Chandra Abhilash, Raj Gaurav, Awasthi Namrata P, Rao Namrata, Srivastava Divya
Department of Nephrology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Radiodiagnosis, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Saudi J Kidney Dis Transpl. 2020 Jan-Feb;31(1):136-143. doi: 10.4103/1319-2442.279933.
Coronary artery calcification is an acceptable tool for cardiovascular risk assessment in end-stage renal disease (ESRD) population. We aimed to identify the association and predictive value of components of blood cell parameters with coronary and thoracic aorta vascular calcification (VC) in ESRD population on dialysis. All ESRD patients receiving hemodialysis or peritoneal dialysis aged between 18 and 60 years were included in the study. Exclusion criteria comprised patients with active infection or inflammatory disease, autoimmune disease, congestive heart failure, angina pectoris and/or documented coronary artery disease, thyroid disease, and hepatic dysfunction. Agatston scoring was used for the evaluation of coronary aorta calcification (CAC) score (CACS) and thoracic aorta calcification (TAC) score (TACS). Compared to participants with no VC, those who had VC were statistically significantly older (P <0.001) and had higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) (P = 0.02 and <0.001, respectively). On multivariate logistic regression analysis, increasing age (P = 0.00) and higher PLR (P = 0.04) were associated with an increased likelihood of exhibiting VC (CAC or TAC). There was a positive correlation between CACS and age (rs = 0.495, P = 0.00). A statistically significant positive correlation existed between TACS and age (rs = 0.516, P = 0.00). Similarly, a positive correlation was found between NLR, PLR, and TACS (rs = 0.334, P = 0.001, and rs = 0.438, P = 0.00, respectively). On multivariate linear regression analysis, increased age and red cell distribution width were found to be significant predictors of log(n) TACS. PLR of 135 gave a sensitivity of 80% and a specificity of 50% for predicting VC. Being a cost-effective and easily available investigation, the utilization of the correlation of NLR and PLR with CAC and TAC appears promising, particularly in the age group of 30-60 years.
冠状动脉钙化是终末期肾病（ESRD）人群心血管风险评估的一种可接受工具。我们旨在确定血细胞参数各组分与接受透析的ESRD人群冠状动脉和胸主动脉血管钙化（VC）之间的关联及预测价值。该研究纳入了所有年龄在18至60岁之间接受血液透析或腹膜透析的ESRD患者。排除标准包括患有活动性感染或炎症性疾病、自身免疫性疾病、充血性心力衰竭、心绞痛和/或有记录的冠状动脉疾病、甲状腺疾病以及肝功能不全的患者。采用阿加斯顿评分法评估冠状动脉钙化（CAC）评分（CACS）和胸主动脉钙化（TAC）评分（TACS）。与无VC的参与者相比，有VC的参与者在统计学上年龄显著更大（P<0.001），中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）更高（分别为P = 0.02和<0.001）。在多因素逻辑回归分析中，年龄增加（P = 0.00）和PLR升高（P = 0.04）与出现VC（CAC或TAC）的可能性增加相关。CACS与年龄呈正相关（rs = 0.495，P = 0.00）。TACS与年龄在统计学上存在显著正相关（rs = 0.516，P = 0.00）。同样，在NLR、PLR与TACS之间也发现了正相关（分别为rs = 0.334，P = 0.001和rs = 0.438，P = 0.00）。在多因素线性回归分析中，年龄增加和红细胞分布宽度被发现是log(n)TACS的显著预测因素。PLR为135时，预测VC的灵敏度为80%，特异度为50%。作为一种经济有效且易于获得的检查方法，NLR和PLR与CAC和TAC的相关性应用前景广阔，尤其是在30至60岁年龄组。
