The Correlation Between Serum Levels Of Matrix Metalloproteinase-9, High Sensitive-C-reactive Protein And Atherosclerosis In Patients With Chronic Kidney Disease

Objective:To approach the correlation between serum levels of matrix metalloproteinase-9 (MMP-9) and high sensitive-C-reactive protein(hs-CRP) with atherosclerosis in patients with chronic kidney disease.Methods:The experimental group: From Oct 2009 to Sep 2010, seventy-five non-dialytic chronic kidney disease(CKD) patients (21 women, 54 men, mean age, 41.15±14.14 years) were enrolled in the study. The etiology of patients was chronic glomerulonephritis(72 cases), and autosomal dominant polycystic kidney disease(3 cases).All CKD patients were classified into 3 groups according to glomerular filtration rate(GFR) that computed by CKD-EPI formula:CKD 3 stage(3 women, 16 men, mean age, 38.16±13.58 years), CKD 4 stage(7 women, 10 men, mean age, 40.12±15.56 years) and CKD 5 stage(11 women, 28 men, mean age, 43.05±13.84 years). Fifteen age and sex matched healthy volunteers(6 women, 9 men, mean age, 44.80±5.36 years) were recruited as the normal control group.ELISA was used for measurement of serum levels of matrix metalloproteinase-9 and high sensitive-C-reactive protein in all subjects.Using noninvasive high-resolution B-mode ultrasonography to detect intima-media thickness(IMT) of carotid artery and atherosclerotic plaques. Collected the clinical data such as hemoglobin, serum creatinie and serum albumin.All these data were undertook statistical analysis and comparison.Results:1 Compared with the control group, the serum MMP-9 and hs-CRP concentration were obviously increased in CKD patients and each CKD stage group.The serum MMP-9 concentration in CKD patients had no statistical significance among different CKD stage.In CKD patients,the serum level of hs-CRP was increased with the GFR decreased.2 Compared with the control group,the value of IMT in patients with CKD was higher.The value of IMT in CKD4 and CKD5 groups were higher than that in the control group.3 Serum levels of MMP-9 and hs-CRP were significantly higher in subjects with atherosclerosis of carotid artery than those in normal ones.4 Compared with the hs-CRP less than 8mg/L group,the value of IMT and MMP-9 was higher in hs-CRP more than 8mg/L group.5 The linear correlation analysis showed the serum levels of MMP-9 and hs-CRP were positively correlated with the value of IMT (r=0.588,P<0.001.r=0.524,P<0.001).The serum MMP-9 concentration was positively correlated with hs-CRP (r=0.508,P<0.001).In patients with CKD, the value of IMT was positively correlated with age,body mass index(BMI),systolic blood pressure(SBP), cholesterol(CHO), triglyceride(TG) and low density (LDL) (r=0.515,P<0.001.r=0.261, P<0.05. r=0.337,P<0.01. r=0.310,P<0.01.r=0.244,P<0.05.r=0.367,P<0.01).6 Multiple stepwise regression analysis showed that the value of IMT was significantly positively correlated with hs-CRP,age,LDL and serum creatinine(Scr).Conclusion:1 The serum levels of MMP-9 hs-CRP were obviously increased in CKD patients.2 Serum levels of MMP-9 and hs-CRP were significantly higher in subjects with atherosclerosis of carotid artery than those in normal ones.3 The increased level of MMP-9 and inflammation state may both participate in pathogenesis and progression of atherosclerosis in patients with chronic kidney disease.4 Detections of the serum levels of MMP-9,hs-CRP together with the value of IMT by ultrasonography were reliable indexes for chronic kidney disease patients with atherosclerosis in the early stage.