Correlation Between Serum CXCL12 Levels And Carotid Atherosclerosis In Non-dialysis Patients With Chronic Kidney Disease Stages 3-5

Objective:To investigate the correlation between serum CXC chemokine ligand 12(CXCL12)levels and carotid atherosclerosis(CAS)in non-dialysis patients with chronic kidney disease(CKD)stage 3-5 and to analyze the predictive value of serum CXCL12 levels on the development of carotid atherosclerosis in patients with chronic kidney disease.Methods:Seventy-six non-dialysis patients with chronic kidney disease stage 3-5 who attended the Department of Nephrology,First Hospital of Shanxi Medical University from December 2021 to October 2022 were selected and screened according to the inclusion and exclusion criteria.Patients’ age,gender,height,weight,body mass index(BMI),blood pressure,history of smoking and alcohol consumption and comorbidities were recorded.Patients’ albumin(Alb),fasting blood glucose(GLU),haemoglobin(Hb),high-density lipoprotein cholesterol(HDL-C),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),blood potassium(K),blood phosphorus(P),blood calcium(Ca),blood magnesium(Mg),glomerular filtration rate(GFR),creatinine(Scr),Urea nitrogen(BUN),uric acid(UA),parathyroid hormone(PTH)and other clinical indicators were also recorded.;CXCL12 levels in serum were measured by ELISA,and the group was divided into CAS and non-CAS groups according to the results of ultrasonography of neck vessels.The general biochemical indexes and serum CXCL12 levels of the two groups were compared and analyzed.The correlation between serum CXCL12 levels and carotid atherosclerosis and its clinical significance were investigated.Results:Of the 76 non-dialysis patients with chronic kidney disease stages 3-5 38(50%)were in the CAS group and 38(50%)were in the non-CAS group.Of these,28 were women and 48 were men.The primary conditions included chronic nephritis,nephrotic syndrome and polycystic kidney,diabetic nephropathy,small vessel vasculitis kidney injury,Ig A nephropathy.The differences in age,systolic blood pressure,mean arterial pressure,Scr,BUN levels,Hb,GFR levels,serum CXCL12 levels and the proportion of co-morbid diabetes were statistically significant between the two groups(P<0.05).Spearman’s correlation analysis suggests that carotid atherosclerosis in non-dialysis patients with CKD stage 3-5 is negatively correlated with serum CXCL12 levels,GFR and Hb levels,and positively correlated with age,systolic blood pressure,mean arterial pressure,Scr,BUN and the ratio of co-morbid diabetes(P<0.05).Binary logistic regression showed that low serum CXCL12 levels,age and diabetes mellitus were independent risk factors for carotid atherosclerosis in non-dialysis patients with chronic kidney disease stage 3-5.The area under the curve(AUC)of serum CXCL12 level to predict carotid atherosclerosis was 0.7465,and its best predictive sensitivity and specificity were 71.1% and 76.3%,respectively.Conclusions:Low serum CXCL12 levels,age and diabetes mellitus are independent risk factors for carotid atherosclerosis in non-dialysis patients with chronic kidney disease stage 3-5.Serum CXCL12 levels in patients with chronic kidney disease are strongly associated with carotid atherosclerosis and have high application in predicting carotid atherosclerosis.