Correlation Between Carotid Artery Disease And Serum Fibroblast Growth Factor 23 And Homocysteine In Hemodialysis Patients

Objective: To investigate the carotid artery lesions in maintenance hemodialysis(MHD)patients,and to analyze carotid intima-media thickness(CIMT)and fibroblast growth factor 23(FGF23)in MHD patients.The relationship between homocysteine(Hcy)levels.Methods: 120 patients with MHD were enrolled.The expression of FGF23,C-reactive protein(CRP)and Hcy were detected by enzyme-linked immunosorbent assay(ELISA).The results of carotid color Doppler ultrasonography were divided into CIMT thickening group and CIMT normal group.Multivariate analysis of carotid lesions was performed using unconditional logistic regression analysis.Results:(1)Age,dialysis duration,triglyceride,low-density lipoprotein,and serum phosphorus in CIMT thickening group were higher than those in normal group(P<0.05).(2)FGF23,Hcy,PTH and CRP in CIMT thickening group were higher than normal group(P <0.05),while no significant difference was found Kt/V,mean arterial pressure,hemoglobin,albumin,total cholesterol,high density lipoprotein,blood calcium difference between these two groups(P>0.05).(3)The incidence of carotid plaques in CIMT thickening group was higher than that in normal group(P < 0.05).It is suggested that increased possibility of atherosclerosis presence with the age of the patient and the dialysis duration,while triglyceride,low density lipoprotein and phosphorus play a promoting role in the development of atherosclerosis.Moreover,elevated FGF23,Hcy,and CRP may be independent risk factors for carotid artery disease.Conclusions: Multivariate logistic regression analysis showed that elevated FGF23,Hcy and CRP were risk factors for carotid artery disease.FGF23,Hcy and CRP were positively correlated with carotid artery disease after adjusting for other risk factors.FGF23 is not only an important phosphorus regulator,but also a predictor of carotid atherosclerosis.Decreasing FGF23 may reduce the risk of ESRD atherosclerosis,thereby reducing the incidence of cardiovascular disease,and further research is needed to perform to elucidate about how to improve the clinical prognosis of chronic kidney disease by reducing FGF23.