首页|外周血单个核细胞中DUSP6预警糖尿病肾病腹膜透析后不良心血管事件的价值

外周血单个核细胞中DUSP6预警糖尿病肾病腹膜透析后不良心血管事件的价值

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目的:不良心血管事件是腹膜透析患者死亡的主要原因.探究预警腹膜透析患者发生不良心血管事件的指标对于其预后判断至关重要.本研究旨在评估外周血单个核细胞中双特异性磷酸酶6(dual-specificity phosphatase 6,DUSP6)预警糖尿病肾病腹膜透析后不良心血管事件的价值.方法:选取2022年6至9月在河北北方学院附属第一医院肾内科接受腹膜透析治疗的124例糖尿病肾病患者作为研究对象.用蛋白质印迹法检测外周血单个核细胞中DUSP6水平.根据中位DUSP6水平将患者分为DUSP6高水平组和DUSP6低水平组.比较2组体重指数、血清白蛋白、超敏C反应蛋白和透析时长等的差异.用Pearson、Spearman及多元线性回归分析DUSP6的相关因素.随访了解患者不良心血管事件发生情况,用Kaplan-Meier和Cox回归分析患者腹膜透析后发生不良心血管事件的危险因素.结果:截至末次随访,33例(26.61%)患者发生了至少1次不良心血管事件.DUSP6高水平组的体重指数、透析时长和超敏C反应蛋白水平均高于DUSP6低水平组,血清白蛋白水平低于DUSP6低水平组(均P<0.05).DUSP6与血清白蛋白水平呈负相关(r=-0.271,P=0.002),与透析时长(rs=0.406,P<0.001)和超敏C反应蛋白(rs=0.367,P<0.001)均呈正相关.多元线性回归结果显示:透析时长和超敏C反应蛋白均与DUSP6独立相关(均P<0.05).DUSP6高水平组的累积不良心血管事件发生率高于低水平组(46.67%vs 7.81%,P<0.001).Cox回归分析结果显示腹膜透析患者低水平血清白蛋白(HR=0.836,95%CI 0.778⁓0.899)、高水平超敏C反应蛋白(HR=1.409,95%CI 1.208⁓1.644)和高水平DUSP6(HR=6.631,95%CI 2.352⁓18.693)是腹膜透析患者发生不良心血管事件的独立危险因素.结论:透析时长和超敏C反应蛋白与糖尿病肾病腹膜透析患者外周血单个核细胞中DUSP6独立相关.外周血单个核细胞中DUSP6水平高提示患者发生不良心血管事件的风险高.
Value of DUSP6 in peripheral blood mononuclear cells in predicting adverse cardiovascular events after peritoneal dialysis in diabetic nephropathy
Objective:Adverse cardiovascular events are the leading cause of death in peritoneal dialysis patients.Identifying indicators that can predict adverse cardiovascular events in these patients is crucial for prognosis.This study aims to assess the value of dual-specificity phosphatase 6(DUSP6)in peripheral blood mononuclear cells as a predictor of adverse cardiovascular events after peritoneal dialysis in diabetic nephropathy patients.Methods:A total of 124 diabetic nephropathy patients underwent peritoneal dialysis treatment at the Department of Nephrology of the First Affiliated Hospital of Hebei North University from June to September 2022 were selected as study subjects.The levels of DUSP6 in peripheral blood mononuclear cells were determined using Western blotting.Patients were categorized into high-level and low-level DUSP6 groups based on the median DUSP6 level.Differences in body mass index,serum albumin,high-sensitivity C-reactive protein,and dialysis duration were compared between the 2 groups.Pearson,Spearman,and multiple linear regression analyses were performed to examine factors related to DUSP6.Patients were followed up to monitor the occurrence of adverse cardiovascular events,and risk factors for adverse cardiovascular events after peritoneal dialysis were analyzed using Kaplan-Meier and Cox regression.Results:By the end of the follow-up,33(26.61%)patients had experienced at least one adverse cardiovascular event.The high-level DUSP6 group had higher body mass index,longer dialysis duration,and higher high-sensitivity C-reactive protein,but lower serum albumin levels compared to the low-level DUSP6 group(all P<0.05).DUSP6 was negatively correlated with serum albumin levels(r=-0.271,P=0.002)and positively correlated with dialysis duration(rs=0.406,P<0.001)and high-sensitivity C-reactive protein(rs=0.367,P<0.001).Multiple linear regression analysis revealed that dialysis duration and high-sensitivity C-reactive protein were independently correlated with DUSP6 levels(both P<0.05).The cumulative incidence of adverse cardiovascular events was higher in the high-level DUSP6 group than in the low-level DUSP6 group(46.67%vs 7.81%,P<0.001).Cox regression analysis indicated that low serum albumin levels(HR=0.836,95%CI 0.778 to 0.899),high high-sensitivity C-reactive protein(HR=1.409,95%CI 1.208 to 1.644),and high DUSP6(HR=6.631,95%CI 2.352 to 18.693)were independent risk factors for adverse cardiovascular events in peritoneal dialysis patients.Conclusion:Dialysis duration and high-sensitivity C-reactive protein are independently associated with DUSP6 levels in peripheral blood mononuclear cells of diabetic nephropathy patients undergoing peritoneal dialysis.High DUSP6 levels indicate a higher risk of adverse cardiovascular events.

diabetic nephropathyperitoneal dialysisadverse cardiovascular eventsdual-specificity phosphatase 6peripheral blood mononuclear cells

郭宝珠、刘俊芬、韩小丽、李雅琪、田晓敏、靳鑫、卫志锋、刘圣君

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河北北方学院附属第一医院肾内科,河北 张家口 075000

河北北方学院附属第一医院慢病管理科,河北张家口 075000

糖尿病肾病 腹膜透析 不良心血管事件 双特异性磷酸酶6 外周血单个核细胞

河北省医学科学研究项目

20231411

2024

中南大学学报(医学版)
中南大学

中南大学学报(医学版)

CSTPCD北大核心
影响因子:1.459
ISSN:1672-7347
年,卷(期):2024.49(3)
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