中国血液净化 ›› 2022, Vol. 21 ›› Issue (11): 808-812.doi: 10.3969/j.issn.1671-4091.2022.11.005

• 临床研究 • 上一篇    下一篇

维持性血液透析患者血清鸢尾素水平与腰椎骨密度的相关性

赵丹丹   戴仲方   孙嘉遥   苗 晗   

  1. 222061 连云港,连云港市第一人民医院检验科
  • 收稿日期:2022-06-06 修回日期:2022-08-15 出版日期:2022-11-11 发布日期:2022-11-12
  • 通讯作者: 赵丹丹 E-mail:1647422823@qq.com

Correlation between serum irisin level and lumbar bone mineral density in maintenance hemodialysis patients

ZHAO Dan-dan, DAI Zhong-fang, SUN Jia-yao, MIAO Han   

  1. Department of Laboratory Medicine, The First People's Hospital of Lianyungang City, Jiangsu Province, Lianyungang 222061, China
  • Received:2022-06-06 Revised:2022-08-15 Online:2022-11-11 Published:2022-11-12
  • Contact: 222061 连云港,1连云港市第一人民医院检验科 E-mail:1647422823@qq.com

摘要: 目的  探讨维持性血液透析(maintenance hemodialysis,MHD)患者血清鸢尾素水平与腰椎骨密度(bone mineral density,BMD)的关系。 方法  选择2019年1月~2021年12月于连云港市第一人民医院住院的200例MHD患者作为研究对象,进行横断面研究。根据腰椎T值将入组患者分为骨量正常组(T≥-1,n =119)、骨量减少组(-2.5<T<-1,n =53)和骨质疏松组(T≤-2.5,n =28)。比较3组患者临床资料和实验室指标差异。采用Pearson或Spearman相关性分析腰椎BMD(以T值表示)与临床资料和实验室指标的相关性。采用有序Logistic回归分析MHD患者腰椎BMD的影响因素。 结果 骨质疏松组血清鸢尾素水平为(4.88±1.03)μg/L,骨量减少组血清鸢尾素水平为(35.05±8.94)μg/L,骨量正常组血清鸢尾素水平为(62.15±18.44)μg/L,3组比较差异有统计学意义(F =14.036,P<0.001)。MHD患者腰椎BMD与体质量指数(r =0.329,P =0.001)、肌酐(r =0.295,P =0.005)、血清鸢尾素(r =0.448,P<0.001)呈正相关,与女性(r =-0.422,P <0.001)、年龄(r =-0.291,P=0.007)、尿素清除指数(Kt/V,r =-0.266,  P=0.017)、尿素清除率(r=-0.270,P=0.014)和碱性磷酸酶(r=-0.292,P=0.007)呈负相关。有序Logistic回归分析结果显示血清鸢尾素水平是MHD患者腰椎BMD的影响因素(OR=0.466,95%CI:0.304~0.714,P<0.001)。 结论  MHD患者血清鸢尾素水平与腰椎BMD呈正相关,血清鸢尾素水平是MHD患者腰椎BMD的影响因素。

关键词: 维持性血液透析, 鸢尾素, 腰椎, 骨密度, 骨质疏松

Abstract: bjective To investigate the relationship between serum irisin level and lumbar bone mineral density (BMD) in maintenance hemodialysis (MHD) patients.  Methods A total of 200 MHD patients hospitalized in The First People's Hospital of Lianyungang City from Jan 2019 to Dec 2021 were recruited as the subjects for cross-sectional study. Based on the T value of lumbar bone, patients were divided into normal bone mass group (t ≥-1, n=119), osteopenia group (-2.5<t<-1, n=53) and osteoporosis group (t ≤-2.5, n=28). Clinical data and laboratory indexes were compared among the three groups. Pearson or Spearman correlation was used to analyze the correlation between lumbar BMD (expressed as T value) and clinical and laboratory indicators. The influencing factors for lumbar BMD were analyzed by ordered logistic regression.  Results  The serum irisin levels were 4.88±1.03μg/L, 35.05±8.94μg/L and 62.15±18.44μg/L in osteoporosis group, osteopenia group and normal bone mass group respectively (F=14.036, P<0.001). Lumbar BMD in MHD patients was positively correlated with body mass index (BMI), creatinine and serum irisin (r=0.329, 0.295 and 0.448 respectively; P=0.001, 0.005 and <0.001 respectively), and negatively correlated with female, age, urea clearance index (Kt/V), urea clearance rate and alkaline phosphatase (r=-0.422, -0.291, -0.266, -0.270 and -0.292 respectively; P<0.001, P=0.007, 0.017, 0.014 and 0.007 respectively). Ordered logistic regression showed that serum irisin level was an influencing factor for lumbar BMD in MHD patients (OR=0.466, 95% CI:0.304~0.714, P<0.001).  Conclusion There is a positive correlation between serum irisin level and lumbar BMD in MHD patients. Serum irisin level is an influencing factor for lumbar BMD in MHD patients.

Key words: Maintenance hemodialysis, Irisin, Lumbar, Bone mineral density, Osteoporosis

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