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肾移植受者代谢标志物与血脂水平的相关性研究

徐媛, 侯霜, 陈乾, 等. 肾移植受者代谢标志物与血脂水平的相关性研究[J]. 器官移植. doi: 10.3969/j.issn.1674-7445.2024014
引用本文: 徐媛, 侯霜, 陈乾, 等. 肾移植受者代谢标志物与血脂水平的相关性研究[J]. 器官移植. doi: 10.3969/j.issn.1674-7445.2024014
Xu Yuan, Hou Shuang, Chen Qian, et al. Correlation between metabolic markers and blood lipid levels in kidney transplant recipients[J]. ORGAN TRANSPLANTATION. doi: 10.3969/j.issn.1674-7445.2024014
Citation: Xu Yuan, Hou Shuang, Chen Qian, et al. Correlation between metabolic markers and blood lipid levels in kidney transplant recipients[J]. ORGAN TRANSPLANTATION. doi: 10.3969/j.issn.1674-7445.2024014

肾移植受者代谢标志物与血脂水平的相关性研究

doi: 10.3969/j.issn.1674-7445.2024014
基金项目: 贵州省基础研究计划(自然科学类)项目(黔科合基础-ZK[2023]376);贵州省卫生健康委科学技术基金项目(gzwkj2023-164)
详细信息
    通讯作者:

    徐媛(ORCID 0000-0001-9027-6286),硕士,副主任医师,研究方向为器官移植,Email:xuyuan@gmc.edu.cn;李海洋(ORCID 0000-0003-0015-5750),博士,主任医师,研究方向肝胆外科、器官移植,Email:xuyuan@gmc.edu.cn

  • 中图分类号: R617, R589.2

Correlation between metabolic markers and blood lipid levels in kidney transplant recipients

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  • 摘要:   目的   分析肾移植受者血脂代谢、高脂血症、他克莫司药物代谢中共表达的基因及其与血脂水平的相关性。  方法   从比较毒理基因组学数据库(CTD)中筛选出共表达的基因。收集25例肾移植受者的一般资料,检测ATP结合盒亚家族A成员1(ABCA1)、过氧化物酶体增殖物激活受体γ(PPAR-γ)、糖基磷脂酰肌醇锚定高密度脂蛋白结合蛋白1(GPIHBP1)的表达情况。对肾移植受者进行跟踪随访,收集采术后1、3、6、12个月空腹血糖、糖化血红蛋白、甘油三酯、总蛋白、白蛋白、球蛋白、胆固醇、高密度脂蛋白、低密度脂蛋白、他克莫司血药浓度,并分析受者高脂血症的发生情况。分析ABCA1、GPIHBP1、PPAR-γ与临床指标的相关性,及其与相关指标对肾移植术后高脂血症的诊断效能。  结果   共筛选出3个共表基因ABCA1、PPAR-γ、GPIHBP1。ABCA1与术后6个月胆固醇、术后3个月他克莫司血药浓度成正相关,与术后3个月空腹血糖呈负相关(均为P<0.05);GPIHBP1与术前胆固醇、术前甘油三酯呈负相关,与术后3个月他克莫司血药浓度呈正相关(均为P<0.05)。PPAR-γ与术前球蛋白、术前低密度脂蛋白呈负相关(均为P<0.05)。ABCA1、GPIHBP1、PPAR-γ联合球蛋白及术后1、6个月血糖水平诊断肾移植术后高甘油三酯血症的效果较好(AUC=0.9)。ABCA1、GPIHBP1、PPAR-γ联合术后1、6个月他克莫司血药浓度、术后6个月血糖水平诊断肾移植术后高胆固醇血症的效果较好(AUC=0.931)。  结论   ABCA1、GPIHBP1、PPAR-γ与肾移植术后血脂、他克莫司血药浓度等指标存在不同程度的相关关系,但用于预测肾移植术后高脂血症尚无确切依据。提升机体免疫力、规范的血糖管理可能是控制高脂血症的有益因素。

     

  • 图  1  DEG的筛选

    Figure  1.  Screening of DEGs

    图  2  ABCA1与临床指标之间的相关性分析

    注:A图为ABCA1与术后6个月胆固醇的相关性分析;B图为ABCA1与术后3个月他克莫司血药浓度的相关性分析;C图为ABCA1与术后3个月空腹血糖的相关性分析。

    Figure  2.  Correlation analysis between ABCA1 and clinical indexes

    图  3  GPIHBP1与临床指标之间的相关性分析

    注:A图为GPIHBP1与术前胆固醇的相关性分析;B图为GPIHBP1与术前甘油三酯的相关性分析;C图为GPIHBP1与术后3个月他克莫司血药浓度的相关性分析。

    Figure  3.  Correlation analysis between GPIHBP1 and clinical indexes

    图  4  PPAR-γ与临床指标的相关性分析

    注:A图为PPAR-γ与术前球蛋白的相关性分析;B图为PPAR-γ与术前低密度脂蛋白的相关性分析。

    Figure  4.  Correlation analysis between PPAR-γ and clinical indexes

    图  5  各指标对肾移植术后高甘油三酯血症的诊断效能

    注:A图为术前白蛋白、球蛋白、总蛋白、糖化血红蛋白诊断肾移植术后高甘油三酯血症的ROC曲线;B图为术前糖化血红蛋白、空腹血糖,术后1、3、6、12个月空腹血糖诊断肾移植术后高甘油三酯血症的ROC曲线;C图为术前,术后1、3、6、12个月他克莫司血药浓度诊断肾移植术后高甘油三酯血症的ROC曲线;D图为ABCA1、GPIHBP1、PPAR-γ诊断肾移植术后高甘油三酯血症的ROC曲线;E图为ABCA1、GPIHBP1、PPAR-γ联合诊断肾移植术后高甘油三酯血症的ROC曲线;F图为ABCA1、GPIHBP1、PPAR-γ联合术后1、6个月空腹血糖及球蛋白诊断肾移植术后高甘油三酯血症的ROC曲线。

    Figure  5.  Diagnostic efficacy of indicators for hypertriglyceridemia after kidney transplantation

    图  6  各指标对肾移植术后高胆固醇血症的诊断效能

    注:A图为术前白蛋白、球蛋白、总蛋白、糖化血红蛋白诊断肾移植术后高胆固醇血症的ROC曲线;B图为术前糖化血红蛋白、空腹血糖,术后1、3、6、12个月空腹血糖诊断肾移植术后高胆固醇血症的ROC曲线;C图为术前,术后1、3、6、12个月他克莫司血药浓度诊断肾移植术后高胆固醇血症的ROC曲线;D图为ABCA1、GPIHBP1、PPAR-γ诊断肾移植术后高胆固醇血症的ROC曲线;E图为ABCA1、GPIHBP1、PPAR-γ联合诊断肾移植术后高胆固醇血症的ROC曲线;F图为ABCA1、GPIHBP1、PPAR-γ联合术后1、6个月他克莫司血药、术后6个月血糖水平浓度诊断肾移植术后高胆固醇血症的ROC曲线。

    Figure  6.  Diagnostic efficacy of indicators for hypercholesterolemia after kidney transplantation

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  • 收稿日期:  2024-02-10
  • 网络出版日期:  2024-04-28

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