Correlation Analysis Of Bone Morphogenetic Protein 2 With Coronary Calcification And Markers Of Bone Metabolism In Patients With Uremia

Objective: Cardiovascular disease is a main cause of mortality in uremia patients.Vascular calcification is an independent risk factor for cardiovascular mortality.It is a pathological process in which vascular smooth muscle cells are transformed into osteoblastic cells and ectopic bone mineralization occurs.This study aimed to investigate the correlation between morphogenetic protein 2(BMP-2)and coronary calcification and bone metabolic markers in patients with uremia.Methods: Patients with uremia who were hospitalized in our hospital from April 2019 to January 2020 without dialysis treatment were selected as uremia group.According to inclusion and exclusion criteria,a total of 39 patients were enrolled,with an mean age of 60.59±14.7 years.A total of 30 patients with an mean age of 57.93±15.94 years were enrolled in the control group.Basic clinical data were collected on all subjects,including age,sex,blood pressure,height,weight and primary disease.Testing related clinical indicators: hemoglobin(Hb),albumin(ALB),calcium(Ca),phosphorus(P),creatinine(Cre),urea nitrogen(Urea),intact parathyroid hormone(i PTH),triglycerides(TG),cholesterol(TC)and uric acid(UA),calcitonin(CT),alkaline phosphatase(ALP),osteocalcin(OC),total procollagen type1 amino-terminal propeptide(t P1NP),25-hydroxyitamin D(25(OH)D),b collagen degradation products(b-CTX).Collecting Fasting venous blood to detect BMP-2 levels by ELISA kit.Meanwhile,multi-slice spiral CT was used to evaluate coronary artery calcification score(CACS).Statistical analyses were performed by SPSS 26.0 software,and P<0.05 was considered significant difference.Results: Compared with the healthy control group,the systolic blood pressure,UA,Cre,Urea and BMP-2 in uremia patients were significantly increased,and the Hb,ALB and TC level decreased,and there was a statistical difference(P<0.05).The incidence of coronary calcification in the uremia group was 66.7%,and those with two or more coronary calcifications at the same time accounted for 92.3%.Age,Hb and BMP-2 in the coronary calcification group were significantly higher than those in the non-calcification group,while OC and t P1 NP were lower than those in the non-calcification group,with statistical significance(P<0.05).Intergroup analysis of different degrees of coronary calcification showed that age,i PTH,25(OH)D,OC and BMP-2 had statistical significance.Among which BMP-2 and i PTH in the severe calcification group were significantly higher than those in the non-calcification and mild to moderate calcification groups,25(OH)D in the moderate calcification group was significantly higher than that in the non-calcification and mild calcification groups and OC in the severe calcification group were significantly lower than those in the non-calcification group.Correlation analysis showed that BMP-2 was positively correlated with i PTH,P,CACS,and negatively correlated with OC,t P1NP(P<0.05).Age and serum BMP-2 level were risk factors for coronary calcification(p<0.05).Conclusions: Our study demonstrates that serum BMP-2 level in uremia patients is significantly higher than that in healthy people,and serum BMP-2 levels in patients with coronary calcification were significantly higher than in those without calcification.BMP-2 is positively correlated with CACS,and negatively correlated with OC and t P1 NP,which is a risk factor for coronary calcification.