Correlation between homocysteine and abdominal aortic calcification in non-dialysis patients with stage 5 chronic kidney disease

doi:10.3969/j.issn.1004-583X.2024.01.004

Abstract

Abstract:

Objective To evaluate the levels of homocysteine (Hcy) and abdominal aortic calcification (AAC) in patients with chronic kidney disease (CKD), and to explore the correlation between Hcy levels and AAC in CKD patients. Methods A total of 291 CKD patients who visited the Department of Nephrology at Cangzhou Central Hospital from December 1, 2019 to December 1, 2022 were selected. They were assigned into a calcified group ( $n$ =140) and a non calcified group ( $n$ =151) according to the evaluating results of lateral abdominal X-ray for AAC. The general information and Hcy levels were recorded between groups, and the correlation between Hcy levels and the occurrence of AAC in CKD patients was analyzed. Results The Hcy level in the calcified group was significantly higher than that of the non calcified group ( $P$ <0.05). Multivariate Logistic regression analysis suggests that elevated Hcy ( $O R$ =1.033, 95% $C I$ : 1.016-1.051, $P$ <0.01) was one of the independent risk factors for the occurrence of AAC in CKD patients. Conclusion High Hcy is one of the independent risk factors for the occurrence of AAC in CKD patients.

Key words: chronic kidney disease, homocysteine, abdominal aortic calcification

CLC Number:

R692

Yang Xingmeng, Ma Xiaoying, Sheng Yuping, Liu Ye, Zhang Haoran, Xu Haiping, Wang Na, Sun Fuyun. Correlation between homocysteine and abdominal aortic calcification in non-dialysis patients with stage 5 chronic kidney disease[J]. Clinical Focus, 2024, 39(1): 30-33.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.01.004

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I1/30

Figures/Tables 3

Tab.1 Comparison of general and laboratory between groups

项目	所有患者( $n$ =291)	钙化组( $n$ =140)	非钙化组( $n$ =151)	χ²/ $t$ 值	$P$ 值
年龄(岁)	56.72±14.56	64.89±10.55	49.15±13.67	-11.039	<0.01
男性[例(%)]	183(62.9)	87(62.1)	96(63.6)	0.064	0.809
使用钙剂[例(%)]	174(60.0)	74(52.8)	100(66.2)	5.087	0.031
体质量指数(kg/m²)	24.48±4.19	24.31±3.81	24.64±4.53	2.478	0.511
收缩压(mmHg)	151.24±22.45	151.21±23.42	151.27±21.59	0.022	0.983
舒张压(mmHg)	88.73±15.09	83.79±13.37	93.31±15.18	5.637	<0.01
糖尿病病史[例(%)]	103(35.4)	69(49.3)	34(22.5)	23.249	<0.01
高血压病史[例(%)]	266(91.4)	130(92.9)	136(90.1)	1.141	0.394
白蛋白(g/L)	36.59±5.64	36.41±5.85	36.75±5.46	0.526	0.599
C反应蛋白(mg/L)	5.6(1.3, 14.8)	7.5(1.8, 17.0)	5.1(1.3, 13.3)	0.050	0.824
血磷(mmol/L)	1.9(1.5, 2.2)	1.8(1.5, 2.1)	1.9(1.6, 2.3)	0.996	0.319
血钙(mmol/L)	1.95±0.29	1.99±0.26	1.91±0.31	4.555	0.014
血镁(mmol/L)	1.0(0.9, 1.1)	1.0(0.9, 1.1)	1.0(0.9, 1.1)	1.448	0.230
肌酐(umol/L)	656(506, 852)	612.0(491.0, 783.8)	693.0(541.0, 936.0)	8.590	0.004
尿素(mmol/L)	29.84±10.88	29.68±10.96	29.99±10.86	0.242	0.809
LDL-C(mmol/L)	2.67±0.97	2.77±1.04	2.58±0.89	-1.657	0.099
HDL-C(mmol/L)	1.1(0.9, 1.3)	1.1(0.9, 1.2)	1.1(0.8, 1.3)	0.878	0.350
胆固醇(mmol/L)	4.60±1.36	4.70±1.44	4.52±1.27	-1.068	0.287
甘油三酯(mmol/L)	1.3(1.1, 1.9)	1.3(1.1, 1.8)	1.3(1.1, 2.0)	2.332	0.128
碱性磷酸酶(U/L)	88.0(67.0, 131.3)	85.0(63.0, 126.0)	90.0(68.5, 136.0)	0.856	0.356
Hcy(mmol/L)	28.8(19.2, 42.4)	29.1(18.8, 42.0)	28.5(19.9, 47.0)	4.031	0.046
甲状旁腺激素(ng/L)	276.7(146.8, 455.6)	258.8(131.8, 380.9)	298.0(204.6, 462.6)	9.869	0.002

