The Role Of Galectin-3 In Arterial Stiffness In Maintenance Hemodialysis Patients

Objective: Patients with chronic kidney disease are at high risk for cardiovascular events.End-stage patients with maintenance hemodialysis treatment have high cardiovascular events morbidity and mortality because of large arterial fibrosis and remodeling,hence arteriosclerosis has become an important indicator of poor prognosis.However,there is still a lack of convenient and accurate methods for the diagnosis of arteriosclerosis.Galectin-3 is a member of the lectin family.In recent years,studies have indicated that it is involved in the pathogenesis of arteriosclerosis,and it is related to arteriosclerosis independently in the general population.Therefore,this study intends to investigate the situation of arterial stiffness in maintenance hemodialysis patients,and to analyze the relationship between galectin-3 and arteriosclerosis,evaluating the possibility as a new marker of arteriosclerosis.Methods:1)We selected 332 maintenance hemodialysis patients in Renji Hospital dialysis center.All the patients were determined by biochemical tests and carotid femoral pulse wave velocity to evaluate aortic stiffness and its related factors.2)Cardiac ultrasound and carotid artery ultrasound were used to realize the cardiac valve calcification and carotid atherosclerosis in these patients and abdominal aortic calcification scores were calculated.3)Serum galectin-3 concentrations of 311 maintenance hemodialysis patients were measured by enzyme linked immunosorbent assay(ELISA).The relationships between galectin-3 and effect factors were analyzed.We further analyzed correlations between carotid femoral pulse wave velocity,cardiac valve calcification,abdominal aortic calcification scores and increased carotid intimamedia thickness or plaques.Results: 1)The incidence of arterial stiffness in maintenance hemodialysis patients who was prone to combine abdominal aortic calcification,cardiac valve calcification and increased carotid artery intima media thickness or plaques was high.Carotid femoral pulse wave velocity was affected by various factors.It is related to age,branchial and central blood pressure,fasting blood glucose,glycosylated hemoglobin,B-type brain natriuretic peptide,C-reactive protein positively and albumin,serum phosphate,calcium-phosphorus product negatively.Old age,males,high C-reactive protein levels and high blood pressure were independent risk factors for arterial stiffness.2)Serum galectin-3 concentrations significantly increased in maintenance hemodialysis patients,and they were positively correlated with dialysis vintage,corrected calcium,and the same trend with age was also observed.However,galectin-3 had negative correlations with low density lipoprotein and serum phosphorus.Age,low density lipoprotein and corrected calcium were independently associated with galectin-3.3)Carotid femoral pulse wave velocity in maintenance hemodialysis patients elevated with galectin-3 levels.After adjustments for age,history of hypertension treatments,albumin,phosphorus,glycosylated hemoglobin,B-type brain natriuretic peptide and C-reactive protein,the correlation was still independent.Galectin-3 >33.9ng/ml was an independent risk factor for arteriosclerosis in patients younger than 65 years' old.Galectin-3 concentrations were significantly elevated in patients with aortic valve calcification,and galectin-3 was an independent risk factor for abdominal aortic calcification and carotid plaques.Conclusion: The incidence of arteriosclerosis was high in maintenance hemodialysis patients.The diagnostic accuracy and sensitivity of carotid femoral pulse wave velocity were influenced by many clinical factors.As a new biomarker of arterial stiffness,galectin-3 concentrations were correlated with carotid femoral pulse wave velocity,abdominal aortic calcification scores and carotid plaques independently in maintenance hemodialysis patients.