Correlation between serum CTRP5 and left ventricular diastolic dysfunction in patients with continuous ambulatory peritoneal dialysis and its diagnostic value

doi:10.3969/j.issn.1004-583X.2023.04.006

Abstract

Abstract:

Objective To investigate the correlation between serum complement C1q/tumor necrosis factor related protein 5 (CTRP5) and left ventricular diastolic dysfunction (LVDD) in patients with continuous ambulatory peritoneal dialysis (CAPD), and to evaluate the diagnostic value of serum CTRP5 for LVDD in CAPD patients. Methods A total of 114 CAPD patients who were regularly followed up and treated at the Affiliated Hospital of Chengde Medical College from December 2020 to August 2021 were selected, and their clinical data were collected. Patients were allocated to LVDD group (n=85) and normal left ventricular diastolic function (NLVDD) group (n=29) based on the presence or absence of LVDD. The multivariate Logistic regression analysis was performed to explore the independent risk factors of LVDD in CAPD patients, and diagnostic models were established based on each independent risk factors. The diagnostic value of various risk factors and diagnostic models for LVDD in CAPD patients was assessed using receiver operating characteristic (ROC) curves. Results Compared with those in NLVDD group, patients in LVDD group were older, and the proportion of diabetes, systolic blood pressure, serum CTRP5, and brain natriuretic peptide (BNP) levels were significantly higher, while albumin levels were significantly lower (P<0.05). Multivariate logistic analysis showed that age, serum CTRP5, and BNP were independent risk factors for LVDD in CAPD patients (P<0.05). The ROC curve showed that the area under the curve (AUC) of serum CTRP5 for diagnosing LVDD in CAPD patients was 0.902(95%CI: 0.828-0.975), with a cut-off value of 36.78 ng/ml (sensitivity=0.894, specificity=0.862). The AUC of LVDD in CAPD patients diagnosed with serum BNP was 0.886(95%CI: 0.821-0.950), with a cut-off value of 748.22 pg/ml (sensitivity=0.859, specificity=0.759). The AUC of LVDD in CAPD patients diagnosed with age was 0.773(95%CI: 0.678-0.868), with a cut-off value of 47.50 years old (sensitivity=0.753, specificity=0.690). A diagnostic model for predicting the risk of LVDD in CAPD patients was as follows: Y=-12.472+0.139×CTRP5+0.005×BNP+0.083×Age. The AUC of LVDD in CAPD patients diagnosed with this model was 0.933(95%CI: 0.875-0.991), with a cut-off value of 0.401(sensitivity=0.918, specificity=0.897).Conclusion Age, serum CTRP5, and BNP are independent risk factors for LVDD in CAPD patients. The diagnostic efficacy of the diagnostic model based on the independent risk factors of LVDD in patient with CAPD is better than a single indicator, providing clinical reference for timely detection of LVDD in CAPD patients.

Key words: peritoneal dialysis, continuous ambulatory, complemented-C1q/tumor necrosis factor-related protein 5, natriuretic peptide, brain, left ventricular diastolic function, diagnostic value

CLC Number:

R459.5

Li Hengnan, Huang Yan, Zhao Yajuan, Hu Guicai. Correlation between serum CTRP5 and left ventricular diastolic dysfunction in patients with continuous ambulatory peritoneal dialysis and its diagnostic value[J]. Clinical Focus, 2023, 38(4): 324-329.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.04.006

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I4/324

Figures/Tables 7

References 24

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组别	例数	年龄(岁)	性别(例)		BMI(kg/m²)	HT(例)		DM(例)		SBP (mmHg)	DBP (mmHg)	24 h腹膜透析超滤量(ml)	24 h尿量 (ml)	CAPD龄 (月)
组别	例数	年龄(岁)	男	女	BMI(kg/m²)	有	无	有	无	SBP (mmHg)	DBP (mmHg)	24 h腹膜透析超滤量(ml)	24 h尿量 (ml)	CAPD龄 (月)
NLVDD组	29	42.00±11.25	21	8	23.35±3.04	29	0	1	28	140.90±24.57	95.76±19.16	580(200, 900)	450(0, 775)	21(5.5, 55)
LVDD组	85	53.96±11.17	44	41	23.83±3.25	82	3	24	61	152.89±24.67	93.81±17.08	650(450, 1 000)	200(0, 600)	32(8.5, 63)
统计值		t=-4.972	χ²=3.762		t=-0.693			χ²=7.760		t=-2.264	t=0.514	Z=-1.511	Z=-0.932	Z=-1.087
P值		0.000	0.052		0.490	0.569		0.005		0.026	0.608	0.131	0.352	0.277

组别	例数	年龄(岁)	性别(例)		BMI(kg/m²)	HT(例)		DM(例)		SBP (mmHg)	DBP (mmHg)	24 h腹膜透析超滤量(ml)	24 h尿量 (ml)	CAPD龄 (月)
组别	例数	年龄(岁)	男	女	BMI(kg/m²)	有	无	有	无	SBP (mmHg)	DBP (mmHg)	24 h腹膜透析超滤量(ml)	24 h尿量 (ml)	CAPD龄 (月)
NLVDD组	29	42.00±11.25	21	8	23.35±3.04	29	0	1	28	140.90±24.57	95.76±19.16	580(200, 900)	450(0, 775)	21(5.5, 55)
LVDD组	85	53.96±11.17	44	41	23.83±3.25	82	3	24	61	152.89±24.67	93.81±17.08	650(450, 1 000)	200(0, 600)	32(8.5, 63)
统计值		t=-4.972	χ²=3.762		t=-0.693			χ²=7.760		t=-2.264	t=0.514	Z=-1.511	Z=-0.932	Z=-1.087
P值		0.000	0.052		0.490	0.569		0.005		0.026	0.608	0.131	0.352	0.277

