Relationship between serum levels of FGF-23,sVCAM-1,MCP-1 and maturation of arteriovenous fistula in maintenance hemodialysis
Objective:To investigate the relationship between the expression levels of serum fibroblast growth factor-23(FGF-23),soluble vascular cell adhesion molecule-1(sVCAM-1),monocyte chemotactic protein-1(MCP-1)and the maturation of arteriovenous fistula(AVF)in patients with maintenance hemodialysis(MHD).Methods:96 MHD patients who underwent AVF plastic surgery for the first time in our Hospital from October 2019 to March 2023 were selected.They were divided into mature group(70 cases)and immature group(26 cases)based on the maturity of internal fistula after surgery.The general information and serum levels of FGF-23,sV-CAM-1,and MCP-1 between the two groups were compared.The influencing factors for poor maturation of AVF were analyzed using logistic regression analysis.The value of serum FGF-23,sVCAM-1,and MCP-1 in predicting the poor maturation of AVF was analyzed using ROC curves.Results:The proportion of diabetes nephropathy in the immature group was higher than that in the mature group(P＜0.05),the diameter of the cephalic vein,the diameter of the posterior cephalic vein,the diameter of the radial artery,and the flow velocity of the radial artery were lower than those in the mature group(P＜0.05).The levels of serum FGF-23,sVCAM-1,and MCP-1 in the immature group were higher than those in the mature group(P＜0.05).Logistic regression analysis showed that the diabetes nephropathy(OR=1.110,95％CI 1.027-1.200),high FGF-23(OR=1.156,95％CI 1.045-1.325),high sVCAM-1(OR=1.082,95％CI 1.001-1.125),and high MCP-1(OR=1.127,95％CI 1.100-1.285)were risk factors for poor maturation of AVF(P＜0.05).The ROC curve showed that:with the cut-off value of 566.35 μg/mL,611.05 pg/L and 51.98 μg/mL,the AUC of serum FGF-23,sVCAM-1 and MCP-1 in predic-ting the poor maturation of AVF were 0.700,0.796,and 0.802.The AUC of the three combined in predicting the poor maturation of AVF was 0.926,which was higher than the single indicator(P＜0.05).Conclusion:The levels of serum FGF-23,sVCAM-1 and MCP-1 were risk factors for the maturation of AVF in MHD,and FGF-23,sVCAM-1 and MCP-1 might have certain predictive value for the maturation of AVF.FGF-23,sVCAM-1 and MCP-1 might serve as biomarkers in predicting the maturation of AVF.
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