Objective To investigate the association of vascular calcification,fetuin A and Creaction protein (CRP),and explore the influence on cardiovascular events.Methods Sixty peritoneal dialysis (PD) patients were enrolled in this study.Carotid intima-media thickness (cIMT),fetuin A and CRP,along with the other serum related parameters were detected to find out their influence on vascular calcification in PD patients.The relationship between cIMT,fetuin A,CPR and cardiovascular events was analyzed in PD patients with 18 months followed-up.Results Of the 60 PD patients,carotid intima-media thickness (cIMT) was increased in 38 patients(63.3％).Compared with the non-increased cIMT patients,serum fetuin A concentration was significantly decreased(P ＜ 0.05),CRP(P＜0.01) and calcium × phosphate products(P＜0.05) were significantly increased in the highincreased cIMT group.Compared with the low-increased cIMT patients,fetuin A concentration was obviously lower(P ＜ 0.05) and calcium×phosphate products were obviously higher(P ＜ 0.05) in the highincreased cIMT group.Linear regression analysis discovered an obvious negative correlation between CRP and fetuin A(R2 =0.629,F=47.522,P ＜ 0.01),as well as fetuin A and calcium×phosphate products (R2=0.299,F=11.948,P=0.002).Multiple regression analysis indicated that fetuin A was independently negatively correlated with cIMT(B=-0.019,t =-6.042,P ＜ 0.01).At 18 months,there were 36 newly-happened cardiovascular events and among which 6 cases died.Logistic regression analysis found that increased cIMT was risk factor to cardiovascular events in PD patients(OR=3.691,95％CI 1.467-9.258,P=0.006).Conclusion Decreased fetuin A and increased calcium×phosphate products deteriorate carotid calcification in PD patients.Micro-inflammation of PD patients represented by high CRP levels may increase calcium×phosphate products by depressing the fetuin A level,and in the end will stimulate carotid calcification.Increased cIMT is a risk factor for cardiovascular events.

BACKGROUND: Preliminary study has proven that adult human bone marrow-derived mesenchymal stem cells (MSCs) suppress peripheral blood lymphocytes proliferation.But the mechanism was still to be investigated.OBJECTIVE: To study the negatively regulatory effect of adult human MSCs on allogeneic lymphocyte proliferation by cell-free condition.DESIGN,TIME AND SETTING: Cytological observation in vitro,which was performed in the Lanzhou General Hospital,Lanzhou Military Area Command of Chinese PLA between October 2005 and December 2007.MATERIALS: The bone marrow sample was provided by the allo-transplantation donor.The peripheral blood lymphocytes were provided by the healthy volunteer.METHODS: Adult human MSCs were separated with Percoll + adherence method.Allogeneic peripheral blood lymphocytes were obtained from healthy donors with Ficoll solution and the cell concentration was adjusted as 2×109/L for use.100μ L MSCs culture supernatant was taken out in 96-well plates.The groups were following: A superuatant + 3-day MSCs culture media (100 μ L/well); B superuatant + phytohemagglutini (PHA; 1 g/L,5 μ L); C medium + LG-DMEM culture media containing 10% fetal bovine serum (100 μ L); D medium + PHA (1 g/L,5 μ L).The cells were incubated at 37 ℃ with 5% CO2 in a fully humidified atmosphere for three days.MAIN OUTCOME MEASURES: Effect of MSCs supematant on proliferation and transformation of variant lymphocytes.RESULTS: Peripheral blood lymphocytes proliferation was suppressed as compared with the blank control group and PHA group after MSCs culture,and the inhibition ratio was 9.00% (P ＜ 0.05).When lymphocytes were stimulated by PHA,the suppression effects were even stronger and the inhibition ratio was 20.91% (P ＜ 0.01).CONCLUSION: Adult human MSCs supernatant can suppress peripheral blood lymphocytes proliferation and transformation; furthermore,PHA can enhance the inhibitory effect,suggesting the negative regulation is at least in part due to indirectly inhibiting lymphocytes via soluble cytokines.