Relationship between Lp(a),Fib Levels and Vascular Calcification and Severity of Autogenous Arteriovenous Fistula in Maintenance Hemodialysis Patients
10.3969/j.issn.1671-7414.2024.06.024
- VernacularTitle:维持性血液透析患者血液Lp(a),Fib水平检测与自体动静脉内瘘血管钙化及严重程度的关系
- Author:
Yuping SU
1
;
Yanmei WANG
Author Information
1. 遂宁市中心医院肾内科,四川 遂宁 629000
- Keywords:
lipoprotein(a);
fibrinogen;
maintenance hemodialysis;
arteriovenous fistula;
vascular calcification
- From:
Journal of Modern Laboratory Medicine
2024;39(6):141-146,166
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between lipoprotein(a)[Lp(a)],fibrinogen(Fib)levels and vascular calcification and severity of autogenous arteriovenous fistula(AVF)in maintenance hemodialysis(MHD)patients.Methods A total of 112 MHD patients who visited Suining Central Hospital from November 2021 to November 2023 were selected as the study subjects.According to the degree of AVF vascular calcification,these patients were divided into a non calcified group(n=45)and a calcified group(n=67),in which the calcified group was divided into a mild calcification group(n=19),a moderate calcification group(n=28)and a severe calcification group(n=20).The general information and Lp(a)and Fib levels between non calcified group and calcified group were compared.Multivariate logistic regression model was used to determine the independent risk predictors of AVF vascular calcification in MHD patients.Clinical data of patients with different degrees of calcification were compared.Generalized mixed effects model was used to analyze the relationship between Lp(a),Fib levels and the degree of AVF vascular calcification in MHD patients.Restricted cubic spline model was used to analyze the dose-response relationship between Lp(a)and Fib and severe vascular calcification in AVF.The interaction between Lp(a)and Fib on the severity of vascular calcification in AVF was analyzed.Results Dialysis time,P,PTH,Scr,Hb,BMP-2,FGF-21,Lp(a)and Fib levels of patients in the calcification group were increased(t=17.420,9.640,4.863,6.646,2.158,12.046,13.290,2.395,6.674,all P<0.05),while Ca level was decreased(t=2.820,P=0.006),the differences were statistically significant,respectively.The results of multivariate analysis showed that dialysis time(OR:3.130,95%CI:1.652～5.931),P(OR:4.760,95%CI:2.103～7.133),PTH(OR:3.314,95%CI:1.062～6.045),Scr(OR:2.288,95%CI:1.168～4.481),Hb(OR:4.616,95%CI:2.384～7.949),BMP-2(OR:5.527,95%CI:2.598～9.212),FGF-21(OR:6.242,95%CI:1.201～11.184),Lp(a)(OR:5.509,95%CI:2.787～10.886)and Fib(OR:6.159,95%CI:2.125～12.140)were all independent risk factors for AVF vascular calcification in MHD patients(all P<0.05).There were statistically significant in dialysis time,Ca,PTH,Scr,Hb,BMP-2,FGF-21,Lp(a)and Fib levels among the three groups(F=2.028～6.324,all P<0.05).Patients in the severe calcification group had higher dialysis time,PTH,Scr,Hb,BMP-2,FGF-21,Lp(a)and Fib levels than those in the mild calcification group(t=2.204～11.064)and the moderate calcification group(t=2.025～3.197),while Ca level was reduced(t=3.121,2.471),with statisitcally significant differences(all P<0.05),respectively.The results of the generalized mixed effects model showed that the levels of Lp(a)and Fib were related to the degree of AVF vascular calcification in MHD patients.The results of the restricted cubic spline model showed a non-linear dose-response relationship between Lp(a)and Fib levels and severe vascular calcification in AVF.There was an interactive effect between serum Lp(a)and Fib levels on the severity vascular calcification in AVF(OR=6.324,2.534,all P<0.05).Conclusion Lp(a)and Fib have a certain correlation with the degree of vascular calcification in patients,which may be influencing factors of autogenous AVF vascular calcification in MHD patients.
