Elevated levels of serum sclerostin are linked to adverse cardiovascular outcomes in peritoneal dialysis patients
Elevated levels of serum sclerostin are linked to adverse cardiovascular outcomes in peritoneal dialysis patients
复制标题
血清硬化素水平升高与腹膜透析患者的不良心血管结局有关
DOI：
10.1007/s11255-018-1795-z
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发表时间：
2018-05-01
影响因子：
2
通讯作者：
Fang, Wei
中科院分区：
文献类型：
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作者：
Gong, Li;Zheng, Dongxia;Fang, Wei
目的探讨腹膜透析(PD)患者血清硬化素水平升高与慢性肾脏疾病预后的关系。采用酶免疫法测定血清硬化素水平，根据血清硬化素中位数将患者分为高、低硬化素组。结果98例患者[平均年龄52.5±10.9岁，男性49%，糖尿病21.4%，透析年龄40.7(17.9~72.2)个月]。与低硬化素组相比，高硬化素组患者的总胆固醇、NT-proBNP和骨保护素水平较高(均P<0.05)。在6年的研究期间，高硬化素组发生了25例CVE和17例心血管死亡，而低硬化素组发生了11例CVE和4例心血管死亡。多因素调整后，COX回归分析显示，高水平的硬化素水平显著增加了心血管疾病的危险性(HR 2.475，95%CI 1.116~5.489，P=0.026)和心血管死亡的危险性(HR 3.484，95%CI 1.134~10.706，P=0.029)。
PurposeTo investigate the correlation between elevated serum sclerostin levels and chronic kidney disease outcomes for patients receiving peritoneal dialysis (PD).MethodsWe performed a prospective observational study in stable PD patients. Serum sclerostin levels were determined via enzyme immunoassay, and median levels of sclerostin were used to divide patients into high and low sclerostin groups. New-onset cardiovascular events (CVEs) and cardiovascular mortality were evaluated during a 6-year follow-up period.ResultsNinety-eight patients [mean age 52.5 ± 10.9 years, 49% males, 21.4% diabetic, median dialysis vintage 40.7 (range 17.9–72.2) months] were recruited. Compared with those in the low sclerostin group, patients in the high sclerostin group demonstrated higher levels of total-cholesterol, NT-proBNP, and osteoprotegerin (allP< 0.05). During the 6-year study period, 25 CVEs and 17 cardiovascular deaths occurred in the high sclerostin group, whereas 11 CVEs and four cardiovascular deaths occurred in the low sclerostin group. A Cox regression analysis determined that high sclerostin levels significantly increased the risk for CVEs (HR 2.475, 95% CI 1.116–5.489,P= 0.026) and cardiovascular death (HR 3.484, 95% CI1.134–10.706,P= 0.029), after multiple adjustments were made.ConclusionsOur data suggest that high sclerostin levels may predict the onset of CVEs and cardiovascular mortality among PD patients.