| 程小莉,李开鹏,崔琼.终末期肾脏病患者骨密度与血清维生素D、尿尿酸、钙磷乘积、全段甲状旁腺激素的相关性研究[J].中国医药导报,2024,21(6):90-93 |
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| 终末期肾脏病患者骨密度与血清维生素D、尿尿酸、钙磷乘积、全段甲状旁腺激素的相关性研究 |
| Correlation study of bone mineral density with serum vitamin D, urinary uric acid, calcium-phosphorus product and total parathyroid hormone in patients with end-stage renal disease |
| 收稿日期： 修订日期：2023-07-25 |
| DOI：10.20047/j.issn1673-7210.2024.06.21 |
| 关键词: 终末期肾脏病 骨密度 维生素D 尿尿酸 钙磷乘积 全段甲状旁腺激素 |
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| 基金项目:安徽省自然科学基金项目（2108085MH215） |
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| 摘要:目的 分析终末期肾脏病患者骨密度与血清维生素D、尿尿酸、钙磷乘积、全段甲状旁腺激素（iPTH）的相关性。 方法 回顾性分析2019年1月至2022年1月淮北职业技术学院附属医院收治的86例终末期肾脏病患者的临床资料，根据患者骨密度水平分为骨量正常组（34例）、骨量减少组（33例）和骨质疏松组（19例）。以受试者操作特征曲线分析维生素D、尿尿酸、钙磷乘积、iPTH诊断终末期肾脏病患者骨质疏松的价值，并通过相关性Pearson系数分析维生素D、尿尿酸、钙磷乘积、iPTH与骨密度的相关性，采用非条件logistic逐步回归分析终末期肾脏病患者骨质疏松的危险因素。 结果 骨量正常组维生素D、iPTH水平高于骨量减少组、骨质疏松组，尿尿酸、钙磷乘积低于骨量减少组、骨质疏松组（P＜0.05）；骨量减少组维生素D、iPTH水平高于骨质疏松组，尿尿酸、钙磷乘积低于骨质疏松组（P＜0.05）。维生素D、尿尿酸、钙磷乘积曲线下面积分别为0.764（95%CI：0.660～0.849）、0.736（95%CI：0.630～0.826）、0.734（95%CI：0.628～0.824）、0.745（95%CI：0.621～0.869）。相关性分析显示，尿尿酸、钙磷乘积与骨密度呈负相关（r=-0.274、-0.296，P＜0.05），维生素D、iPTH水平与骨密度呈正相关（r=0.357、0.326，P＜0.05）。维生素D、iPTH水平降低，尿尿酸、钙磷乘积升高是终末期肾脏病患者骨质疏松的危险因素（P＜0.05）。结论 终末期肾脏病患者骨密度与尿尿酸、钙磷乘积水平呈负相关，与维生素D、iPTH水平呈正相关。 |
| Abstract:Objective To analysis the correlation of bone mineral density with serum vitamin D, urinary uric acid, calcium- phosphorus product and total parathyroid hormone (iPTH) in patients with end-stage kidney disease. Methods Clinical data of 86 patients with end-stage kidney disease admitted to the Affiliated Hospital of Huaibei Vocational and Technical College from January 2019 to January 2022 were retrospectively analyzed, according to bone mineral density level, patients were divided into normal bone mass group (34 cases), reduced bone mass group (33 cases) and osteoporosis group (19 cases). The value of vitamin D, ururic acid, calcium-phosphorus product, and iPTH in the diagnosis of osteoporosis in patients with end-stage kidney disease was analyzed by receiver operating characteristic curve, and the correlation between vitamin D, ururic acid, calcium-phosphorus product and iPTH and bone mineral density was analyzed by Pearson coefficient. The risk factors of osteoporosis in patients with end-stage kidney disease were analyzed by unconditional logistic stepwise regression. Results The levels of vitamin D and iPTH in normal bone mass group were higher than those in osteopenia group and osteoporosis group, and the uric acid and calcium-phosphorus product was lower than those in osteopenia group and osteoporosis group (P＜0.05). The levels of vitamin D and iPTH in osteopenia group were higher than those in osteoporosis group, and the uric acid and calcium-phosphorus product was lower than that in osteoporosis group (P＜0.05). The areas under the curves of vitamin D, uric acid, and calcium- phosphorus product were 0.764 (95%CI: 0.660-0.849), 0.736 (95% CI: 0.630-0.826), 0.734 (95%CI:0.628-0.824) and 0.745 (95%CI: 0.621-0.869) respectively. Correlation analysis showed that the uric acid, calcium and phosphorus was negatively correlated with bone mineral density (r=-0.274, -0.296, P＜0.05), while vitamin D and iPTH levels were positively correlated with bone mineral density (r=0.357, 0.326, P＜0.05). Decreased levels of vitamin D and iPTH, and increased of uric acid and calcium-phosphorus product were risk factors for osteoporosis in patients with end-stage kidney disease (P＜0.05). Conclusion End-stage renal disease patients, bone mineral density is negatively correlated with urinary uric acid, calcium-phosphorus product levels, and positively correlated with vitamin D and iPTH levels. |
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