Relationship between major adverse cardiovascular events and serum levels of heat shock protein 70 and clusterin in patients undergoing maintenance hemodialysis

doi:10.3877/cma.j.issn.2095-3216.2024.01.005

Abstract

Abstract:

Objective

To investigate the relationship between major adverse cardiovascular events (MACE) and serum levels of heat shock protein 70 (HSP-70) and clusterin in patients undergoing maintenance hemodialysis.

Methods

A total of 183 end-stage renal disease patients undergoing maintenance hemodialysis were selected as the study subjects whose baseline data were recorded. And the patients were divided into the MACE group (57 cases) and the non-MACE group (126 cases) based on MACE during the one-year follow-up. Enzyme-linked immunosorbent assay (ELISA) was applied to measure the serum levels of HSP-70 and clusterin. Receiver operating characteristic (ROC) curve was applied to analyze the value of serum HSP-70 and clusterin in evaluating occurrence of MACE in the patients. Multivariate logistic regression method was used to analyze the affecting factors for occurrence of MACE in the patients.

Results

The serum levels of HSP-70, clusterin, triglyceride, and parathyroid hormone of the MACE group were higher than those of the non-MACE group (t=7.763, 8.550, 4.156, 4.908, respectively), while LVEF was lower than that of the non-MACE group (t=10.931) (P<0.05). The AUC of serum HSP-70, clusterin, and HSP-70 plus clusterin in evaluating MACE in the patients was 0.757, 0.859, and 0.903, respectively. HSP-70 and clusterin were independent affecting factors for MACE occurrence in the patients (OR=2.947, 3.074, respectively; 95%CI: 1.549-5.605, 1.691-5.589, respectively; P<0.05).

Conclusion

In maintenance hemodialysis patients complicated with MACE, elevated levels of serum HSP-70 and clusterin were influencing factors for the occurrence of MACE. When evaluating the risk of MACE occurrence in clinical practice, serum HSP-70 and clusterin might serve as reference indicators.

Key words: Maintenance hemodialysis, Major adverse cardiovascular events, Heat shock protein 70, Clusterin

Juan Feng, Weiqiang Zhan. Relationship between major adverse cardiovascular events and serum levels of heat shock protein 70 and clusterin in patients undergoing maintenance hemodialysis[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(01): 34-38.

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Figures/Tables 4

References 18

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项目	非MACE组(n＝126)	MACE组(n＝57)	统计值(t/χ²)	P值
年龄(岁)	55.72±8.95	55.41±9.02	t＝0.216	0.829
男性[例(%)]	71(56.35)	33(57.89)	χ²＝0.038	0.845
BMI(kg/m²)	22.42±3.15	22.45±3.36	t＝0.058	0.953
透析龄(月)	45.78±9.33	46.21±9.52	t＝0.287	0.775
收缩压(mmHg)	132.08±10.16	133.45±10.97	t＝0.824	0.411
舒张压(mmHg)	85.04±7.42	85.91±7.57	t＝0.730	0.466
吸烟史[例(%)]	67(53.17)	30(52.63)	χ²＝0.005	0.946
饮酒史[例(%)]	25(19.84)	11(19.30)	χ²＝0.007	0.932
原发病[例(%)]			χ²＝0.043	0.998
高血压肾病	48(38.10)	21(36.84)
糖尿病肾病	35(27.78)	16(28.07)
肾小球肾炎	33(26.19)	15(26.32)
其他	10(7.94)	5(8.77)
总胆固醇(mmol/L)	4.86±0.49	4.91±0.48	t＝0.643	0.521
三酰甘油(mmol/L)	1.72±0.32	1.95±0.40	t＝4.156	<0.001
LDL-C(mmol/L)	2.96±0.37	3.04±0.29	t＝1.443	0.151
HDL-C(mmol/L)	1.19±0.23	1.17±0.25	t＝0.530	0.597
血钙(mmol/L)	2.21±0.28	2.19±0.30	t＝0.438	0.662
血磷(mmol/L)	1.68±0.32	1.70±0.35	t＝0.380	0.704
Kt/V	1.27±0.23	1.26±0.24	t＝0.269	0.788
血肌酐(μmol/L)	682.51±55.93	692.34±50.66	t＝1.133	0.259
血尿素氮(mmol/L)	23.94±2.76	24.02±2.81	t＝0.181	0.857
pH	7.01±0.86	6.98±0.89	t＝0.216	0.829
PTH(ng/L)	291.35±50.11	330.14±48.16	t＝4.908	<0.001
LVEF(%)	59.51±6.46	48.09±6.73	t＝10.931	<0.001
LVEDD(mm)	52.46±6.86	53.08±6.94	t＝0.564	0.573
LVESD(mm)	36.75±7.71	37.12±7.96	t＝0.298	0.766
HSP-70(ng/ml)	22.73±4.87	30.26±8.15	t＝7.763	<0.001
簇集蛋白(μg/L)	118.42±20.35	148.66±25.74	t＝8.550	<0.001

