CKD非透析患者的血清IDO1、β-catenin水平对冠脉血管钙化的诊断效能

The diagnostic efficacy of serum IDO 1 andβ-catenin levels on coronary vascular calcification in non-dialysis patients with chronic kidney disease

目的探讨慢性肾脏病(CKD)非透析患者的血清吲哚胺2,3-双加氧酶1(IDO1)、β-连环蛋白(β-catenin)水平对冠状血管钙化的诊断效能。方法选取2021年1月至2022年12月郴州市第一人民医院收治的106例CKD非透析患者设为研究组,另选取同期入院治疗的100例健康人群作为对照组。采用酶联免疫吸附法检测所有研究对象的血清IDO1、β-catenin水平。根据冠状动脉钙化积分(CACs)结果将研究组患者分为无钙化组(67例)和钙化组(39例)。比较所有研究对象的血清IDO1、β-catenin水平。采用受试者工作特征(ROC)曲线评估血清IDO1、β-catenin水平对CKD非透析患者冠状血管钙化的诊断价值。采用多因素logistic回归分析CKD非透析患者冠状血管钙化的影响因素。结果研究组患者的血清IDO1水平低于对照组,β-catenin水平高于对照组(均P<0.001);钙化组患者的血清IDO1水平低于无钙化组,β-catenin水平高于无钙化组(均P<0.001)。血清IDO1、β-catenin预测CKD非透析患者冠状血管钙化的ROC曲线下面积(AUC)分别为0.751(95%CI:0.706~0.819)、0.835(95%CI:0.785~0.877),两者联合预测的AUC为0.906(95%CI:0.861~0.958)。钙化组的糖尿病史、CKD分期(3~5期)例数、血钙、血磷、血钾、白蛋白值高于无钙化组(均P<0.05)。多因素logistic回归分析显示,CKD分期、IDO1、β-catenin均是CKD非透析患者冠状血管钙化的影响因素(均P<0.05)。结论发生冠状血管钙化的CKD非透析患者血清IDO1水平降低、β-catenin水平升高,二者联合有望作为CKD非透析患者冠状血管钙化诊断的生物标志物。

ObjectiveTo explore the diagnostic efficacy of serum indoleamine 2,3-dioxygenase-1(IDO1)andβ-catenin levels for vascular calcification in non-dialysis patients with chronic kidney disease(CKD).MethodsA total of 106 non-dialysis patients with CKD admitted to Chenzhou First People′s Hospital from January 2021 to December 2022 were selected as study group,and 100 healthy people admitted to hospital during the same period were selected as the control group.Serum levels of IDO1 andβ-Catenin were detected by enzyme-linked immunosorbent assay.Patients in study group were classified into non-calcification group(67 cases)and calcification group(39 cases)based on the results of coronary artery calcification scores(CACs).The levels of serum IDO1 andβ-catenin in all subjects were compared.ROC was used to evaluate the diagnostic value of serum IDO1 andβ-catenin levels for vascular calcification in non-dialysis patients with CKD.Multivariate logistic regression analysis was used to investigate the factors affecting vascular calcification in non-dialysis patients with CKD.ResultsSerum IDO1 level in the study group was lower than that in the control group,andβ-catenin level was higher than that in the control group(all P<0.001).The level of serum IDO1 in the calcification group was lower than that in the control group,and andβ-catenin level was higher than than in the non-calcification group(all P<0.001).The AUC of serum IDO1 andβ-catenin predicting vascular calcification in non-dialysis CKD patients was 0.751(95%CI:0.706-0.819)and 0.835(95%CI:0.785-0.877),respectively,and the AUC predicted by the combination of the two was 0.906(95%CI:0.861-0.958).The diabetes history,number of CKD stages(3-5 stages),blood calcium,blood phosphorus,blood potassium and albumin values in calcification group were higher than those in non-calcification group(all P<0.05).CKD stages,IDO1 andβ-catenin were the influential factors for vascular calcification in non-dialysis patients with CKD(all P<0.05).ConclusionsSerum IDO1 level decreased andβ-catenin level increased in CKD non-dialysis patients with coronary artery calcification,and the combination of the two may be used as biomarkers for the diagnosis of coronary artery calcification in CKD non-dialysis patients.