The Relationship Between C-reactive Protein To Albumin Ratio,alkaline Phosphatase To Albumin Ratio And Coronary Artery Calcification In Patients With Chronic Kidney Disease At The 3～5 Stage

Objective To analyze the risk factors of coronary artery calcification(CAC)in chronic kidney disease(CKD)patients at the 3～5 stage,and to investigate the value of C-reactive prote in to albumin ratio(CAR)and alkaline phosphatase to albumin ratio(APAR)in the pred iction of CAC.Methods This was a cross-sectional and retrospective study on the CKD patients at 3～5 stag e.According to the Agatston method,the coronary artery calcium score(CACS)of the s tudy population was assessed,and the patients were divided into a non-calcification gro up(88 cases)(CACS 0-10 points)and a calcification group(87 cases)(CACS≥11 poin ts).The differences of CAR and APAR were analyzed between the two groups.Spearma n correlation was used to analyze the correlation between CAR,APAR and CAC.Binar y logistic regression was used to analyze the risk factors of CAC.The receiver operating characteristic(ROC)curve was used to explore the values of CAR and APAR in the pre diction of CAC.Results (1)The detection rate of CAC was 49.7% in the 175 CKD patients at 3～5 stage,in cluding calcification group(CACS≥11,n=87)and non-calcification group(CACS<10,n=88).(2)Spearman correlation analysis showed that age,proportion of dialysis treatme nt,diabetes prevalence,serum creatinine,APAR and CAR in calcification group were si gnificantly higher than those in non-calcification group(P<0.05).Binary Logistic regres sion analysis showed that age(OR=1.047,95%CI:1.012～1.083,P=0.007),diabetes(OR=0.132,95%CI:0.038～0.456,P=0.001),CAR(OR=16.332,95%CI:2.415～110.447,P=0.004),APAR(OR=1.500,95%CI:1.043～2.155,P=0.029)were independent risk factors fo r CAC.(3)ROC curve analysis showed that when CAR,APAR,age and diabetes predi cted CAC in the CKD patients at 3～5 stage,the areas under the curve were 0.765(95%C I:0.695～0.835,P<0.001),0.648(95%CI:0.567～0.730,P=0.001),0.698(95%CI:0.620～0.776,P<0.001),0.612(95%CI:0.528～0.696,P=0.011).Conclusions The detection rate of coronary artery calcification i in the CKD patients at 3～5stage was 49.7%,and the detection rate of severe calcification in patients with calcium was 32.2%.Age,diabetes,CAR and APAR were positively correlated with the occurrence of coronary artery calcification in the CKD patients at 3～5 stage.CAR and APAR are important independent risk factors for coronary artery calcification,and CAR have good predictive value for the presence of coronary artery calcification.