背景:在接受腹膜透析(PD)的患者中,已发现引流的透析液或腹膜中的一些生物标志物与4h时肌酐的透析液/血浆比率(D/PCr)有关。但到目前为止,没有血清标志物的报告。一些生物标志物与心血管疾病(CVD)相关。Chemerin是一种多功能的趋化脂肪因子,在炎症中发挥重要作用,脂肪生成,和新陈代谢。我们旨在研究Chemerin在腹膜转运功能和CVD中的作用。
方法:这项前瞻性队列研究在我们的PD中心进行。患者在PD后接受初始标准化腹膜平衡测试4-6周。通过酶联免疫吸附法测定血清chemerin水平。在随访期间记录患者的CVD。
结果:纳入151名符合条件的患者,平均年龄为46.59±13.52岁,PD的中位持续时间为25.0个月。血清chemerin的中位浓度为29.09ng/mL。基线D/PCr与血清Chemerin呈正相关(r=0.244,p=0.003)。多变量分析显示,血清chemerin(p=0.002),年龄(p=0.041),白蛋白(p=0.000),高密度脂蛋白(p=0.022)是D/PCr的独立影响因素。糖尿病(DM)患者的血清趋化素水平明显高于无DM患者(36.45ng/mLvs.27.37ng/mL,p=0.000),高chemerin组(≥29.09ng/mL)和低chemerin组(<29.09ng/mL)之间的CVDs存在显着统计学差异(42vs.21%,p=0.009)。
结论:PD患者血清趋化素与基线D/PCr呈正相关。它可能是一种生物标志物,可以预测腹膜的基线运输功能,血清chemerin可能是PD患者心血管疾病的危险因素。未来有必要进行样本量更大的多中心研究。
Some biomarkers in drained dialyzate or peritoneal membrane have been found related to the dialyzate/plasma ratio of creatinine at 4 h (D/P Cr) in patients undergoing peritoneal dialysis (PD). But so far, there is no report on serum markers. Some biomarkers are associated with cardiovascular diseases (CVDs). Chemerin is a multifunctional chemoattractant adipokine which plays important roles in inflammation, adipogenesis, and metabolism. We intended to investigate the role of chemerin in the peritoneal membrane transport function and CVDs in incident PD patients.
This prospective cohort study was conducted in our PD center. The patients underwent initial standardized peritoneal equilibration test after PD for 4-6 weeks. Level of serum chemerin was determined via enzyme-linked immunosorbent assay. The patients\' CVDs were recorded during the follow-up period.
151 eligible patients with a mean age of 46.59 ± 13.52 years were enrolled, and the median duration of PD was 25.0 months. The median concentration of serum chemerin was 29.09 ng/mL. Baseline D/P Cr was positively correlated with serum chemerin (r = 0.244, p = 0.003). The multivariate analyses revealed that serum chemerin (p = 0.002), age (p = 0.041), albumin (p = 0.000), and high-density lipoprotein (p = 0.022) were independent factors of D/P Cr. The serum chemerin level was significantly higher in diabetes mellitus (DM) patients than that of patients without DM (36.45 ng/mL vs. 27.37 ng/mL, p = 0.000), and there was a significant statistical difference in CVDs between the high chemerin group (≥29.09 ng/mL) and low chemerin group (<29.09 ng/mL) (42 vs. 21%, p = 0.009).
Serum chemerin has a positive correlation with baseline D/P Cr in incident PD patients. It may be a biomarker that can predict the baseline transport function of the peritoneal membrane, and serum chemerin may be a risk factor of CVDs for incident PD patients. Multicenter studies with a larger sample size are warranted in the future.