline serum Clusterin indicated poor prognosis in CRF patient during hemodialysis. Combining baseline serum Adropin and Clusterin detection achieved better performance for predicting prognosis in CRF patients.

Conclusion

We demonstrated that decreased Adropin, or increased Clusterin could be novel but useful tool for predicting cardiovascular/cerebrovascular complications and overall survival. Importantly, combination of Adropin and Clusterin detection might be help to construct new management system for CRF patients to effectively improve their prognosis in the future.

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来源期刊

Clinica Chimica Acta 医学-医学实验技术

CiteScore

10.10

自引率

2.00%

发文量

1268

审稿时长

23 days

期刊介绍： The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells. The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.