Value of serum Hcy and FGF-23 in prediction of cardiovascular and cerebrovascular events in patients with uremia and hypertension treated with hemodialysis
Objective To analyze the value of serum homocysteine(Hcy)and fibroblast growth factor-23(FGF-23)in the prediction of cardiovascular and cerebrovascular events in patients with uremia and hypertension treated with hemodialysis.Methods A total of 98 patients with uremia and hypertension who underwent hemodialysis in Huangshi Hospital of Traditional Chinese Medicine from February 2019 to December 2022 were selected as the research objects,including 58 males and 40 females who were 53-76(64.18±5.39)years old.The clinical data,such as serum Hcy and FGF-23,were collected.The patients were followed up for 1 year.The incidence of cardiovascular and cerebrovascular events in the patients during the follow-up period was statistically analyzed.The factors affecting the occurrence of cardiovascular and cerebrovascular events in the patients were analyzed by t and x2 tests and logistic regression analysis.The values of Hcy and FGF-23 in the prediction of the occurrence of cardiovascular and cerebrovascular events in the patients was analyzed by the receiver operating characteristic curves(ROC).Results Among the 98 patients,37 cases(37.76％)had cardiovascular and cerebrovascular events,and the remaining 61 cases(62.24％)did not have cardiovascular and cerebrovascular events.There were no statistical differences in gender,age,body mass index,smoking history,drinking history,heart rate,hypertension course,systolic and diastolic pressures,antihypertensive drugs,fasting blood glucose,triacylglycerol,total cholesterol,high-density lipoprotein cholesterol,prealbumin,transferrin,urea nitrogen,creatinine,uric acid,alanine transaminase,gamma-glutamyltransferase,blood Ca and P,blood urea clearance index,parathyroid hormone,and left ventricular ejection fraction between the two groups(all P＞0.05).The dialysis age,albumin,low density lipoprotein cholesterol,urinary albumin excretion rate,red blood cell distribution width,Hcy,and FGF-23 in the patients with cardiovascular and cerebrovascular events were higher than those in the patients with no cardiovascular and cerebrovascular events[(4.83±0.81)years vs.(4.39±0.58)years,(36.33±5.08)g/L vs.(32.66±5.39)g/L,(3.59±0.75)mmol/L vs.(3.25±0.35)mmol/L,(38.77±4.43)mg/24 h vs.(35.54±4.41)mg/24 h,(15.59±2.19)％vs.(13.21±1.16)％,(18.82±2.31)μmol/L vs.(14.46±2.20)μmol/L,and(189.71±32.69)ng/L vs.(154.59±27.68)ng/L];the estimated glomerular filtration rate(eGFR)in the patients with cardiovascular and cerebrovascular events was lower than that in the patients with no cardiovascular and cerebrovascular events[(40.56±7.12)ml/min/1.73 m2 vs.(46.37±6.23)ml/min/1.73 m2];there were statistical differences(t=3.126,3.388,3.043,3.509,7.303,9.333,5.683,and 4.239;all P＜0.05).The logistic multivariate regression analysis showed that dialysis age,Hcy,FGF-23,and eGFR were the factors affecting the occurrence of cardiovascular and cerebrovascular events in the patients(all P＜0.05).The ROC analysis showed that the sensitivities of Hcy,FGF-23,and their combination in the prediction of cardiovascular and cerebrovascular events in the patients were 71.68％,76.57％,and 78.04％;the specificities were 78.59％,74.31％,and 89.36％;the areas under the curves were 0.768,0.745,and 0.886.Conclusions Serum Hcy and FGF-23 levels are related to cardiovascular and cerebrovascular events in patients with uremia and hypertension taking hemodialysis.The risk of cardiovascular and cerebrovascular events is higher when Hcy and FGF-23 are at high levels.The combination of the two has higher efficacy in predicting cardiovascular and cerebrovascular events in patients with uremia and hypertension taking hemodialysis.
HemodialysisUremia complicated with hypertensionHomocysteineFibroblast growth factor-23Cardiovascular and cerebrovascular diseases
万方数据
维普