Tab.1 Comparison of general and laboratory between groups

项目	所有患者( $n$ =291)	钙化组( $n$ =140)	非钙化组( $n$ =151)	χ²/ $t$ 值	$P$ 值
年龄(岁)	56.72±14.56	64.89±10.55	49.15±13.67	-11.039	<0.01
男性[例(%)]	183(62.9)	87(62.1)	96(63.6)	0.064	0.809
使用钙剂[例(%)]	174(60.0)	74(52.8)	100(66.2)	5.087	0.031
体质量指数(kg/m²)	24.48±4.19	24.31±3.81	24.64±4.53	2.478	0.511
收缩压(mmHg)	151.24±22.45	151.21±23.42	151.27±21.59	0.022	0.983
舒张压(mmHg)	88.73±15.09	83.79±13.37	93.31±15.18	5.637	<0.01
糖尿病病史[例(%)]	103(35.4)	69(49.3)	34(22.5)	23.249	<0.01
高血压病史[例(%)]	266(91.4)	130(92.9)	136(90.1)	1.141	0.394
白蛋白(g/L)	36.59±5.64	36.41±5.85	36.75±5.46	0.526	0.599
C反应蛋白(mg/L)	5.6(1.3, 14.8)	7.5(1.8, 17.0)	5.1(1.3, 13.3)	0.050	0.824
血磷(mmol/L)	1.9(1.5, 2.2)	1.8(1.5, 2.1)	1.9(1.6, 2.3)	0.996	0.319
血钙(mmol/L)	1.95±0.29	1.99±0.26	1.91±0.31	4.555	0.014
血镁(mmol/L)	1.0(0.9, 1.1)	1.0(0.9, 1.1)	1.0(0.9, 1.1)	1.448	0.230
肌酐(umol/L)	656(506, 852)	612.0(491.0, 783.8)	693.0(541.0, 936.0)	8.590	0.004
尿素(mmol/L)	29.84±10.88	29.68±10.96	29.99±10.86	0.242	0.809
LDL-C(mmol/L)	2.67±0.97	2.77±1.04	2.58±0.89	-1.657	0.099
HDL-C(mmol/L)	1.1(0.9, 1.3)	1.1(0.9, 1.2)	1.1(0.8, 1.3)	0.878	0.350
胆固醇(mmol/L)	4.60±1.36	4.70±1.44	4.52±1.27	-1.068	0.287
甘油三酯(mmol/L)	1.3(1.1, 1.9)	1.3(1.1, 1.8)	1.3(1.1, 2.0)	2.332	0.128
碱性磷酸酶(U/L)	88.0(67.0, 131.3)	85.0(63.0, 126.0)	90.0(68.5, 136.0)	0.856	0.356
Hcy(mmol/L)	28.8(19.2, 42.4)	29.1(18.8, 42.0)	28.5(19.9, 47.0)	4.031	0.046
甲状旁腺激素(ng/L)	276.7(146.8, 455.6)	258.8(131.8, 380.9)	298.0(204.6, 462.6)	9.869	0.002

Tab.2 Correlation analysis between AAC and other variables

项目	$r s$ 值	$P$ 值
年龄(岁)	0.541	<0.01
钙剂	-0.132	0.024
肌酐	-0.170	0.004
Hcy	0.119	0.046
舒张压	-0.316	<0.01
糖尿病	0.283	<0.01

Tab.2 Correlation analysis between AAC and other variables

项目	$r s$ 值	$P$ 值
年龄(岁)	0.541	<0.01
钙剂	-0.132	0.024
肌酐	-0.170	0.004
Hcy	0.119	0.046
舒张压	-0.316	<0.01
糖尿病	0.283	<0.01

Tab.3 Logistic regression analysis of risk factors of AAC in CKD patients

因素	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
因素	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	下限	上限
年龄	0.105	0.016	42.365	<0.01	1.111	1.076	1.147
钙剂	-0.150	0.345	0.189	0.664	0.861	0.438	1.692
肌酐	0.000	0.001	0.013	0.908	1.000	0.999	1.001
LDL-C	0.533	0.171	9.708	0.002	1.704	1.219	2.383
Hcy	0.033	0.008	14.888	<0.01	1.033	1.016	1.051
舒张压	-0.022	0.013	2.851	0.091	0.979	0.954	1.003
糖尿病	1.274	0.355	12.898	<0.01	3.574	1.784	7.163

Tab.3 Logistic regression analysis of risk factors of AAC in CKD patients

因素	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
因素	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	下限	上限
年龄	0.105	0.016	42.365	<0.01	1.111	1.076	1.147
钙剂	-0.150	0.345	0.189	0.664	0.861	0.438	1.692
肌酐	0.000	0.001	0.013	0.908	1.000	0.999	1.001
LDL-C	0.533	0.171	9.708	0.002	1.704	1.219	2.383
Hcy	0.033	0.008	14.888	<0.01	1.033	1.016	1.051
舒张压	-0.022	0.013	2.851	0.091	0.979	0.954	1.003
糖尿病	1.274	0.355	12.898	<0.01	3.574	1.784	7.163

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