Correlation Study Of The Relationship Between Serum Vitamin K2 And Vascular Calcification In Peritoneal Dialysis Patients

OBJECTIVE:To compare the differences of serum vitamin K2(VK2)levels between different vascular calcification(VC)groups in continuous Ambulatory Peritoneal Dialysis(CAPD)patients and to investigate the relationship between serum VK2 levels and CAPD Patient VC relevance.METHODS:A total of 66 CAPD patients were enrolled in the outpatient department of PD at the Municipal Hospital of Qingdao City from October 2016 to June2017.All patients had a low Ca2~+concentration of 1.5%or a low Ca2~+concentration of1.24 mmol/L 2.5%PD solution(purchased from the United States Baxter company)for standardized CAPD treatment,dialysis age greater than 3 months.Exclusion of pregnancy,primary hyperparathyroidism,severe infection in nearly 1 month,nearly 1month history of surgery,fractures,severe liver dysfunction,cachexia,cancer patients,with mental illness.The basic information of the patients was collected and the subjects'names,sex,age,height and weight were recorded.Body mass index(BMI,BMI=body weight(kg)/height,(BUN),creatinine(CR),Uric acid(UA),low density lipoprotein(LDL),high density lipoprotein(HDL),Total Cholesterol(TC),Triglycerides(TG),Alkaline Phosphatase(ALP),Albumin(ALB),Glucose Calcium,CA~+),Phosphorus(P~+),Parathyroid Hormone(iPTH),Hypersensitive C-reactive Protein(Hs-CRP)Serum VK2 concentration was measured by immunoadsorption assay(ELISA).Abdominal Aortic Calcification Score,AACS.According to the segmentation method used in the CORD experiment,the distribution of AACS scores of control patients was divided into:no,or less calcified group(0?AACS?4),moderate calcification group(5?AACS?15)and severe calcification group(AACS?16).Using SPSS17.0 software to complete the processing and analysis,to meet the normal distribution of the data belonging to the measurement data,the application(x±s)said,and the data consistent with the count data,We use the number of cases or percentage to represent.For the correlation analysis of the data belonging to the normal distribution,the study uses the Pearson test method.For the data between multiple groups,belonging to the measurement data,we use One way ANOVA was used to analyze the relationship between serum VK2concentration and AACS and each clinical index.If the result shows that P<0.05,we think the difference is statistically significant.Result:1.Selected 66 cases of CAPD patients,the concentration of serum VK2(3.73±2.07)pg/ml.2.Pearson correlation analysis showed that serum VK2 levels were positively correlated with AACS scores of CAPD patients(r=-0.342,p=0.005),LDL(r=-0.321,p=0.009)0.001),TG(r=-0.252,p=0.041),TC(r=-0.286,p=0.02)and ALP(r=-0.302,p=0.014).Serum vitamin K2 level had no correlation with blood Ca~+(r=-0.071,p=0.57),blood P~+(r=-0.005,p=0.966)and iPTH(r=-0.191,p=0.132).3.Abdominal lateral X-ray showed that AAC occurred in 37 of 66 patients(56.06%of the total).Among these patients,50%(33%)had no or mild calcification,37.8%(25%)had moderate calcification,and 12.2%(8%)had severe calcification.Serum VK2 levels in CAPD patients differed among different degrees of calcification,with serum VK2 levels(2.85±1.97 pg/ml)in patients with severe VC being significantly lower than those in moderate VC patients(3.17±1.04 pg/ml)and Serum VK2 levels were(4.37±2.49 pg/ml)in no or mild VC patients(P<0.05).4.The levels of VK2,diastolic blood pressure,dialysis age,Serum P~+,HS-CRP,BUN,ALP and ALB levels,iPTH are differences in different calcifications Group(P<0.05).Diastolic blood pressure was lower in patients with severe AACS(P=0.034).Patients with severe AACS had a longer dialysis age(P=0.007),higher blood P~+(P=0.042),higher HS-CRP(P=0.004),lower serum ALB(P=0.019),higher BUN level(P=0.018)and a higher iPTH level(P=0.049).5.The levels of AACSare no differences in different calcifications Group with TC?TG?HDL?LDL?Serum Scr?Serum UA?BMI.TC(P=0.138)?TG(P=0.539)?HDL(P=0.797)?LDL(P=0.233)?Serum calcium(P=0.239)?Serum Scr(P=0.282)?Serum UA(P=0.700)?BMI(P=0.534)(P>0.05).Conclusion:Serum vitamin K2 levels are associated with the severity of vascular calcification in peritoneal dialysis patients.With the decrease of serum vitamin K2levels,the degree of abdominal aortic calcification in peritoneal dialysis patients gradually increased.Serum vitamin K2 levels were associated with low-density lipoprotein,high-density lipoprotein,serum alkaline phosphatase,total cholesterol,and triglycerides in peritoneal dialysis patients.