The Prevalence And Influencing Factors Of Carotid Plaques In Peritoneal Dialysis Patients With Vitamin D Deficiency

Objective: To observe the levels of25-hydroxy vitamin D [25(OH)D] in patients withcontinuous ambulatory peritoneal dialysis (CAPD) and to investigate the prevalence andinfluencing factors of carotid atherosclerosis in peritoneal dialysis patients with25(OH)Ddeficiency.Methods: This cross-sectional study was carried out in CAPD patients who were regularlyfollowed up at the Department of Nephrology, Wuxi People’s Hospital from January1,2008to December31,2012. The levels of25(OH)D were tested by enzyme-linkedimmunosorbent assay (ELISA). PD patients were divided into Vitamin D deficiency group(Group A) and Vitamin D normal group (Group B). Vitamin D deficiency was defined if25(OH)D levels were less than50nmol/L, while Vitamin D normal was defined if25(OH)D levels were more than50nmol/L.Carotid plaques were measured bytwo-dimensional ultrasonography.The effect factors were analysed by logistic regression.Results:1.A total of160CAPD patients were enrolled in this study. Of these patients,72cases(45%) were considered25(OH)D adequate,88(55%) were deficiency.2. There were84patients(52.5%) with carotid plaques, which was defined as intima-mediathickness(IMT)>1.0mm. In Vitamin D deficiency group,62patients(70.45%) had carotidplaques. Compared with Vitamin D normal group, Vitamin D deficiency group hadsignificantly more patients with carotid plaques (p<0.001).Carotid artery IMT levels werepositively correlated with age, history of smoking, duration of diabetes, BMI, CRP, LDL-Cand PTH (P<0.05). Spearman correlation analysis showed that25(OH)D was negativelycorrelated with carotid artery IMT (γ=-0.82,t=8.68,95%CI:-0.92,-0.72,p=0.024). Afteradjustment for factors including BMI,history of smoking, hypertension, heart disease,CHOL, LDL,CRP and ALB, older age (OR1.07,95%CI:1.03-1.14, p=0.014), diabetesmellitus (OR3.23,95%CI:1.96-6.54, p<0.001), hyperphosphatemia (OR1.02, 95%CI:1.01-1.03, p=0.042), higher calcium-phosphorus product (OR1.32,95%CI:1.14-4.38, p=0.016) and lower vitamin D levels (OR2.26,95%CI:1.64-4.08,p=0.018) were independent risk factors for carotid plaques formation.Conclusion:1.CAPD patients generally have vitamin D deficiency.2.Compared withnormal controls, the incidence of carotid plaques is higher in CAPD patients with vitaminD deficiency.3.The levels of25(OH)D have linear negative correlation with carotid arteryIMT.4.The independent risk factors for carotid plaques formation included vitamin Ddeficiency, older age, diabetes mellitus,hyperphosphatemia, and higher calcium-phosphorus product.