| Objective To investigate the serum levels of matrix metalloproteinases-10(MMP-10), matrix metalloproteinases-8(MMP-8), tissue inhibitor of metalloproteinase-1(TIMP-1), and their correlation with serum phosphate, calcium-phosphorus product(Ca×P), high-sensitivity C-reactive protein(hs-CRP), interventricular septum thickness(IVST), as well as other related clinical parameters in continuous ambulatory peritoneal dialysis patients(CAPD).Methods Patients who were diagnosed with continuous ambulatory peritoneal dialysis or chronic kidney disease(CKD) from the first affiliated hospital of Anhui medical university, from January 2014 to December 2014 were enrolled in the study. The experimental group: CAPD group( 24 men,44 women,mean age 46.79±10.19 years), CKD3 stage(12 men,3 women, mean age 56.53±11.47 years), CKD4 stage(5 men,11 women, mean age 53.44±13.43 years), CKD5 stage(19 women, 17 men, mean age 53.64±15.81 years).ELISA was used for measurement of serum levels of MMP-10, MMP-8, TIMP-1.Recorded the height and weight of the patients and calculated their body surface area(BSA). Collected the clinical data such as hemoglobin(HB), serum albumin(ALB), triglycerides(TG), total cholesterol(TC), Serum calcium, serum phosphate, serum creatinine, brain natriuretic peptide. Left ventricular diastolic diameter(LVDd), interventricular septum thickness(IVST), left ventricular posterior wall thickness(LVPWT) were measured by color doppler ultrasonic cardiogram. Left ventricular mass index(LVMI) and relative left ventricular wall thickness(RLVT)were calculated according to the equation. All these data were undertook statistical analysis and comparison by SPSS17.0 software, P values <0.05 is regard as statistically significant.Results 1 Compared with the CKD groups, the serum MMP-10, MMP-8 and TIMP-1 concentration were obviously increased in CAPD patients, had statistical significance with different CKD stages(P<0.01); The serum MMP-10, MMP-8 and TIMP-1 concentration had no statistical significance among different CKD stage groups.2 Compared with the CKD groups, the serum phosphate concentration(1.89±0.45)mmol/L in CAPD group was highest, had statistical significance with CKD3, CKD4, CKD5 stage groups(P<0.01); classified into groups according to serum phosphate concentration in CAPD group, Compared with the serum phosphate concentration less than 1.6 mmol/L group, the serum MMP-10 concentration was higher in serum phosphate concentration not less than 1.6 mmol/L group, differences was statistically significant, although the serum MMP-8, TIMP-1 concentration were higher in the increased serum phosphate group, but had no statistical significance.3 Compared with the CKD groups, the calcium-phosphorus product(Ca×P) was highest in the CAPD group, had statistical significance with CKD3, CKD4, CKD5 stage groups(P<0.01); classified into groups according to Ca×P in CAPD group, compared with the Ca×P less than 40 mg2/d L2 group, the serum MMP-10 was higher in the Ca×P not less than 40 mg2/d L2 group(P =0.04), although the serum MMP-8, TIMP-1 concentration were higher in the increased Ca×P group, but had no statistical significance.4 Classified into groups according to IVST in CAPD group, compared with the normal septal group, the serum MMP-10 was higher in the hypertrophy septal group, had statistical significance, although the serum MMP-8,TIMP-1 concentration were higher in the hypertrophy septal group, but had no statistical significance; classified into concentric hypertrophy and non-concentric hypertrophy groups according to RLVT in CAPD group, the serum levels of MMP-10,MMP-8,TIMP-1 had no statistical difference between the two groups; classified into left ventricular hypertrophy(LVH) and non-left ventricular hypertrophy groups according to LVMI in CAPD group, the serum levels of MMP-10, MMP-8, TIMP-1 also had no statistical difference between the two groups;5 Spearman correlation analysis in the CAPD group showed that serum MMP-10 concentration was positively correlated with IVST, serum phosphate, Ca×P, and negatively correlated with ALB; serum MMP-8 concentration was positively correlated with serum phosphate, hs-CRP, erythrocyte sedimentation rate, Ca×P; serum TIMP-1 concentration was positively correlated with serum phosphate, IVST; multivariate linear regression method showed that serum MMP-10 concentration was associated with serum phosphate and IVST;These three indicators was not statistically significant with serum calcium, LVPWT, LVD, LVMI, RLVT, PTH, age, dialysis month, serum creatinine, TG, TC, brain natriuretic peptide and HB.Conclusion1 Compared with the pre-dialysis CKD stage, the serum MMP-10, MMP-8 and TIMP-1 concentration were obviously increased in CAPD patients.2Compared with the pre-dialysis CKD stage, the serum phosphate, calcium-phosphorus product were obviously increased in the CAPD group. The serum MMP-10, MMP-8 and TIMP-1 concentration of CAPD patients may associated with calcium andphosphorus metabolism. 3 The serum MMP-10 and TIMP-1 concentration in CAPD patients were associated with IVST, they may have a role on ventricular remodeling. |
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