Analysis Of Risk Factors Of Coronary Artery Calcification In Patients With Chronic Kidney Disease Stage 3-5 And Its Correlation With Iron Metabolism Index

Objective:To evaluate the hazard factors of coronary artery calcification(CAC)in patients with chronic kidney disease(CKD)stage 3-5 and the relationship between iron metabolism indexes and CAC.Methods:One hundred and sixty-two patients with CKD stage 3-5 were recruited from The Department of Nephrology of The Second Hospital of Anhui Medical University.Clinical data and laboratory indexes were collected.Serum iron,ferritin,transferrin and total iron binding capacity(TIBC)were examined,and transferrin saturation(TSAT)was calculated.Ferrin>800μg/L and/or TSAT>50%were defined as iron overload.The coronary artery calcification score(CACs)was measured by multi-slice spiral computed tomography.According to CACs>10,patients were divided into calcification group and non-calcification group.To analyze the risk factors of CAC and the correlation between iron metabolism index and CAC,and to explore the predictive value of risk factors on CAC.Results:(1)Ninety-two patients(56.8%)were complicated with CAC.Diabetes prevalence rate,incidence rate of iron overload,age,neutrophil/lymphocyte ratio(NLR),serum phosphorus,calcium-phosphorus product,parathyroid hormone(i PTH)and ferritin in calcification group were higher than those in non-calcification group(P<0.05),while albumin(ALB),transferrin and TIBC levels were lower than those in non-calcification group(P<0.05).(2)Transferrin and TIBC were negatively correlated with CACs(r_svalues were-0.293,-0.253,P values were<0.001,0.001,respectively),the incidence of iron overload was positively correlated with CACs(r_s=0.200,P=0.011).(3)Binary logistic regression analysis showed that advanced age(OR=1.050,95%CI=1.013-1.088,P=0.007),diabetes(OR=4.712,95%CI=1.445-15.371,P=0.010),high NLR(OR=1.253,95%CI=1.025-1.533,P=0.028),high blood phosphorus(OR=3.981,95%CI=1.791-8.849,P=0.001),and the decreased level of transferrin(OR=0.130,95%CI=0.044-0.378,P<0.001)were independent risk factors of CAC.(4)ROC curve showed that the area under the curve of combined prediction of CAC by age,diabetes,NLR,blood phosphorus and transferrin was 0.828(95%CI0.766–0.891,P<0.001),the sensitivity was 79.3%,and the specificity was 75.7%.Conclusion:The incidence of coronary artery calcification is high in patients with chronic kidney disease stage 3-5.Advanced age,diabetes,hyperphosphatemia,high neutrophil/lymphocyte ratio and decreased blood transferrin level are independent risk factors of coronary artery calcification.The combined indicators of the above risk factors have good predictive value for the occurrence of coronary artery calcification.