Correlation Between High Plasma Fibrinogen Level And Metabolic Syndrome In Maintenance Hemodialysis Patients

Objective: To study the risk factors of metabolic syndrome in maintenance hemodialysis(MHD)patients,and the relationship between fibrinogen and metabolic syndrome and metabolic abnormalities.Methods: 114 patients admitted to the hemodialysis department of the Second Hospital of Tianjin Medical University from January 2017 to January 2018 were included.The basic clinical data of the included patients were recorded separately.Patients with different serum fibrinogen concentrations were divided into two groups.Patients with serum fibrinogen concentration of > 4g/L were in the high fibrinogen group,while patients with serum fibrinogen concentration < 4g/L were in the normal fibrinogen group.The relationship between serum fibrinogen levels and various metabolic indicators,including fasting blood glucose(FBG),low-density lipoprotein cholesterol(LDL),high density lipoprotein cholesterol(HDL),triglyceride(TG),waist circumference,systolic blood pressure(SBP),and diastolic blood pressure(DBP)was analyzed by t-test or Mann-Whitney U test and c2 test for continuous and categorical variables,respectively.Univariate logistic regression analysis was used to screen out P<0.1 variables and included them in multivariate logistic regression analysis,and to analyze the risk factors of metabolic syndrome in MHD patients.Correlation between fibrinogen levels and metabolic abnormalities in patients with MHD was analyzed by t-test or Mann-Whitney U test.Correlation between fibrinogen levels in MHD patients and diagnostic indicators of metabolic syndrome was analyzed by linear correlation or rank correlation analysis.Results: The prevalence of metabolic syndrome in 114 MHD patients was 43.9%(50 cases).There were 46 males and 29 females in the normal fibrinogen group(75 cases in total),24 males and 15 females in the high fibrinogen group(39 cases in total).The prevalence of TG,metabolic syndrome,fasting blood glucose and uric acid in the high-fibrinogen group were higher than those in the normal fibrinogen group,while the HDL level was lower than that in the normal fibrinogen group,with statistically significant differences(P < 0.05).Multivariate logistic regression analysis showed fibrinogen(OR=2.307,95% CI: 1.042-5.109),TG(OR=8.511,95% CI: 1.19-60.82),FBG(OR=0.275,95% CI: 1.08-1.51)and waist circumference(OR=1.276,95% CI: 1.08-1.51)were independent risk factors for metabolic syndrome(P<0.05).Further statistical analysis found that fibrinogen levels were associated with elevated TG,decreased HDL,hyperglycemia,hypertension,and central obesity in MHD patients(P<0.05).In addition,our study found that fibrinogen levels in patients with MHD were positively correlated with TG levels,FBG levels,waist circumference levels,and SBP,and were statistically significant(P<0.05);while fibrinogen levels and DBP in MHD patients were irrelevant(P>0.05);in addition,fibrinogen was negatively correlated with HDL level,and the difference was statistically significant(P=0.002).Conclusion: Our study suggests that patients with MHD have a high prevalence of metabolic syndrome,and high plasma serum fibrinogen levels may be independent risk factors for metabolic syndrome in MHD patients.In addition,fibrinogen levels are associated with metabolic abnormalities in metabolic syndrome,including elevated TG,decreased HDL,hyperglycemia,hypertension,and central obesity.