視黃醇結合蛋白-4與代謝症候群的血液透析病人周邊動脈阻塞疾病的相關性

研究目的：台灣慢性腎衰竭的發生率和盛行率高於世界第一。主要是因糖尿病和高血壓所引起。周邊動脈血管阻塞是心臟血管的危險因子，有研究指出血液中之脂肪因子的濃度與周邊動脈阻塞疾病有關，但針對血液透析病人周邊動脈血管阻塞疾病的探討甚少。故希望透過本研究，探討並分析脂肪因子的濃度與代謝症候群的血液透析病人之相關性，以降低周邊動脈阻塞疾病的發生。研究方法及資料：回溯性分析自2009年6月至2013年7月，49位血液透析病人飯前血液檢體報告，並檢測及定義足踝及手臂收縮壓(ankle-brachial index；ABI)小於0.9為罹患有周邊動脈阻塞疾病。再以univariate regression analysis及multivariate regression analysis分析各變數之相關性。研究結果：49位血液透析病人，有代謝症候群的病人生物指標中RPB4的P=0.012。周邊動脈血管阻塞疾病的高危險群以univariate regression analysis的結果：代謝症候群中糖尿病的P=0.049 (OR=4.875 95%C I =1.008-23.57)。周邊動脈血管阻塞疾病的生物指標中以univariate regression analysis的結果：代謝症候群的病人RPB4的P=0.034 (OR=1.064 95% C I =1.005-1.127)。周邊動脈血管阻塞疾病的生物指標中以multivariate regression analysis的結果：代謝症候群的病人RPB4的P=0.048 (aOR=1.073 95% C I =1.005-1.127)，有統計差異。結論與建議：代謝症候群的血液透析病人，血液中高濃度的RPB4則罹患周邊動脈血管阻塞疾病的風險性增加，故針對血液中高濃度的RPB4病人應進行預防措施，以降低周邊動脈血管阻塞疾病的發生。

Objective：The incidence and prevalence of chronic renal failure in Taiwan is higher than the world''s first. Mainly caused by diabetes and high blood pressure. Peripheral arterial occlusion is a risk factor for cardiovascular arteries. Studies have shown that the concentration of adipokines in the blood is related to peripheral arterial occlusive disease, but little is known about peripheral arterial occlusion disease in hemodialysis patients. Therefore, through this study, we hope to explore and analyze the correlation between the concentration of adipokines and hemodialysis patients with metabolic syndrome to reduce the incidence of peripheral arterial occlusive disease.Methods and Materials：Retrospective analysis From June 2009 to July 2013, 49 hemodialysis patients reported pre-prandial blood samples, and detected and defined ankle-brachial index (ABI) less than 0.9 for the surrounding area peripheral arterial occlusive disease. The correlation between the variables was analyzed by univariate regression analysis and multivariate regression analysis.Results： In 49 hemodialysis patients, P=0.012 of RPB4 in the biological index of patients with metabolic syndrome. The high risk group of peripheral arterial occlusion disease was the result of univariate regression analysis: P=0.049 for diabetes in metabolic syndrome (OR=4.875 95% C I = 1.008-23.57). The results of univariate regression analysis in the biomarkers of peripheral arterial occlusion disease: P=0.034 (OR=1.064 95% C I = 1.005-1.127) for RPB4 in patients with metabolic syndrome. The results of multivariate regression analysis in the biomarkers of peripheral arterial occlusion disease: P = 0.048 (aOR = 1.073 95% C I = 1.005-1.127) in patients with metabolic syndrome, with statistical differences.Conclusion and Suggestion：In hemodialysis patients with metabolic syndrome, the high concentration of RPB4 in the blood increases the risk of peripheral arterial occlusion disease. Therefore, preventive measures should be taken for patients with high concentrations of RPB4 in the blood to reduce the incidence of peripheral arterial occlusion disease.