The Correlation Between Serum Osteopontin And Coronary Artery Calcification In Patients With End-stage Renal Disease

Objective:Chronic kidney disease(CKD)has become a global burden for health.Coronary artery calcification is considerate as one of most important reasons of mortality for CKD patients.Thus,exploring the potential mechanisms of coronary artery calcification in patients with CKD has great interest.OPN(osteopontin)is a secreted multifunctional glycophos phoprotein that plays important roles in physiological and pathophysiological processes.In this study,to investigate the association between serum osteopontin(OPN)and coronary artery calcification(CAC)in patients with end-stage renal disease(ESRD)and find the potential mechanisms of CAC development,providing theoretical basis for clinical diagnosis and treatment.Methods:A total of 48 patients with hemodialysis or peritoneal dialysis who presented to the department of nephrology in the affiliated hospital of Qingdao university were enrolled in the study between January 2016 and December 2019.According to the result of CAC index which was detected by coronary angiography + intravascular ultrasound(IVUS),the whole subjects were divided into three groups: no calcification group,mild calcification group(low calcification index group,Calc Index≤0.14)and severe calcification group(medium-high calcification index group,Calc Index>0.14).Clinical data,including sex,age,dialysis age,BMI,past medical history(hypertension,diabetes and calcium agent using or not,et al),serum phosphorus,serum calcium,parathyroid hormone,calcium×phosphorus,glycosylated hemoglobin,alkaline phosphatase(ALP),and other indicators,were compared between groups.In this study,ANOVA analysis,Kruskal–Wallis H test,Pearson and Spearman analysis,Logistic regress analysis and ROC curve were used.Results:Among patients in no-calcificanton group,mild calcification group and severe calcification group,the age,dialysis age,the proportion of hypertension and diabetes,calcium agent using,the CRP,serum phosphorus,glycosylated hemoglobin,parathyroid hormone,calcium×phosphorus,and ALP levels were increased significantly in severe calcification group(p<0.05).Meanwhile,the serum OPN levels were also increased significantly(p<0.05).The level of serum OPN was associated with serum phosphorus(r=0.399),parathyroid hormone(r=0.328),calcium×phosphorus(r=0.298)and serum ALP(r=0.201)(p<0.05).The Logistic regress analyses showed that dialysis age,serum phosphorus,parathyroid hormone,calcium×phosphorus and serum OPN were the independent risk factors for CAC in maintenance dialysis patients.The ROC curve showed that the area under the OPN curve was 0.947(95% CI,0.882-0.981,p<0.01).The sensitivity and specificity were 72.5% and 75.9% when the cross-section was 81.73ng/L.Conclusion:1).The serum OPN,which is significantly increased in patients with ESRD,is an independent risk factor for CAC;2).The OPN could be the potential biomarker for CAC in ESRD patients.Thus,our founding has provided theoretical basis for clinical diagnosis and treatment.