The Correlation Between Macrophage Migration Inhibitory Factor, Plasma High-sensitivity C-Reactive Proteins And Atherosclerosis In Patients With Chronic Kidney Disease

Objective:To approach the correlation between macrophage migration inhibitory factor(MIF), high sensitive-C-reactive protein(hs-CRP) and atherosclerosis in patients with chronic kidney disease.Methods:(1)We collected 75 patients with chronic kidney disease (54 men and 28 women) aged 41.15±14.14 old (mean±SD). The primary diseases: 72 patients were chronic glomerulonephritis and 3 patients were polycystic kidney. All CKD patients were classified into 3 groups according to glomerular filtration rate(GFR) that computed by CKD-EPI formula: CKD 3 stage(16 men, 3 women, mean age 38.16±13.58 years), CKD 4 stage(10 men, 7 women,mean age 40.12±15.56 years), CKD 5 stage(28 men, 11 women,mean age 43.05±13.84 years). Excluding standards :①To be infected operate and trauma in recently one month,②To have acut cardiovascular disease (CVD) in recently one month,③used the cortical hormone or other immunity conditioner in recently six months,④To affiliate malignancy, pregnancy,⑤connective tissue disease,⑥To have dialysis or renal transplantation,⑦Acute exacerbation of chronic renal insufficiency.(2) Healthy control group:15 healthy volunteers (9 men and 6 women, aged 44.80±5.36 old). (3)The Macrophage migration inhibitory factor(MIF)and high sensitive-C-reactive protein (hs-CRP)were tested by the enzyme linked immunosorbent assay(ELISA)mothod. Collected the clinical data such as hemoglobin, serum albumin,blood creatinine, ureanitrogen, blood sugar, the cholesterol, triglyceride, heigh dense lipoprotein, cholesterol, low dense lipoprotein and so on. Intima-medial thickness (IMT)of extracranial common carotid artery and the presence of atherosclerotic plaques was determined by using noninvasive high-resolution B-mode ultrasonography.All these data were undertook statistical analysis and comparison.Results:1 Levels of MIF, hs-CRP in the chronic kidney disease (CKD) patients were significantly higher than those in the healthy controls.With GFR decreased, the serum level of MIF, hs-CRP gradually increased.2 Compared with the normal group and CKD3 stage ,IMT were significantly increased (P < 0.05) in patients with CKD4 and CKD5 stage. Levels of MIF, Hs-CRP in the CKD patients with carotid intimamedia thickness(IMT) increased were significantly higher than those with normal IMT.3 According to the level of carotid artry IMT the CKD patients were divided into two groups. The level of serum MIF,hs-CRP were higher in the group with AS than the group without AS.4 It was found that CKD patients with high hs-CRP groups had serum MIF concentration and IMT of carotid artery significantly increased compared with the low hs-CRP group.5 The analysis of linear correlatetion was showed as follows:5.1 The serum MIF levels were correlated positively with serum hs-CRP, Age , serum creatinine(r=0.626 P<0.001, r=0.300 P<0.01, r=0.273 P<0.05), negatively correlated with GFR(r=0.295,P<0.01).The hs-CRP concentration was correlated positively with serum MIF, Age , serum creatinine, systolic blood pressure (SBP)(r=0.626 P<0.001, r=0.457 P<0.001, r=0.263 P<0.05, r=0.241 P<0.05), negatively correlated with GFR(r=0.327, P<0.01)5.2 The thickness of carotid intimamedia were correlated positively with serum MIF, hs-CRP, age, BMI,cholesterol, trilyceride, low-density lipoprotein (LDL) and SBP(r=0.383 P<0.01, r=0.524 P<0.001, r=0.515 P<0.001, r=0.261 P<0.05, r=0.310 P<0.01, r=0.244 P<0.05, r=0.367 P<0.001, r=0.337 P<0.01), and were no correlated with serum creatinine,albumin (r=0.014 P >0.05, r=0.051 P >0.05)6 Multiple linear regression analysis further indicated that hs-CRP(β=0.552, P<0.001),low-density lipoprotein(β=0.241, P =0.008),age(β=0.227, P =0.021),MIF(β=-0.201, P =0.027)serum creatinin(eβ=-0.181,P =0.052)were risk factors of atherosclerosis-related cardiovascular events in chronic disease (CKD).Conclusion: There is hige level of serum MIF and microinflammatory state in chronic kidney disease (CKD) patients. The MIF and microinflammation state might be correlation closely with atherosclerosis related cardiovascular events in chronic kidney disease (CKD). To measure serum MIF, hs-CRP concentration and carotid ultrasound can early diagnosis atherosclerosis, and then more intervention and treatment could be given to cardiovascular complication in the CKD patients.