目的 探讨维持性血液透析(maintenance hemodialysis，MHD)患者血清鸢尾素水平与腰椎骨密度(bone mineral density，BMD)的关系。 方法 选择2019年1月～2021年12月于连云港市第一人民医院住院的200例MHD患者作为研究对象，进行横断面研究。根据腰椎T值将入组患者分为骨量正常组(T≥-1，n =119)、骨量减少组(-2.5＜T＜-1，n =53)和骨质疏松组(T≤-2.5，n =28)。比较3组患者临床资料和实验室指标差异。采用Pearson或Spearman相关性分析腰椎BMD(以T值表示)与临床资料和实验室指标的相关性。采用有序Logistic回归分析MHD患者腰椎BMD的影响因素。 结果 骨质疏松组血清鸢尾素水平为(4.88±1.03)μg/L，骨量减少组血清鸢尾素水平为(35.05±8.94)μg/L，骨量正常组血清鸢尾素水平为(62.15±18.44)μg/L，3组比较差异有统计学意义(F =14.036，P＜0.001)。MHD患者腰椎BMD与体质量指数(r =0.329，P =0.001)、肌酐(r =0.295，P =0.005)、血清鸢尾素(r =0.448，P＜0.001)呈正相关，与女性(r =-0.422，P ＜0.001)、年龄(r =-0.291，P=0.007)、尿素清除指数(Kt/V，r =-0.266， P=0.017)、尿素清除率(r=-0.270，P=0.014)和碱性磷酸酶(r=-0.292，P=0.007)呈负相关。有序Logistic回归分析结果显示血清鸢尾素水平是MHD患者腰椎BMD的影响因素(OR=0.466，95%CI：0.304～0.714，P＜0.001)。 结论 MHD患者血清鸢尾素水平与腰椎BMD呈正相关，血清鸢尾素水平是MHD患者腰椎BMD的影响因素。
bjective To investigate the relationship between serum irisin level and lumbar bone mineral density (BMD) in maintenance hemodialysis (MHD) patients. Methods A total of 200 MHD patients hospitalized in The First People's Hospital of Lianyungang City from Jan 2019 to Dec 2021 were recruited as the subjects for cross-sectional study. Based on the T value of lumbar bone, patients were divided into normal bone mass group (t ≥-1, n=119), osteopenia group (-2.5＜t＜-1, n=53) and osteoporosis group (t ≤-2.5, n=28). Clinical data and laboratory indexes were compared among the three groups. Pearson or Spearman correlation was used to analyze the correlation between lumbar BMD (expressed as T value) and clinical and laboratory indicators. The influencing factors for lumbar BMD were analyzed by ordered logistic regression. Results The serum irisin levels were 4.88±1.03μg/L, 35.05±8.94μg/L and 62.15±18.44μg/L in osteoporosis group, osteopenia group and normal bone mass group respectively (F=14.036, P＜0.001). Lumbar BMD in MHD patients was positively correlated with body mass index (BMI), creatinine and serum irisin (r=0.329, 0.295 and 0.448 respectively; P=0.001, 0.005 and ＜0.001 respectively), and negatively correlated with female, age, urea clearance index (Kt/V), urea clearance rate and alkaline phosphatase (r=-0.422, -0.291, -0.266, -0.270 and -0.292 respectively; P＜0.001, P=0.007, 0.017, 0.014 and 0.007 respectively). Ordered logistic regression showed that serum irisin level was an influencing factor for lumbar BMD in MHD patients (OR=0.466, 95% CI:0.304～0.714, P＜0.001). Conclusion There is a positive correlation between serum irisin level and lumbar BMD in MHD patients. Serum irisin level is an influencing factor for lumbar BMD in MHD patients.
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