Objective To observe the clinical features of coronary artery calcification(CAC)in peritone-al dialysis(PD)patients,to find out serological markers for evaluating CAC,and to estimate their application values for the diagnosis of CAC.Methods The PD patients treated during March 2022 to March 2023 in the Department of Nephrology,Nanjing Gaochun People's Hospital were recruited for this study.Their clinical da-ta were collected,laboratory examinations were improved,and serum sclerostin,dephospho-uncarboxylated matrix glaprotein(dp-ucMGP)and soluble growth stimulation expressed gene 2(sST2)were dtermined by ELISA.Spiral CT was used to assess the coronary artery calcification score(CACS).According to CACS,pa-tients were then divided into non-calcified group(CACS=0),mild calcified group(0＜CACS＜100),moder-ate calcified group(100≤CACS≤400)and severe calcified group(CACS＞400).Clinical data and serum in-dexes were compared among the four groups,and the serological markers were then screened for evaluating CAC.Results The prevalence of CAC was 67.96％(70 cases)in a total of 103 PD patients.There were sta-tistical differences in age(F=9.644,P＜0.001),dialysis age(F=8.141,P=0.043),cardiovascular disease rate(F=8.424,P=0.038),total Kt/V(F=3.775,P=0.013),alkaline phosphatase(F=7.909,P=0.048),sclerostin(F=31.513,P＜0.001),dp-ucMGP(F=24.188,P＜0.001),sST2(F=8.691,P=0.034),and B-type natriuretic pep-tide precursor(F=13.922,P=0.003)among the four groups.Multivariate logistic regression showed that older age(OR=1.192,95％CI:1.070～1.327,P=0.001),low Kt/V(OR=0.006,95％CI:0.000～0.418,P=0.018),higher sclerotin(OR=1.826,95％CI:1.194～2.792,P=0.006),and higher dp-ucMGP(OR=1.990,95％CI:1.235～3.207,P=0.005)were the independent risk factors for CAC.ROC curve analysis showed that the ar-eas under the curve of serum sclerostin,dp-ucMGP and their combined for predicting CAC in PD patients were 0.817(95％CI:0.715～0.919,P＜0.001),0.797(95％CI:0.705～0.889,P＜0.001),and 0.855(95％CI:0.776～0.935,P＜0.001)respectively.Conclusion Serum sclerostin and dp-ucMGP levels are potentially sensitive serological markers for predicting CAC in PD patients,having important value for clinical applica-tion.
万方数据
维普
