The Study Of Correlation Between Serum Cat-S Level And Vascular Calcification In Maintenance Hemodialysis Patients

Objective: This paper takes maintenance hemodialysis(MHD)patients as the main research object,analyzes the correlation between serum cathepsin S(cat-s)level and vascular calcification(VC)in MHD patients.The feasibility of cat-s as an early predictor of VC in MHD patients is evaluated comprehensively.To provide a theoretical basis for early prediction of VC in MHD patients.Methods: Methods from January 2019 to August 2020,83 MHD patients with continuous regular hemodialysis in the Fourth Affiliated Hospital of China Medical University were selected(excluding severe malnutrition,liver function damage,severe cardiac insufficiency,mental disease,application of large amount of vitamin D treatment,etc.).All patients were examined by computed tomography(CT)to evaluate the degree of abdominal aortic calcification.According to the abdominal aortic calcification index(AACI),they were divided into non calcification(0),mild calcification(AACI score < 23)and moderate to severe calcification(AACI score ≥23).Collect and record the general basic data of patients,and test the serum cat-s level before dialysis and other laboratory test results(including urea,creatinine,uric acid,hemoglobin,albumin,blood calcium,blood phosphorus,parathyroid hormone),and analyze the correlation between the above significant variables and AACI,Then,the significant variables in correlation analysis were included in multivariate logistic regression analysis.Finally,the risk of VC in MHD patients was estimated by cat-s curve.Results: 1.In 83 MHD patients,the incidence of VC was 77%.2.There was significant difference in cat-s level among the three groups(F = 59.421,P < 0.05),and cat-s level increased with the increase of calcification degree;there were significant differences in dialysis age,systolic blood pressure,diastolic blood pressure,pulse pressure difference,history of diabetes,blood calcium,blood phosphorus and parathyroid hormone among the three groups(all P < 0.05)There was no significant difference in age,gender,urea,creatinine and uric acid among the three groups.3.According to Pearson correlation analysis,serum cat-s level was positively correlated with AACI(r = 0.767,P < 0.05);AACI was positively correlated with dialysis age(r= 0.403,P < 0.05),systolic blood pressure(r = 0.478,P < 0.05),diastolic blood pressure(r = 0.312,P < 0.05),pulse pressure difference(r = 0.453,P < 0.05),history of diabetes(r = 0.439,P < 0.05),blood calcium(r = 0.284,P < 0.05),blood phosphorus(r = 0.520,P < 0.05),thyroid carcinoma(r = 0.439,P < 0.05)483,P <0.05).4.According to multivariate logistic regression analysis,cat-s(or = 1.006,95%CI = 1.001-1.010,P < 0.05),systolic blood pressure(or = 1.250,95% CI =1.082-1.443,P < 0.05),dialysis age(or = 2.868,95% CI = 1.076-7.647,P < 0.05),parathyroid hormone(or = 1.007,95% CI = 1.001-1.014,P < 0.05)were independent risk factors for VC.5.The ROC curve showed that the area under the curve of cat-s was 0.954 [95% CI(0.90,1.00),P < 0.05],the best cutoff value was 1.81ng/ml,Youden index was 0.795,the sensitivity was 95.3%,and the specificity was 84.2%.Conclusion: In MHD patients,serum cat-s level is positively correlated with the severity of VC,and cat-s level is an independent risk factor of VC in MHD patients,which has a certain value for the early prediction of VC.