Research On The Level Of Serum TWEAK And Its Relationship With Micro-inflammation And Atherosclerosis In Peritoneal Dialysis Patients

Objective：To investigate the serum level of tweak tumor necrosis factor like weak inducer ofapoptosis(TWEAK) and explore its relationship with micro-inflammation state andatherosclerosis (AS) in peritoneal dialysis patients.Methods：From June to December2011,49patients treated with maintenance dialysis therapywere enrolled in this study, who were hospitalized in the nephrology department of theSecond Affiliated Hospital of Soochow University. The PD treatment group (PD group)included26cases, Maintenance hemodialysis treatment group (MHD group) included23cases,22cases of healthy controls were also enrolled. The age and gender among thethree groups were matched. Plasma TWEAK levels were tested by enzyme-linkedimmunosorbent assay (ELISA). And biochemical parameters were collected, inculdingC-reactive(CRP), fibrinoren(FIB), white blood cell(WBC), Phosphorus(P), Calcium(Ca),Parathyroid hormone(PTH) alkalinephosphates(ALP), albumin(Alb), Triglyceride(TG),Total Cholesterol(TC), low density lipoprotein(LDL), etc were examined. Carotid arteryintima-media thickness(CIMT) was tested by carotid ultrasonography. All statisticalanalysis were performed with SPSS17.0. P<0.05was considered statistically significant.Results1. Compared with the healthy control group, the level of plasma TWEAK in PD group(155.46±3.69pg/ml) and in HD group (150.16±7.23pg/ml) were significantly decreased(P<0.05). But there was no significant difference between PD group and HD group(P=0.75).2. Compared with the healthy control group, the level of plasma CPR、FBI、WBC inPD group and MHD group were significantly increased (P<0.05). Compared with the MHD group, the PD group, the level of plasma WBC were significantly increased(P<0.001), the level of plasma FIB、Fer were increased (P=0.07、P=0.053).3. Compared with the healthy control group, the levels of CIMT in PD group(0.93±0.03mm) and MHD group(0.95±0.02mm) were significantly increased (P<0.05),andthe rate of plaques in PD group (76%) and MHD group(79%) was significantly increased(P<0.01). But there was no significant difference between PD group and HD group(P=0.14).4. Patients with lower sTWEAK presented higher level of WBC, CRP, CIMTthickness and the rate of plaques(P<0.05), while lower level of BMI(P<0.05)andALB(P=0.074).5. The level of sTWEAK was negatively correlated with inflammatory makers, suchas CRP, FIB, WBC, CIMT and the rate of plaques in maintenance dialysis group(P﹤0.05). The level of sTWEAK was negatively correlated with CRP, FIB, Glu in thehealthy control group (P﹤0.05). Neither of the level of sTWEAK was correlated with Ca,P, iPTH, TG, TC, LDL in groups(P﹥0.05).6． Multiple linear stepwise regression analysis showed that sTWEAK and CRP wereobvious correlating factors to CIMT.Conclusion1．The level of sTWEAK was decreased in both MHD and HD patients;2．The level of CRP, FBI, WBC, CIMT thickness and the rate of plaques weresignificantly elevated in both MHD and HD patients;3． Serum TWEAK level was correlated with CRP, FIB, WBC as well as CIMT, therate of plaques, which indicated that sTWEAK was an independent risk factor of AS inPD patients.