| Objective:To analyze the correlation between the levels of serum indoxyl sulfate(IS),p-cresol sulfate(PCS)and carotid atherosclerosis(CAS)in patients with MHD.Methods:According to the inclusion and exclusion criteria,115 MHD patients treated in the Department of Nephrology,the first Hospital of Shanxi Medical University from October2021 to August 2022 were selected as subjects.The general clinical data and laboratory indexes of the patients were collected.The levels of serum IS and PCS were detected by enzyme linked immunosorbent assay,and CAS was evaluated by carotid ultrasound.According to the results of carotid ultrasound,the patients were divided into carotid atherosclerosis group(78 cases)and non-carotid atherosclerosis group(37 cases).To compare general clinical data and laboratory indicators between the two groups.Spearman correlation analysis and Logistic regression analysis were performed to analyze the correlative factors of CAS in MHD patients.IS and PCS were divided into three groups,and the incidence of CAS was compared among the three groups.The ROC curve was drawn to evaluate the predictive efficacy of serum IS and PCS levels in patients with MHD.Results:1.Among the 115 MHD patients,78 were positive for carotid atherosclerosis(67.83%),with IS level of 271.315(265.015,293.770)pg/ml and PCS level of 48.323(45.818,50.250)pg/ml.37 patients were negative for carotid atherosclerosis(32.17%),with IS level of 265.664(261.445,267.109)pg/ml and PCS level of 43.786(42.211,48.151)pg/ml,showing a statistically significant difference(P<0.05).2.Compared with patients in the non-carotid atherosclerosis group,age,hypertension,diabetes mellitus,TC,UA,PTH,hs-CRP,IS and PCS were higher in the carotid atherosclerosis group,and ALB was lower(P<0.05).The difference was statistically significant(P<0.05).3.Spearman rank correlation analysis showed that CAS was negatively associated with ALB,but was positively associated with age,systolic blood pressure,hypertension,diabetes mellitus,TC,PTH,hs-CRP,IS and PCS.The results of Logistic regression analysis showed that IS increased(OR=1.059,95%CI:1.007-1.115),PCS increased(OR=1.410,95%CI:1.123-1.770),advanced age(OR=1.131,95%CI:1.055-1.213),PTH increased(OR=1.006,95%CI:1.000-1.011),were risk factors for carotid arteriosclerosis in patients with MHD.4.The included population was divided into three groups according to the IS level,and the incidence of CAS from the Q1 group to the Q3 group was 52.6%,66.7% and 84.2%.The difference between the three groups was statistically significant(P <0.001).Then they were divided into three groups according to the PCS level,and the incidence of CAS from Q1 group to Q3 group was 42.1%,79.5%,and 81.6%.The difference between the three groups was statistically significant(P <0.001).5.Receiver operating characteristic(ROC)analysis: The area under the curve of IS and PCS for predicting the occurrence of CAS in MHD patients was 0.718 and 0.741,respectively.While the area under the curve of IS combined with PCS for predicting the occurrence of CAS in MHD patients was 0.798,diagnostic sensitivity of 71.8%,and specificity of 78.4%,which has higher diagnostic efficacy for predicting CAS in MHD patients.Conclusions:Serum IS and PCS may be risk factors of CAS progression in MHD patients,and the combined detection of IS and PCS has some predictive value for carotid atherosclerosis in MHD patients. |
