Relationship Between Sclerostin (SOST) Level And Cardiac Valve Calcification In Middle-aged And Elderly Patients Undergoing Maintenance Hemodialysis(MHD)

Objective To observe the status of heart valve calcification in maintenance hemodialysis(MHD)patients and analyze the relationship between Sclerostin(SOST)level and heart valve calcification in elderly patients.Methods1 Subjects A total of 100 patients with clear diagnosis and complete data who received long-term regular MHD treatment for 3 months or above in the Affiliated Hospital of Chengde Medical College from December 2019 to December 2020 were selected,including 53 males and 47 females,respectively,with an average age of 62.20 ± 10.81 years(45-91years).According to the ultrasound results,the patients were divided into 44 patients with calcification of heart valves and 56 patients without calcification.2 Specimen SOST collection and detection Ffasting venous blood was collected before dialysis and fasted at night.After the blood was placed at room temperature,the serum was separated and collected.The ELISA kit was used for enzyme-immunosorbent assay(ELISA)with the detection range of 12.5pg/ m L-200 pg /ml.3 Biochemical indexes and clinical data collection Fastening venous blood was collected in the morning to detect hemoglobin(HGB),creatinine(Cr),albumin,Ip TH,urea nitrogen(BUN),calcium value(Ca),phosphorus value(P),alkaline phosphatase(ALP)levels.The general condition,age,primary disease,complications and dialysis age of the subjects were recorded. 4 Detection of vascular calcification level The level of vascular calcification was assessed using calcification of the valve according to the guidelines.Valvular calcification in patients with long-term regular MHD was detected in the auxiliary department of Chengyi Medical Affiliated Hospital.Diagnostic criteria for cardiac valve calcification:the bright echo of one or more valve tips in the aortic and mitral valves is greater than 1mm,and the sensitivity and specificity of this standard for the detection of valve calcification are high.5 Statistical Methods Using IBM SPSS Statistics24.0 statistical analysis,measurement data(such as age,calcium,phosphorus,etc.)in line with the normal distribution,to mean ± standard deviation((?)± S)description,calcification and no calcification group comparison using t test;Skewness distribution(such as dialysis age and IPTH in this study)was represented by M(P25,P75),and rank sum test was used for comparison between groups.Enumeration data:expressed as [n(%)].Chi-square test was used for comparison between calcification group and non-calcification group.The method of logistics regression was used to find out the influencing factors of valve calcification in middle-aged and elderly patients with regular MHD,and the verification level was 0.05.The correlation was tested by Pearson method.ROC curve was used to evaluate whether SOST could predict valve calcification and the accuracy of prediction.Results1 Comparison between general conditions and relevant indicators1)Comparison of general conditions: A total of 100 regular MHD patients were included in this study,including 53 males and 47 females,with an average age of 62.20±10.81 years old(45-91 years old).There were 44 patients in the heart valve calcification group,with an incidence rate of 44%,and 56 patients in the non-calcification group,with an incidence rate of56%.The age of patients in the calcification group(66.23±10.81)was slightly higher than that in the non-calcification group(59.04±9.790),and the dialysis age in the calcification group [36.00(7.50,76.50)] months was significantly higher than that in the non-calcification group [10.50(4.25,32.75)] months,with statistical significance(P < 0.05).There was no statistical significance in gender difference(P > 0.05).2)Comparison of relevant indicators:In the calcification group,the levels of HGB,albumin,i PTH,BUN,creatinine,ALP,calcium,phosphorus and osteosclerin were(105.80±17.75)g/L,(37.71±4.43)g/L,[217.85(143.18,326.38)]mg/L,(21.61±8.39)mmol/L,(738.25±225.18)umol/L,(94.93(73.89,120.98)]U/L,(2.27±0.21)mmol/L,(1.94±Mmol /L,[38.57(25.74,64.73)]pg/ml,The levels of HGB,albumin,parathyrohormone,BUN,creatinine,alkaline phosphatase,calcium,phosphorus and osteosclerosis protein in the non-calcification group were(97.20±17.07)g/L,(36.79±4.44)g/L,[212.35(159.58,330.28)]mg/L,(23.96±9.16)mmol/L,(737.89±320.27)umol/L,(93.15(78.23,119.67)]U/L,(2.10±0.23)mmol/L,(2.10±0.23)mmol/L,Mmol /L,[30.93(18.52,40.12)]pg/ m L;Visible HGB levels in patients with valvular calcification,albumin,a hormone levels,creatinine,alkaline phosphatase,calcium,phosphorus,osteosclerosis protein expression levels were higher than patients without calcification,BUN level lower than patients without calcification,with HGB,calcium,bone sclerosis protein expression levels compare differences were statistically significant(P< 0.05),and albumin,parathyroid hormone,creatinine,alkaline phosphatase,phosphorus contrast difference meaningless(P > 0.05),respectively.2 Logistic regression was used to analyze the results Logical regression method showed that age(OR=1.070,P=0.002),dialysis age(OR=1.023,P=0.002),calcium(OR=41.531,P=0.001)and bone sclerosclin levels(OR=1.043,P=0.001)were correlated with the occurrence of heart valve calcification in middle-aged and elderly patients with long-term and regular MHD,with statistical significance(all P < 0.01).In addition,the multivariate analysis showed that the level of osteosclerotic protein was correlated with the occurrence of valve calcification in MHD patients,with statistical significance(OR=1.041,P < 0.01). 3 Pearson correlation analysis of valve calcification According to the results of Pearson,middle-aged and old people long-term regular line of the MHD age(r = 0.332,P = 0.001),and dialysis age(r = 0.353,P = 0.000),bone sclerosis protein levels(r = 0.359,P = 0.000),calcium(r = 0.372,P = 0.000)was positively correlated with heart valve calcification(P < 0.01),while phosphorus(r = 0.095,P = 0.349),a hormone levels(r = 0.067,P = 0.509),alkaline phosphatase levels(r = 0.023,P=0.823)had no significant correlation with valve calcification(P > 0.05).4 The ROC curve was used to predict the calcification of heart valves The results of ROC analysis showed that the feasibility area of serum SOST expression in predicting calcification of heart valves was 0.673,95%CI was 0.565~0.780,P=0.003,the best cutoff value was 47.085pg/ml,the sensitivity was 0.409,and the specificity was 0.893.Conclusion1 Middle-aged and elderly people with MHD have a high incidence of cardiac valve calcification.2 The older the age,the longer the dialysis age,the more prone to cardiac valve calcification,the calcification group SOST expression was significantly higher.3 SOST expression level in middle-aged and elderly people with MHD is positively correlated with cardiac valve calcification,which may be an independent risk factor for heart valve calcification.4 SOST level has predictive value on the occurrence of heart valve calcification in MHD patients.