Relationship Between Serum CHI3L1,HSP60 and Calcium and Phosphorus Metabolism,Coronary Artery Calcification in Cases with Maintenance Peritoneal Dialysis
Objective To explore the relationship between serum chitinase 3-like protein 1(CHI3L1),heat shock protein 60(HSP60),calcium and phosphorus metabolism and coronary artery calcification in cases with maintenance peritoneal dialysis.Methods A total of 98 maintenance peritoneal dialysis patients who received continuous or daytime non bed rest peritoneal dialysis treatment for more than 3 months at Zhoukou Central Hospital from January 2021 to January 2023 were selected as the study subjects.According to the presence of abnormal calcium and phosphorus metabolism,they were divided into a normal calcium and phosphorus group and an abnormal calcium and phosphorus group.The coronary artery calcification score(CACS)was calculated based on the results of multi-slice spiral CT using the Agatston scoring method.The 98 maintenance peritoneal dialysis patients were further divided into an uncalcified group and a calcified group,and the serum CHI3L1 and serum HSP60 levels of the two groups were detected and compared.Pearson correlation analysis was used to explore the relationship between serum CHI3L1,HSP60 and calcium and phosphorus metabolism indicators.Receiver operating characteristic(ROC)curves were used to evaluate the value of serum CHI3L1,HSP60 in assessing coronary artery calcification in maintenance peritoneal dialysis patients.The influencing factors of coronary artery calcification in maintenance peritoneal dialysis patients was explored through multiple logistic stepwise regression analysis.Results A total of 98 maintenance peritoneal dialysis patients were divided into two groups:normal calcium and phosphorus group(43 cases)and abnormal calcium and phosphorus group(55 cases).Patients in the abnormal calcium and phosphorus metabolism group had higher serum levels of CHI3L1 and HSP60 than those in the normal calcium and phosphorus metabolism group(P＜0.05).The serum CHI3L1,HSP60,and calcium phosphate product of maintenance peritoneal dialysis patients were positively correlated(P＜0.05).According to the results of multi-slice spiral CT and the Agatston scoring method,the CACS score of 98 maintenance peritoneal dialysis patients was calculated.They were divided into an uncalcified group(37 cases)and a calcified group(61 cases).The serum levels of CHI3L1 and HSP60 in the calcified group were higher than those in the uncalcified group(P＜0.05).The AUC of serum CHI3L1 and HSP60 for evaluating the prognosis of maintenance peritoneal dialysis patients were 0.741 and 0.826,respectively,and the AUC of their combined evaluation was 0.915.The number of patients with hypoalbuminemia,high phosphorus diet,and dialysis age in the calcification group were higher than those in the non calcification group(P＜0.05).Multivariate logistic regression analysis showed that high phosphorus diet,dialysis age,CHI3 L1,and HSP60 were risk factors for coronary artery calcification in maintenance peritoneal dialysis patients(P＜0.05).Conclusion Serum CHI3L1 and HSP60 are highly expressed in maintenance peritoneal dialysis patients with abnormal calcium and phosphorus metabolism and coronary artery calcification.Early detection of serum CHI3L1 and HSP60 levels is helpful for timely prevention and treatment of coronary artery calcification.
maintenance peritoneal dialysischitinase 3-like protein 1heat shock protein 60calcium and phosphorus metabolismcoronary artery calcification
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