Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Dis Markers. 2013;34(4):229-35. doi: 10.3233/DMA-130965.
Cardiovascular calcification, including arterial intimal and medial calcification (AIC and AMC) and valvular calcification (VC) are important predictors of outcome in chronic dialysis patients. We aimed to compare their prevalence and analyze respective risk factors in hemodialysis (HD) patients.
A total of 81 HD patients were enrolled. Vascular calcification was assessed by plain film radiography of the pelvis and VC was diagnosed by echocardiography. Demographic data was reviewed and serum levels of calcification-relevant biomarkers were determined. Patients with and without calcification were then compared.
The prevalence study indicated that 36 patients had AIC (44.4%), 17 had AMC (21%) and 60 (74.1%) had VC. Patients with vascular calcification were older, and had a higher prevalence of diabetes. Their IL-6, osteoprotegerin, and uric acid levels were higher. Serum fetuin-A was lower in patients with VC. Logistic regression analysis revealed age, uric acid and diabetes to be independently associated with AIC; uric acid, diabetes and osteoprotegerin with AMC. Fetuin-A was the sole associate of VC.
It is concluded that the prevalence of cardiovascular calcification in chronic HD patients was high with cardiac valve involvement more frequent. Factors associated with different type of calcification were not identical. Changes in biomarkers may represent clinical clues for assessment of cardiovascular calcification in HD patients.
心血管钙化，包括动脉内膜和中膜钙化（AIC 和 AMC）和瓣膜钙化（VC），是慢性透析患者预后的重要预测因素。我们旨在比较血液透析（HD）患者中它们的患病率，并分析各自的危险因素。
共纳入 81 名 HD 患者。通过骨盆的平片评估血管钙化，通过超声心动图诊断 VC。回顾了人口统计学数据，并测定了钙化相关生物标志物的血清水平。然后比较有和没有钙化的患者。
患病率研究表明，36 名患者有 AIC（44.4%），17 名有 AMC（21%），60 名（74.1%）有 VC。有血管钙化的患者年龄较大，且糖尿病的患病率较高。他们的 IL-6、骨保护素和尿酸水平较高。VC 患者的血清胎球蛋白 A 较低。Logistic 回归分析显示年龄、尿酸和糖尿病与 AIC 独立相关；尿酸、糖尿病和骨保护素与 AMC 相关。胎球蛋白 A 是 VC 的唯一相关因素。
总之，慢性 HD 患者心血管钙化的患病率较高，且心脏瓣膜受累更为常见。与不同类型钙化相关的因素并不相同。生物标志物的变化可能代表了评估 HD 患者心血管钙化的临床线索。
