The Levels And Clinical Significance Of Serum PTX3and MCP-1in Patients With Chronic Kidney Disease

Objective:To study the levels and clinical significance of serum PTX3and MCP-1in patients withchronic kidney disease (CKD).Methods:We measured serum PTX3and MCP-1concentration in66patients with CKD. Thepatients were divided into cardiovascular diseases (CVD) and without CVD according tocardiovascular complication. There were42seleceted patients without CVD in total,including23male,19females, the average age was (53.57±11.61) years. There were24seleceted patients with CVD in total, including17male,7females, the average age was(59.58±14.35) years. According to the estimated glomerular filtration rate (eGFR), thepatients were divided into stage1to3CKD without CVD(22cases), stage4to5CKDwithout CVD(20cases) and stage1to3CKD with CVD(10cases), stage4to5CKD withCVD(14cases). The patients were divided into stage4to5CKD without CVD(20cases)and stage4to5CKD with CVD(14cases) according to cardiovascular complication instage4to5CKD patients. Seventeen sex-and age-matched healthy chinese volunteerswere recruited as normal controls. Concentrations of PTX3and MCP-1in serum weremeasured by Enzyme linked immunosorbent essay (ELISA). And the clinical andlaboratory data of the patients were collected.The methods of statistical analysis included One-Way ANOVA, chi square test,Logistic regression analysis and Spearman’s rank correlation. SPSS17.0was used forstatistical analysis. P values less than0.05were considered significant. Results:1. Compared to normal controls, the levels of serum PTX3in patients with CKD with orwithout CVD were significantly increased (P<0.001, P<0.01, respectively); and CVD werehigher than non-CVD (P<0.01).2. Serum PTX3levels of patients with stage4to5CKD without CVD weresignificantly higher than control group and stage1to3CKD without CVD group (P<0.05,P<0.05).3. In CVD group, serum PTX3levels were higher in patients with stage4to5CKDthan those with stage1to3CKD and control group (P<0.05, P<0.001).4. In stage4to5CKD group, serum PTX3levels were higher in patients with CVDthan those without CVD (P<0.01).5. Compared to normal controls, the levels of serum MCP-1in patients with CKDwith or without CVD were significantly increased (P<0.05, P<0.01, respectively); therewere no significant difference in MCP-1levels between CVD group and non-CVD group(P>0.05).6. In stage4to5CKD group, serum MCP-1levels were no significant difference inpatients with and without CVD(P>0.05).7. In CVD group, non-CVD group, and CKD group, serum PTX3levels werepositively correlated with BUN(P<0.01, respectively)，serum creatinine(P<0.01, P<0.05,P<0.01, respectively)，blood uric acid(P<0.01, P<0.05, P<0.01, respectively) and hsCRP(P<0.05, P<0.05, P<0.01, respectively); and negatively correlated with eGFR (P<0.01,P<0.05, P<0.01, respectively); In CVD group and CKD group, serum PTX3levels werepositively correlated with neutrophil ratio(P<0.05, respectively), triglycerides(P<0.05,P<0.01, respectively), ESR(P<0.05, P<0.01, respectively); In non-CVD group and CKDgroup, serum PTX3levels were positively correlated with MCP-1(P<0.05, respectively).8. In CVD group, non-CVD group, and CKD group, serum MCP-1levels werepositively correlated with serum creatinine(P<0.05, P<0.01, P<0.01, respectively)，blooduric acid(P<0.05, P<0.01, P<0.01, respectively) and ESR(P<0.05, P<0.05, P<0.01,respectively); and negatively correlated with eGFR(P<0.05, P<0.01, P<0.01, respectively); In non-CVD group and CKD group, serum MCP-1levels were positively correlated withBUN(P<0.01, respectively).9. In CVD group, there were no correlation between serum PTX3levels and MCP-1levels(P>0.05).10. Using Logistic regression analysis, serum PTX3was found to be associated withCVD of risk factors for atherosclerosis (OR=1.766,95%CI:1.121-2.781, P=0.014).11. The ROC curve analysis showed that the area under the curve (AUC) for levels ofPTX3in stage4to5CKD patients with CVD was0.889. The serum PTX3cutoff valuewas3.04ng/mL, and its sensitivity and specificity were92.9%and80%, respectively.Conclusions:1. Serum PTX3and MCP-1levels are elevated in patients with CKD, and bothnegatively correlated with eGFR. Unlike MCP-1independently of association with CVD,serum PTX3is significantly higher in patients with CVD. In stage4to5CKD group,serum PTX3levels are higher in patients with CVD than these without CVD. These resultsprompt PTX3, not MCP-1, has certain reference value to predict the presence of CVD inCKD patients.2. In CVD patients, serum PTX3levels were positively correlated with neutrophilratio, triglycerides, ESR and hsCRP; moreover, increasing levels of PTX3associated witha significant increase in the risk of CVD.3. In CKD patients, serum PTX3levels were positively correlated with hsCRP, ROCcurve analysis suggests that PTX3, but not MCP-1and hsCRP, could predict the presenceof CVD as a complication associated with CKD. Additionally, PTX3might be a moresensitive marker for the association of CVD than hsCRP in patients with CKD.