Role Of Adiponectin And Relative Inflammatory Factors In Carotidatherosclerosis Patients With End-stage Renal Disease

Objective:To investigate the expression and correlation of adiponectin and relative inflammatory factors and to analyze its possible molecular mechanism in carotidatherosclerosis patients with end-stage renal disease(ESRD).Methods:We carried on our reseach by case-control method.From March 2015 to March 2016 in the Department of nephrology in our hospital,we collected 64 patients of carotid atherosclerosis with end stage renal disease(ESRD)as the experimental group(ESRD group).In the same term,we chosed 42 patients of carotid atherosclerosi-s without chronic kidney disease(CKD)as positive control group(non CKD group).30 healthy volunteers were used as normal control group.We tested serum adiponectin and serumtumor necrosis factor alpha(TNF-a)by enzyme-linked immunosorbent assay.Methods of sarcosine oxidase,Urease continuous monitorion and immune transmission turbidity were respectively used to meseaure the serum concentration of creatinine,urea and C reactive protein(CRP).Real-time quantitative PCR(RT-PCR)were used to detected the expressionof adiponectin DNAin peripheral blood mononuclear cells.We detected carotid artery intima-media thickness(IMT)and atherosclerotic plaque by high resolution ultrasound.All data were expressed as mean±standard deviation,and single factor analysis of variance was used in each group.Correlation analysis was conducted by Pearson correlation analysis,and multiple factor Logistic regression analysis was used to analyze independent risk factors.Results: In ESRD group,levels of CRP,TNF-a and IMT were respectively11.18±8.62 mmol/L,37.69±12.73 ng/L and 0.79±0.13 mm,which were higher than the normal control group of 4.28±3.86 mmol/L 30.30±9.96 mm and 0.56±0.10 ng/L(P<0.01),lower than non CKD group of 18.19 ±11.67mmol/L,124.86±37.86 ng/L and0.98±0.14 mm(P<0.01).In ESRD group,level of ADPN was 46.20±10.62 g/mL,higher than the normal control group(13.15±4.33 g/mL)and non CKD group of4.99±1.48 ug/m L(P<0.01).In ESRD group,the relative expression of ADPN mRNA was 0.185±0.121,lower than the normal group of 1.502 ±1.09(P<0.01)),and non CKD group of 0.184 ±0.095.Compared ESRD group with non CKD group,levels expression of ADPN mRNA were not statistically significant.In ESRD group,the correlation coefficient between ADPN and Scr,BUN,eGFR were respective 0.634,0.638,-0.871(P<0.01),the correlation coefficient between ADPN and CRP,TNF-a,IMT were respectively-0.307,-0.779 and-0.538(P<0.01).In ESRD group,the correlation coefficient between CRP and BUN,Scr,eGFR were respectively 0.952,0.832 and-0.925(P<0.01).In ESRD group,the correlation coefficient between TNF-a and BUN,Scr,eGFR were respectively 0.973,0.862 and-0.916(P<0.01).In ESRD group,the correlation coefficient between IMT and CRP,TNF-a were espectively0.912 and 0.896(P<0.01).In ESRD group,the OR values of CRP and TNF-a were 27.376 and 36.512,95% CI were respectively 1.935~387.325 and 1.335~998.385.Conclusion:(1)There were high serum concentration of ADPN and low expression of ADPN mRNA in patients of carotid atherosclerosis with ESRD.ADPN was negatively correlated with eCFR,which suggested that high serumconcentrations of ADPN may not be caused by the mRNA regulation,mainly affected kidney function.(2)In patients of carotidatherosclerosis with ESRD,carotidatherosclerosis IMT was positively correlated with CRP and TNF-a.CRP and TNF-awere independent the risk factors of carotidatherosclerosis patients with ESRD.(3)In patients of carotidatherosclrosis with ESRD,ADPN was negatively correlated with IMT,CRP and TNF-a,ADPNmay inhibit inflammatory reaction and carotidatherosclerosis of ESRD patients.