Association Of Homocysteine,C-reactive Protein And Vascular Calcification In Uremic Patients

Objective: Cardiovascular disease has been cause of death in chronic kidney disease patients.Vascular calcification in patients with end-stage renal disease is strong predictor of cardiovascular events and death,myocardial infarction and sudden cardiac arrest and other cardiovascular events are closely related.Homocysteine is a sulfur-containing essential amino acid,participate in methionine metabolism.Homocysteine is chronic kidney disease one of the non-traditional risk factors of cardiovascular disease,and end-stage renal disease prevalence and mortality of cardiovascular disease,an independent predictors.This study was to explore uremia patients serum homocysteine,serum C-reactive protein and the correlation of vascular calcification.Methods: We selected 62 uremic patients who were hospitalized from 2014 November to January 2016,in Department of Nephrology,First Affiliated Hospital of Dalian Medical University.Inclusion criteria:(1)The patients meet the standard definition of CKD from American K/DOQI,and their e GFR which was calculated according to MDRD formula,reached stage 5;(2)All the selected candidates agreed to the study protocol and signed informed consent.Exclusion criteria:(1)the use of effect of folic acid metabolism drugs within 3 months(folic acid and B vitamins)patients;(2)Clearly have apparent infection patients;The general information of patients was collected.Serum total homocysteine,C-reactive protein and some otherbiochemical indicators such as serum Cre,BUN,ALB,Ca,P,TG,TC,Hb,LDL-C,i PTH of them were detected at the same time.The uremia patients received coronary CT scans to determine coronary arterial calcification score(CACS)and received whole abdominal CT scans to calculate abdominal aortic calcification index(AACI).The data was analyzed by SPSS.19.0 software.Differences between mean values of two groups were assessed t-test;Differences between multiple groups were used one-way ANOVA.Pearson's correlation coefficient was used to test the association between two kinds of parameters.P<0.05 was considered statistically significant.Results: In 40 uremic patients,who also received coronary CT scans and Serum index,CAC group presented higher tHcy,compared to non-CAC group.Serum Cre,BUN,ALB,Ca,P,TG,TC,Hb,LDL-C and i PTH had no significant difference between CAC and non-CAC group.In 29 uremia patients,who also received coronary CT scans and CRP,the statistical results in CAC group of CRP significantly elevated in non-CAC group,sex ratio,age differences between the two groups has no statistical significance.Comparison of different calcification degree between the four groups,tHcy and CRP had no significant difference in statistics.In 50 uremic patients,who also received abdominal CT scans and Serum index,AACI group presented higher tHcy,compared to non-AACI group.sex ratio,age,Serum Cre,BUN,ALB,Ca,P,TG,TC,Hb,LDL-C and i PTH had no significant difference between AACI and non-AACI group.In 39 uremia patients,who also received abdominal CT scans and CRP,abdominal aortic calcification in positive elevated CRP in the negative group,but there was no statistically significant difference.Comparison of different calcification degree between the four groups,severe abdominal aortic calcification group presented higher tHcy compared to negative group,but CRP had no significant difference in statistics.Hypertension group had no significant difference with tHcy compared to non hypertension group.The DN patients had no significant difference with tHcy compared to non-DN patients.lower segment AACI was significantly positively correlated with tHcy(r=0.558,P=0.000).The significant positive correlations of log10[CACS+1](r=0.318,P=0.045)and tHcy were found.CRP and CACS,AACI had no significant correlation in statistics.Conclusion: Coronary artery calcification group presented higher tHcy,CRP compared to negative group.Abdominal aortic calcification presented higher tHcy compared to non-AACI group,severe calcification group presented higher compared to negative group.CACS,AACI were positively correlated with tHcy.