| Objective: Serum Galectin-3(Gal-3)and soluble Suppression of Tumorigenicity 2(s ST2)are validated inflammation associated factors sharing similar targets and downstream pathways.Emerging evidence implied a strong connection between high levels of two factors and inflammatory status,cardiovascular complications and adverse clinical prognosis in patients with end stage renal disease(ESRD).The aim of the current study was to detect the levels of serum Gal-3 and s ST2,find out their associated factors and examine their relationship with abdominal aortic calcification(AAC)and mortality in maintenance hemodialysis(MHD)patients.Methods: The patients were enrolled from Blood Purification Center undergoing MHD treatment during July 2014 in accordance with inclusive criteria.Laboratory measurement results,clinical data,dialysis prescriptions and serum samples were collected during enrollment period.Serum Gal-3 and s ST2 were detected by quantified ELISA kits.All the patients were followed-up for 3 years until July 2017.Lateral lumbar X-ray plain radiography examination was carried out twice first within a month around recruiting period and second around July 2017 in order to generate abdominal aortic calcification score(AACS)of the patients in baseline and after 3 years.1-year to 3-year mortality and the causes of death were continuously recorded.SPSS 23.0 and Med Calc 11.4.2.0 were used to analyse data.Results:(1)In total,205 MHD patients were enrolled in the study.Mean level of serum Gal-3 was 29.03±9.63 ng/ml.Median serum s ST2 level was 5.99(11.60,20.49)ng/ml.The levels of both biomarkers were significantly higher than that in healthy volunteers.No significant effect of drug utilization to Gal-3 and s ST2 was observed.Correlation analysis indicated serum Gal-3 was positively connected to CRP,SF and P,and was negatively related to ALB.Multivariate lineal regression analysis showed P and ALB were independently associated with serum Gal-3.Lgs ST2 was significantly related to NT-pro BNP,BMI and ALB.Age,NT-pro BNP,Hb A1 c,and BMI were independent influencing factors to serum s ST2.(2)152 patients were enroll in this part of the research.Median AACS was 5.50(1.00,13.00)points.After 3-year follow-up,median AACS increased to 11.0(4.25,20).AAC progressed in 51.9% patients.Logistic regression analysis indicated that serum Gal-3 was an independent risk factor to severe AAC and AAC progression in 3 years.ROC analysis revealed a moderate prognostic value of Gal-3 over AAC progression(AUC=0.709,95%CI 0.612-0.794,P=0.0001).Serum s ST2 was neither an independent risk factor to severe AAC nor a predictive factor to AAC progression.(3)During 3 years follow-up period,46(22.4%)patients died in total,65.2% were attributed to cardiovascular causes.All-cause and cardiovascular mortality of 1-year and 3-year elevated dramatically with the ascent of serum s ST2,while no difference was found in patients with dstinct levels of Gal-3.Serum s ST2 was not only an independent risk factor but also significant in predicting mortality of MHD patients within 3 years especially to short-term(1-year)and cardiovascular mortality.No significant prognostic value was found in Gal-3 to mortality within 3 years of MHD patients.Conclusion: Serum Gal-3 and s ST2 were novel biomarkers associated with cardiovascular diseases and adverse clinical outcomes in MHD patients,influenced by few clinical parameters.Serum Gal-3 was an independent risk factor and prognostic factor to AAC progression while s ST2 appeared to be a promising predictive factor to short-term and cardiovascular mortality in MHD patients.Gal-3 and s ST2 may be new targets for clinical intervention of cardiovascular calcification and poor prognosis in MHD patients. |
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