ADIPOKINE AND GLYCOCALYX DAMAGE CORRELATES WITH CORONARY ARTERY CALCIFICATION IN ELDERLY HEMODIALYSIS PATIENTS

Abstract

Objective: Elderly hemodialysis patients are at high risk for developing coronary artery calcification (CAC), which can lead to cardiovascular complications. The pathogenesis of CAC in these patients is not well understood. Adipokines and glycocalyx damage have been implicated in cardiovascular disease, but their role in CAC progression in hemodialysis patients is unclear. Methods: A total of 122 elderly patients treated at the Hemodialysis Center of Huai'an Hospital affiliated to Xuzhou Medical University were enrolled, with 30 healthy individuals serving as controls. Based on coronary computed tomography angiography (CTA), the elderly maintenance hemodialysis(MHD) patients were categorized into a non-coronary calcification group and groups with varying degrees of coronary calcification. Spearman correlation analysis was used to examine the correlation between Leucine-Richα-2-Glycoprotein-1(LRG1) and Syndecan-1 expressions and other laboratory parameters in elderly MHD patients. Multivariate logistic regression models were used to analyze the risk factors of coronary artery calcification. Receiver operating characteristic (ROC) curves were constructed to evaluate the feasibility and efficacy of LRG1 and Syndecan-1 as diagnostic biomarkers for coronary artery calcification in elderly MHD patients. Results: In the present study, we observed a detection rate of 66.39% for coronary artery calcification in the enrolled patients. Furthermore, we found that levels of LRG1 and Syndecan-1 were significantly elevated in elderly MHD patients compared with the healthy control group (P < 0.001). Serum LRG1 and Syndecan-1 were positively correlated with CAC levels in elderly MHD patients, exhibiting a linear relationship (r=0.80,P<0.001). Our multiple logistic regression analysis revealed LRG1 as an independent risk factor for the progression of coronary artery calcification. Additionally, LRG1 exhibited an AUC of 0.934 for diagnosing the occurrence of coronary artery calcification, with a specificity of 87.8% and a sensitivity of 91.4%. Finally, our results showed that the combined use of LRG1 and Syndecan-1 yielded an AUC of 0.953 for diagnosing coronary artery calcification in elderly MHD patients, indicating a higher diagnostic value compared to the use of a single biomarker. Conclusions: LRG1 is an independent risk factor for coronary artery calcification in elderly MHD patients. The levels of LRG1 and Syndecan-1 were positively correlated with the severity of coronary artery calcification in elderly MHD patients. The combination of both biomarkers has strong diagnostic value for the occurrence of coronary artery calcification in elderly MHD patients.