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目的分析慢性肾脏病(chronic kidney disease,CKD)患者血清Klotho蛋白水平与炎症因子的相关性,评价CKD患者Klotho与微炎症状态的关系。方法采用ELISA检测314例CKD 1~5期患者血清中Klotho蛋白、C反应蛋白(C-reaction protein,CRP)、白介素6(interleukin 6,IL-6)、肿瘤坏死因子α(tumor necrosis factor alpha,TNF-α)水平。生化检测血清白蛋白(albumin,ALB)、血磷(serum phosphorus,P)、血肌酐、尿酸(uric acid,UA)、胱抑素,记录患者年龄、性别、身高等指标,通过CKD-EPI公式估算肾小球滤过率(estimated glomerular filtration rate,e GFR)。单因素方差分析比较CKD不同分期血清中炎症因子水平,炎症因子与ALB、e GFR、UA、Klotho、P相关性采用等级相关(Spearman)分析,影响CKD患者炎症因子的因素采用多元线性回归分析。结果 1单因素方差分析结果显示CKD 1~5期患者血清TNF-α含量逐渐升高(P<0.05),CRP、IL-6差异无统计学意义(P>0.05),Klotho蛋白水平逐渐降低(P<0.01)。2Spearman相关分析结果显示,CKD患者血清TNF-α水平与e GFR呈负相关(r=-0.550,P<0.01);CKD患者血清TNF-α与Klotho呈负相关(r=-0.753,P<0.01);Klotho与e GFR呈正相关(r=0.643,P<0.01)。3多元线性回归分析结果显示,CKD患者血清TNF-α水平与Klotho、e GFR关系密切。结论 CKD患者随着e GFR的降低,血清Klotho水平逐渐下降,炎症因子TNF-α水平逐渐升高,两者之间具有明显的相关性,提示Klotho蛋白降低与CKD微炎症状态的发生和发展有着密切关联。
Objective To analyze the correlation between Klotho protein level and inflammation in patients with chronic kidney disease (CKD) and to evaluate the relationship between Klotho and microinflammatory state in patients with CKD. Methods Serum levels of Klotho protein, C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor alpha TNF-α) levels. Biochemical tests were performed to detect albumin (ALB), serum phosphorus (P), serum creatinine, uric acid (UA) and cystatin, and the age, sex and height of patients were recorded. Estimated glomerular filtration rate (eGFR). One-way ANOVA was used to compare the levels of inflammatory cytokines in serum of different stages of CKD. Correlation between inflammatory factors and ALB, e GFR, UA, Klotho, P was analyzed by Spearman analysis. Multiple linear regression analysis was used to analyze the factors influencing inflammatory factors in CKD patients. Results One-way analysis of variance showed that serum TNF-αlevels in patients with CKD stages 1-5 gradually increased (P <0.05), CRP and IL-6 levels had no statistical significance (P> 0.05), Klotho protein level decreased P <0.01). The results of 2Spearman analysis showed that serum TNF-αlevels in CKD patients were negatively correlated with eGFR (r = -0.550, P <0.01), but negatively correlated with Klotho in CKD patients (r = -0.753, P <0.01) ). There was a positive correlation between Klotho and eGFR (r = 0.643, P <0.01). 3 Multiple linear regression analysis showed that the level of serum TNF-α in CKD patients was closely related to Klotho and e GFR. Conclusions With the decrease of e GFR, serum Klotho level and the level of TNF-α in inflammation patients gradually increased in patients with CKD. There is a clear correlation between Klotho level and the occurrence and development of micro-inflammatory state of CKD Closely linked.