Retinol Binding Protein 4 With The Heart And Vessel Diseasein Patients With Different Stages Of Chronic Kidney Disease

Objective:The aim of this study was to explore clinical significance of serum RBP4 levels in patients with chronic kidney disease(CKD), and the correlation and clinical significance of RBP4 and pathological changes of heart and great vessels.Research design and methods:We investigated 887 patients(572male and 315 female) withchronic kidney disease(CKD). And we applied independent sample t-test, bivariate correlation analysis,Pearson`s test and multiple stepwise regression to analyse the correlation of serum RBP4 levels and cardiovascular events, cardiac ultrasound and carotid ultrasound.Results:(1)With the progression of renal damage, the serum RBP4 level increased gradually, The level of RBP4 was negatively correlated with the level of e GFR(r=-0.692,p<0.001).It demonstrated that along with the progress of deterioration reduced glomerular filtration rate and renal function, RBP4 levels increased gradually, and therelationship is notble. The multiple stepwise regression indicated that the levels of e GFR?CRP?Cys-C and age are the independent dangerous factor elements of the serum RBP4 level.Along with the progress of CKD, the incidence of cardiovascular events increased.The incidence of cardiovascular events is higher in patients with diabetes mellitus than those without. With the increasing of cardiovascular events, the RBP4 level elevate gradually. And there was significant difference between the each groups of RBP4 level. RBP4 level and the incidence rate and severity of cardiovascular disease are positive related(r=0.086,p=0.013).(2)The serum RPB4 level is positively correlated with LVDd, LVDs, LAD, IVST, LVMI but negatively correlated with EF. It indicated that RBP4 level is closely related to the change of heart structure and function in patients with chronic kidney disease. The lower RBP4 level is in diabetic group than that in non-diabetic group(84.15±26.26)ug/ml vs(91.31±32.46)ug/ml(P<0.05). The numericalvalue of LAD, IVST and LVPWT are higer in diabetic group than that in the non-diabetic group(P<0.05). In the non-diabetic group, there was significant correlation between RBP4 levels and cardiac structure index, such as LVDd, LVDs, LAD, IVST, LVPWT and LVMI. And the correlation is more notabl in diabetic group.(3)In the DN patients,with the elevation of RBP4 serum levels, the incidence of carotid artery plaques and stenosis increased accordingly. An average of carotid intima-media thickness is associated with carotid artery plaque, stenosis, e GFR(p<0.05).Divid the average carotid intima-media thickness into two groups according to the average, the average high level group of carotid intima-media thickness, carotid artery plaque group and carotid stenosis group have higher levels of RBP4 than the control group.Conclusions:The serum RBP4 level increased with the decline of e GFR, gradually. The serum RBP4 level is positively correlated with the incidence and severity of the rate of cardiovascular, cerebrovascular diseases, carotid artery lesions.With the increase of RBP4, cardiovascular function and structure change seriously.It seems that RBP4 level showed a lower effect on the aboved conditons in diabetic patients in contrast to those in non-diabetic groups. In diabetic nephropathy patients,serum RBP4 levels associated with carotid artery plaque and stenosis.When RBP4 levels increasing, the incidence of carotid plaque, stenosis and carotid artery intima-media thickeness rising.