Relationship Between MHR And Cardiac Valve Calcification In Patients With Stage 3-5 Non-dialysis Chronic Kidney Disease

Objective:To explore the relationship between a new inflammatory marker monocyte to high-density lipoproteinratio(MHR)and Cardiac valve calcification in patients with stage 3-5 Non-dialysis Chronic Kidney Disease.Methods:Using the method of retrospective study,166 patients hospitalized in the Department of Nephrology of the affiliated Hospital of North Sichuan Medical College from January to September 2020 were selected according to the inclusion and exclusion criteria.Divided into valve calcification group(n=65)and non-calcification group(n=101)according to echocardiography results,and collectthe general data,laboratory indexes and cardiac ultrasound index results of the two groups.Binary Logistic regression analysis was used to analyze the risk factors of heart valve calcification.The receiver operating characteristic curve(ROC curve)was used to evaluate the predictive value of MHR in valvular calcification in patients with CKD.Results:1.Among the 166 CKD patients,Valvular calcification was found in 65 cases(39.2%),including aortic valve calcification in 54 cases(32.5%),mitral valve calcification in 4 cases(2.4%),mitral valve calcification+aortic calcification in 6 cases(3.6%).Mitral valve calcification+tricuspid valve calcification was found in 1 case(0.6%),and there was no patient with tricuspid valve calcification only.2.Age,alkaline phosphatase(ALP),MHR,hypersensitive C-reactive protein,serum phosphorus,calcium-phosphorus product,left ventricular mass index(LVMI)in calcified group were higher than those in non-calcified group,while high density lipoproteinin calcified group were lower than those in non-calcified group(P<0.05).3.Spearman correlation analysis showed that MHR was positively correlated with monocyte count,hsCRP and end-diastolic interventricular septum thickness(IVST)(P<0.05),and negatively correlated with high density lipoprotein(P<0.05).4.The results of binary Logistic regression analysis showed that age(OR=1.046,P=0.015),ALP(OR=1.020,P=0.045)and MHR(OR=19.84,P=0.001)were risk factors for valvular calcification with CKD.5.The results of ROC curve analysis showed that the area under the curve of MHR was 0.727,The best cut-off value of serum MHR for predicting valvular calcification in patients with CKD was 0.385,with a sensitivity of 72.3%and a specificity of 68.3%.Conclusion:The incidence of valvular calcification is higher in patients with CKD,which is mainly characterized by aortic calcification.Age,ALP and MHR are the risk factors of valvular calcification in patients with CKD.MHR reflects the inflammatory state of the body and has a good predictive value for valvular calcification in patients with CKD.