血维生素K水平与慢性肾脏病血管钙化相关性研究

摘要

目的 探讨血维生素K水平与慢性肾脏病(CKD)血管钙化的相关性.方法 选取2015年2月至2017年2月四川省医学科学院·四川省人民医院收治的CKD患者80例为研究对象,按是否合并血管钙化分为钙化组(n=50)和对照组(n=30),对比两组血钙(Ca)、血磷(P)、钙磷乘积(Ca×P)、碱性磷酸酶(ALP)和骨保护素(OPG)水平,检测其血清超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、甲状旁腺激素(PTH)、成纤维生长因子23(FGF-23)、基质-γ-羧基谷氨酸蛋白(MGP)、维生素K2水平及血管钙化评分,分析影响CKD患者血管钙化的危险因素,同时对比不同血管钙化程度患者血清K2及上述指标水平,分析血清K2与血管钙化指标的相关性.结果 钙化组血清P、Ca×P、ALP、OPG高于对照组(P<0.05),而血Ca低于对照组(P<0.05);钙化组血清hs-CRP、IL-6、PTH、FGF、MGP和血管钙化评分高于对照组,血清K2水平较对照组低(P<0.05);Logistic回归分析显示,血Ca、MGP、hs-CRP、FGF-23、K2水平是影响CKD患者血管钙化的独立危险因素(P<0.05);血管重度钙化组与轻中度钙化组比较,血清Ca、K2降低,MGP、hs-CRP、FGF-23升高(P<0.05);相关分析显示,CKD患者血K2水平与血清Ca呈正相关,与MGP、血管钙化积分、FGF-23呈负相关(P<0.05).结论 CKD患者存在的血管钙化与血维生素K水平有关,血维生素K2是影响CKD患者血管钙化的独立危险因素.%Objective To study the correlation between the levels of serum vitamin K and vascular calcification in chronic kidney diseases (CKD).Methods 80 cases of patients with CKD treated in Sichuan Provincial People′s Hospital from February of 2015 to February of 2017 were enrolled as the research object in the study and divided into the observation group (n=50) and the control group (n=30) according to the standard whether the patients had vascular calcification or not.The levels of blood calcium (Ca), serum phosphorus (P), calcium-phosphorus product (Ca×P), alkaline phosphatase (ALP) and osteoprotegerin (OPG) were compared between the two groups.The levels of serum high-sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6), parathyroid hormone (PTH), fibroblast growth factor 23 (FGF-23), matrix Gla protein (MGP) and vitamin K2 and the vascular calcification score were detected.The risk factors of vascular calcification in the patients with CKD were analyzed and the levels of the indexes mentioned above were compared between the patients with different degrees of vascular calcification.The correlation between the levels of serum K2 and vascular calcification was analyzed.Results The levels of Serum P, Ca×P, ALP and OPG were significantly higher in the observation group than in the control group (P<0.05), while the level of serum Ca in the observation group was significantly lower than that in the control group (P<0.05).The levels of serum hs-CRP, IL-6, PTH, FGF and MGP and the vascular calcification score were significantly higher in the observation group than in the control group (P<0.05), while the serum K2 level in the observation group was significantly lower than that in the control group (P<0.05).The results of Logistic regression analysis showed that the levels of serum Ca, MGP, hs-CRP, FGF-23 and K2 were the independent risk factors of vascular calcification in the patients with CKD (P<0.05).The levels of serum Ca and K2 were lower while the levels of MGP, hs-CRP and FGF-23 were higher in the severe vascular calcification group than in the mild and moderate calcification group (P<0.05).The results of correlation analysis showed that the serum K2 level was positively correlated with the serum Ca level and negatively correlated with the levels of MGP and FGF-23 and the vascular calcification score in the patients with CKD (P<0.05).Conclusion The vascular calcification in the patients with CKD is correlated with the level of serum vitamin K, and vitamin K2 is an independent risk factor for vascular calcification in the patients with CKD.