Study on the relationship of serum fetuin-A concentration with aortic stiffness in patients on dialysis
Study on the relationship of serum fetuin-A concentration with aortic stiffness in patients on dialysis
复制标题
DOI：
10.1093/ndt/gfk045
复制
发表时间：
2006-05-01
影响因子：
6.1
通讯作者：
Leunissen, KML
中科院分区：
文献类型：
--
作者：
Hermans, MMH;Brandenburg, V;Leunissen, KML
背景。脉波速度（PWV）或主动脉增强指数（AI）的增加所反映的主动脉僵硬度的增加是透析患者心血管死亡率的重要预测指标。钙化抑制剂（如胎儿蛋白a）的失调与透析患者的血管病理有关，胎儿蛋白a与透析患者的死亡率呈负相关。本研究探讨了终末期肾病患者血清胎儿素- a浓度与主动脉硬度参数的关系。在一项横断面研究中，我们纳入了131例透析患者，年龄62 +/- 14岁（腹膜透析33例，血液透析98例），41例对照组，年龄60 +/- 8岁。透析前血清白蛋白、钙、磷和完整甲状旁腺激素的时间平均值，以及高敏c反应蛋白（hsCRP）、胎蛋白a、年龄、平均动脉压（MAP）和透析方式均纳入多元回归分析。采用SphygmoCor装置测量PWV和AI。透析患者的平均胎蛋白a浓度（0.63 +/- 0.16 g/l）与对照组（0.63 +/- 0.11 g/l）无差异。透析患者的中位hsCRP水平高于对照组（4.0 vs 1.9 mg/l; P < 0.0001）。透析患者的PWV高于对照组（9.9 m/s vs 7.9 m/s; P < 0.0001）。在透析患者的单因素分析中，胎儿素a水平分别与PWV （r = - 0.25, P = 0.007）和AI （r = - 0.26, P = 0.006）呈负相关。然而，在校正了年龄、性别、MAP和糖尿病后，这种关系失去了统计学意义。在炎症活动水平相对较低的透析人群中，可溶性钙化抑制剂胎儿素- a不能被确定为PWV和AI测量的主动脉僵硬的独立预测因子。
Background. An increase in aortic stiffness, as reflected by an increase in pulse wave velocity (PWV) or aortic augmentation index (AI) is an important predictor of cardiovascular mortality in dialysis patients. Dysregulation of calcification inhibitors, such as fetuin-A, is involved in vascular pathology in dialysis patients and fetuin-A is inversely related to mortality in dialysis patients. In this study, the relation between serum fetuin-A concentration and parameters of aortic stiffness was investigated in patients with end-stage renal disease.Methods. In a cross-sectional study we included 131 dialysis patients, aged 62 +/- 14 years (33 on peritoneal dialysis and 98 on haemodialysis), and 41 controls, aged 60 +/- 8 years. Time-averaged pre-dialysis values of serum albumin, Ca, P and intact parathyroid hormone were included in multiregression analysis, as were high-sensitivity C-reactive protein (hsCRP), fetuin-A, age, mean arterial pressure (MAP) and dialysis modality. PWV and AI were measured with the SphygmoCor device.Results. Mean fetuin-A concentration in dialysis patients (0.63 +/- 0.16 g/l) did not differ from controls (0.63 +/- 0.11 g/l). Median hsCRP levels in dialysis patients were higher compared with controls (4.0 vs 1.9 mg/l; P < 0.0001). PWV but not AI was higher in dialysis patients than in controls (9.9 vs 7.9 m/s; P < 0.0001). In univariate analysis in dialysis patients, fetuin-A levels were inversely related to both PWV (r = - 0.25, P = 0.007) and AI (r = - 0.26, P = 0.006), respectively. However, after correction for age, gender, MAP and diabetes mellitus, this relation lost statistical significance.Conclusions. In a dialysis population with a relatively low level of inflammatory activity, the soluble calcification inhibitor fetuin-A could not be identified as an independent predictor of aortic stiffness as measured with PWV and AI.