Objective To explore characteristic of cardiac valve calcification(CVC)and its association with 25-hydroxy vitamin D[25(OH)D]deficiency in patients with end stage renal disease(ESRD).Methods Patients with ESRD who were treated in our hospital were enrolled.Aortic valve calcification(AVC)and mitral valve calcification(MVC)condition were assessed by echocardiography.According to the existence of CVC,AVC and MVC or not,all patients were divided into CVC group and non-CVC group,AVC group and non-AVC group,MVC group and non-MVC group respectively,and clinical data were compared.Multivariate logistic regression analysis was used to evaluate influencing factors of CVC in patients with ESRD.Predictive value of 25(OH)D for CVC in patients with ESRD was evaluated by receiver operating characteristic(ROC)curve.Results A total of 657 patients with ESRD were enrolled,and the incidence of CVC was55.9%,of which AVC accounted for42.8%and MVC accounted for 24.0%.The incidence of 25(OH)D deficiency was 69.6%.Age,dialysis age,Hb,hypersensitive C reactive protein(hs-CRP),serum phosphorus,complete parathyroid hormone(iPTH)levels and proportion of patients with elderly,dialysis therapy,coronary heart disease,diabetes mellitus,AAC,25(OH)D deficiency in CVC group were higher than those in non-CVC group,Alb and 25(OH)D levels were lower than those of non-CVC group(P＜0.05).Age,dialysis age,Hb,hs-CRP,serum phosphorus,iPTH levels and proportion of elderly,dialysis therapy,coronary heart disease,diabetes mellitus,AAC,25(OH)D deficiency in AVC group were higher than those in non-AVC group,Alb and 25(OH)D levels in AVC group were lower than those in non-AVC group(P＜0.05).Proportion of female,elderly,dialysis therapy,coronary heart disease,diabetes mellitus,AAC,25(OH)D deficiency,age,dialysis age,hs-CRP,serum phosphorus,iPTH,low density lipoprotein cholesterol(LDL-C)levels in MVC group were higher than those in non-MVC group,Alb and 25(OH)D levels were lower than those in non-MVC group(P＜0.05).Multivariate logistic regression analysis showed that age,dialysis age,coronary heart disease,diabetes mellitus,hs-CRP,serum phosphorus,iPTH and AAC were independent risk factors for CVC,while Alb and 25(OH)D were independent protective factors for CVC.ROC curve analysis showed that area under ROC curve of 25(OH)D predicted CVC in ESRD patients was0.722(95%CI 0.681～0.763,P＜0.001),the optimal cut-off value was 12.8 ng/ml,and sensitivity was 72.3%,specificity was 76.4%.Conclusion The related factors of AVC and MVC in patients with ESRD are similar and different,and 25(OH)D deficiency is an independent risk factor for CVC in patients with ESRD.
End stage renal diseaseCardiac valve calcification25-hydroxyvitamin D
万方数据
维普
