腹膜透析患者血清胎球蛋白A、NLRP3和sCD14水平的交互性及对血管钙化的诊断价值OA
Interactions Among Serum Fetuin-A,NLRP3,and sCD14 Levels in Peritoneal Dialysis Patients and Their Diagnostic Value for Vascular Calcification
目的 探究血清胎球蛋白A(fetuin-A)、NOD样受体蛋白3(NLRP3)、可溶性CD14(sCD14)水平在腹膜透析患者中的变化,并分析三者交互作用及对血管钙化的诊断价值.方法 研究对象为2022年2月至2025年2月河南医药大学第一附属医院收治的253例腹膜透析患者(设为透析组),根据是否发生血管钙化分为发生组(84例)与未发生组(169例);另选取同期253例健康体检者作为对照组.比较透析组与对照组、发生组与未发生组血清胎球蛋白A、NLRP3和sCD14水平.采用Pearson相关分析血清sCD14、胎球蛋白A和NLRP3与血管钙化的关系,采用相加模型分析三者水平的交互作用.采用ROC曲线分析各指标对血管钙化的预测价值.结果 与对照组相比,透析组NLRP3和sCD14水平升高,胎球蛋白A水平下降(P<0.05).与未发生组相比,发生组胎球蛋白A水平下降,NLRP3和sCD14水平升高(P<0.05).Pearson相关分析显示,NLRP3和sCD14水平与血管钙化呈正相关,胎球蛋白A与血管钙化呈负相关(P<0.05).sCD14与NLRP3同时暴露时,交互效应超额相对危险度(RERI)为60.254,交互作用归因比(API)为74.438,交互效应指数(S)为4.497;胎球蛋白A与NLRP3同时暴露时,RERI为2.738,API为15.294,S为1.243;胎球蛋白A与sCD14同时暴露时,RERI为2.879,API为14.325,S为1.204.ROC曲线显示,胎球蛋白A、NLRP3和sCD14联合诊断的效能优于单一指标.结论 胎球蛋白A、NLRP3和sCD14在腹膜透析患者中存在相加交互作用,三者同时暴露可增加血管钙化的发病风险,联合检测有利于提高血管钙化的诊断效能.
Objective To investigate changes in serum Fetuin-A,NLRP3,and sCD14 levels in peritoneal dialysis patients,and to analyze their interactions and diagnostic value for vascular calcification.Methods The 253 peritoneal dialysis patients were divided into the occurrence group(84 cases)and the non-occurrence group(169 cases)according to the presence of vascular calcifica-tion,and 253 healthy individuals in the same period were selected as the control group.The serum levels of Fetuin-A,NLRP3,and sCD14 were compared between the dialysis and control groups,as well as between the occurrence and non-occurrence groups.Pearson correlation analysis was used to assess the relationships between serum sCD14,Fetuin-A,NLRP3,and vascular calcification.The interactions among serum Fetuin-A,NLRP3,and sCD14 levels were analyzed using an additive model.ROC curves were used to evalu-ate the predictive value of these markers for vascular calcification.Results Compared with the control group,the dialysis group exhib-ited elevated NLRP3 and sCD14 levels,along with decreased Fetuin-A levels(P<0.05).Compared with the non occurrence group,the level of Fetuin-A in the occurrence group decreased and the levels of NLRP3 and sCD14 increased(P<0.05).Pearson results showed that the levels of NLRP3 and sCD14 were positively correlated with vascular calcification,and there was a negative correlation between Fetuin-A and vascular calcification(P<0.05).When sCD14 and NLRP3 were co-exposed,the relative excess risk due to interaction(RERI)was 60.254,the attributable proportion due to interaction(API)was 74.438,and the synergy index(S)was 4.497.When Fetuin-A and NLRP3 were co-exposed,the RERI was 2.738,the API was 15.294,and the S was 1.243.When Fetuin-A and sCD14 were co-exposed,the RERI was 2.879,the API was 14.325,and the S was 1.204.ROC curve analysis indicated that the combined use of Fetuin-A,NLRP3,and sCD14 demonstrated higher diagnostic efficacy than any single marker alone.Conclusion Fetuin-A,NLRP3,and sCD14 exhibited additive interactions in peritoneal dialysis patients,and simultaneous exposure to all three increased the risk of vascular calcification.Combined testing enhanced diagnostic efficiency for vascular calcification.
鲍妍;王云;王树龙;张连云;刘向东
河南医药大学第一附属医院 肾脏病医院二病区(新乡 453000)河南医药大学第一附属医院 肾脏病医院二病区(新乡 453000)河南医药大学第一附属医院 肾脏病医院二病区(新乡 453000)河南医药大学第一附属医院 肾脏病医院二病区(新乡 453000)河南医药大学第一附属医院 肾脏病医院二病区(新乡 453000)
医药卫生
腹膜透析胎球蛋白ANOD样受体蛋白3可溶性CD14血管钙化
Peritoneal dialysisFetuin-ANOD-like receptor protein 3Soluble CD14Vascular calcification
《西南医科大学学报》 2026 (4)
467-471,5
河南省医学科技攻关计划联合共建项目(LHGJ20220591)
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