腹膜透析患者血清脂肪连接蛋白水平低与中心动脉僵化有关。

Ci ji yi xue za zhi = Tzu-chi medical journal Pub Date : 2019-08-02 eCollection Date: 2020-07-01 DOI:10.4103/tcmj.tcmj_67_19
Ti-Kang Chen, Yu-Chien Pan, Chih-Hsien Wang, Jia-Sian Hou, Bang-Gee Hsu
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引用次数: 0

摘要

目的脂联素具有抗糖尿病、抗动脉粥样硬化和抗炎功能,并能保护血管免受损伤。颈动脉-股动脉脉搏波速度(cfPWV)是测量腹膜透析(PD)患者中心动脉僵硬度的一种无创方法,已知中心动脉僵硬度与心血管疾病有关。本研究旨在评估腹膜透析患者中心动脉僵化与血清脂肪连通素水平之间的关系:从 60 名腹膜透析患者中采集空腹血样,并使用经过验证的眼压计系统测量 cfPWV 值。在这项研究中,根据欧洲高血压学会和欧洲心脏病学会指南,cfPWV 值>10 m/s被用来定义高动脉僵化组:在60名帕金森病患者中,19名患者(31.7%)被纳入动脉僵化程度高组。与对照组相比,高动脉僵化组患者的年龄更大(P = 0.029),PD病程更长(P = 0.001),舒张压更高(P = 0.030),空腹血糖更高(P = 0.014),血清脂肪生成素水平更低(P = 0.001)。经过多变量逻辑回归分析,发现血清脂肪连素(几率比 0.612;95% 置信区间:0.426-0.879;P = 0.008)是动脉僵化的独立预测因子。多变量回归分析还显示,在接受腹膜透析的患者中,脂肪连接蛋白水平(β = -0.408;调整后的 R 2 变化 = 0.183;P < 0.001)与 cfPWV 值呈负相关:结论:低血清脂肪连接蛋白水平是腹膜透析患者动脉僵化的独立标志。
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Low serum adiponectin level is associated with central arterial stiffness in patients undergoing peritoneal dialysis.

Objective: Adiponectin has antidiabetic, anti-atherosclerotic, and anti-inflammatory functions and protects against vascular damage. Carotid-femoral pulse wave velocity (cfPWV) is a noninvasive method for measuring central artery stiffness, which is known to be associated with cardiovascular disease in peritoneal dialysis (PD) patients. This study was conducted to evaluate the relationship between central arterial stiffness and serum adiponectin levels in PD patients.

Materials and methods: Fasting blood samples were obtained from 60 PD patients, and the cfPWV value was measured using a validated tonometry system. In this study, cfPWV values of >10 m/s were used to define the high arterial stiffness group according to the European Society of Hypertension and the European Society of Cardiology guidelines.

Results: Among 60 patients with PD, 19 patients (31.7%) were included in the high arterial stiffness group. When compared to those in the control group, the high arterial stiffness group patients were older (P = 0.029), had longer PD vintage (P = 0.001), higher diastolic blood pressures (P = 0.030), higher fasting glucose (P = 0.014), and lower serum adiponectin levels (P = 0.001). After multivariable logistic regression analysis, serum adiponectin (odds ratio, 0.612; 95% confidence interval: 0.426-0.879; P = 0.008) was identified as an independent predictor of arterial stiffness. The multivariable regression analysis also showed that the adiponectin level (β = -0.408; adjusted R 2 change = 0.183; P < 0.001) was negatively associated with cfPWV values in patients undergoing PD.

Conclusion: Low serum adiponectin level is an independent marker of arterial stiffness in patients undergoing PD.

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