组别	例数	HGB (g/L)			ALB (g/L)			TBIL (μmol/L)		TG (mmol/L)		TCH (mmol/L)		HDL-C (mmol/L)
NLVDD组	29	115.31±15.20			42.40(39.60, 46.10)			6.80(5.55, 8.51)		1.34(0.93, 1.96)		4.16(3.50, 5.10)		1.08(0.94, 1.51)
LVDD组	85	110.06±18.01			41.00(37.95, 43.65)			6.40(4.80, 7.60)		1.45(1.04, 2.32)		4.39(3.94, 5.15)		1.17(0.97, 1.47)
统计值		t=1.407			Z=-2.157			Z=-1.494		Z=-1.432		Z=-1.113		Z=-0.293
P值		0.162			0.031			0.135		0.152		0.266		0.770
组别	LDL-C (mmol/L)			P (mmol/L)			Ca (mmol/L)		钙磷乘积 (mmol²/L²)		BUN (mmol/L)			CRE (μmol/L)
NLVDD组	2.51(2.08, 3.30)			1.63(1.47, 1.81)			2.24±0.22		3.59(3.09, 4.20)		21.37±4.95			1025.56±259.73
LVDD组	2.68(2.19, 3.37)			1.44(1.16, 1.82)			2.24±0.24		3.19(2.60, 4.08)		19.98±5.70			954.05±269.38
统计值	Z=-0.839			Z=-1.399			t=0.002		Z=-1.480		t=1.171			t=1.245
P值	0.401			0.162			0.998		0.139		0.244			0.216
组别	UA (μmol/L)		Cys-c (mg/L)			FERR (ng/ml)			PTH (pg/ml)				CTRP5 (ng/ml)		BNP (pg/ml)
NLVDD组	399.55±74.83		7.39(6.67, 8.33)			247.00(84.25, 454.45)			295.00(130.50, 471.00)				33.45±8.77		656.81±143.15
LVDD组	400.16±86.11		7.64(6.65, 8.36)			174.50(100.30, 319.50)			249.00(133.15, 399.15)				46.29±10.12		962.44±242.22
统计值	t=-0.034		Z=-0.026			Z=-1.067			Z=-0.439				t=-6.093		t=-6.412
P值	0.973		0.979			0.286			0.661				0.000		0.000

组别	例数	HGB (g/L)			ALB (g/L)			TBIL (μmol/L)		TG (mmol/L)		TCH (mmol/L)		HDL-C (mmol/L)
NLVDD组	29	115.31±15.20			42.40(39.60, 46.10)			6.80(5.55, 8.51)		1.34(0.93, 1.96)		4.16(3.50, 5.10)		1.08(0.94, 1.51)
LVDD组	85	110.06±18.01			41.00(37.95, 43.65)			6.40(4.80, 7.60)		1.45(1.04, 2.32)		4.39(3.94, 5.15)		1.17(0.97, 1.47)
统计值		t=1.407			Z=-2.157			Z=-1.494		Z=-1.432		Z=-1.113		Z=-0.293
P值		0.162			0.031			0.135		0.152		0.266		0.770
组别	LDL-C (mmol/L)			P (mmol/L)			Ca (mmol/L)		钙磷乘积 (mmol²/L²)		BUN (mmol/L)			CRE (μmol/L)
NLVDD组	2.51(2.08, 3.30)			1.63(1.47, 1.81)			2.24±0.22		3.59(3.09, 4.20)		21.37±4.95			1025.56±259.73
LVDD组	2.68(2.19, 3.37)			1.44(1.16, 1.82)			2.24±0.24		3.19(2.60, 4.08)		19.98±5.70			954.05±269.38
统计值	Z=-0.839			Z=-1.399			t=0.002		Z=-1.480		t=1.171			t=1.245
P值	0.401			0.162			0.998		0.139		0.244			0.216
组别	UA (μmol/L)		Cys-c (mg/L)			FERR (ng/ml)			PTH (pg/ml)				CTRP5 (ng/ml)		BNP (pg/ml)
NLVDD组	399.55±74.83		7.39(6.67, 8.33)			247.00(84.25, 454.45)			295.00(130.50, 471.00)				33.45±8.77		656.81±143.15
LVDD组	400.16±86.11		7.64(6.65, 8.36)			174.50(100.30, 319.50)			249.00(133.15, 399.15)				46.29±10.12		962.44±242.22
统计值	t=-0.034		Z=-0.026			Z=-1.067			Z=-0.439				t=-6.093		t=-6.412
P值	0.973		0.979			0.286			0.661				0.000		0.000

项目	B	SE	Wald χ²值	P值	OR值	95%CI
项目	B	SE	Wald χ²值	P值	OR值	下限	上限
年龄	0.098	0.031	9.919	0.002	1.103	1.038	1.173
ALB	-0.014	0.102	0.018	0.895	0.987	0.807	1.206
DM	0.025	0.016	2.518	0.113	1.026	0.994	1.058
SBP	1.878	1.221	2.366	0.124	6.539	0.598	71.556
CTRP5	0.123	0.058	4.427	0.035	1.131	1.008	1.268
BNP	0.005	0.003	4.030	0.045	1.005	1.000	1.010