项目	非MACE组(n＝126)	MACE组(n＝57)	统计值(t/χ²)	P值
年龄(岁)	55.72±8.95	55.41±9.02	t＝0.216	0.829
男性[例(%)]	71(56.35)	33(57.89)	χ²＝0.038	0.845
BMI(kg/m²)	22.42±3.15	22.45±3.36	t＝0.058	0.953
透析龄(月)	45.78±9.33	46.21±9.52	t＝0.287	0.775
收缩压(mmHg)	132.08±10.16	133.45±10.97	t＝0.824	0.411
舒张压(mmHg)	85.04±7.42	85.91±7.57	t＝0.730	0.466
吸烟史[例(%)]	67(53.17)	30(52.63)	χ²＝0.005	0.946
饮酒史[例(%)]	25(19.84)	11(19.30)	χ²＝0.007	0.932
原发病[例(%)]			χ²＝0.043	0.998
高血压肾病	48(38.10)	21(36.84)
糖尿病肾病	35(27.78)	16(28.07)
肾小球肾炎	33(26.19)	15(26.32)
其他	10(7.94)	5(8.77)
总胆固醇(mmol/L)	4.86±0.49	4.91±0.48	t＝0.643	0.521
三酰甘油(mmol/L)	1.72±0.32	1.95±0.40	t＝4.156	<0.001
LDL-C(mmol/L)	2.96±0.37	3.04±0.29	t＝1.443	0.151
HDL-C(mmol/L)	1.19±0.23	1.17±0.25	t＝0.530	0.597
血钙(mmol/L)	2.21±0.28	2.19±0.30	t＝0.438	0.662
血磷(mmol/L)	1.68±0.32	1.70±0.35	t＝0.380	0.704
Kt/V	1.27±0.23	1.26±0.24	t＝0.269	0.788
血肌酐(μmol/L)	682.51±55.93	692.34±50.66	t＝1.133	0.259
血尿素氮(mmol/L)	23.94±2.76	24.02±2.81	t＝0.181	0.857
pH	7.01±0.86	6.98±0.89	t＝0.216	0.829
PTH(ng/L)	291.35±50.11	330.14±48.16	t＝4.908	<0.001
LVEF(%)	59.51±6.46	48.09±6.73	t＝10.931	<0.001
LVEDD(mm)	52.46±6.86	53.08±6.94	t＝0.564	0.573
LVESD(mm)	36.75±7.71	37.12±7.96	t＝0.298	0.766
HSP-70(ng/ml)	22.73±4.87	30.26±8.15	t＝7.763	<0.001
簇集蛋白(μg/L)	118.42±20.35	148.66±25.74	t＝8.550	<0.001

指标	AUC	95%CI	敏感度(%)	特异度(%)	截断值
热休克蛋白70	0.757	0.679～0.835	57.94	85.96	27.90 ng/ml
簇集蛋白	0.859	0.819～0.884	80.95	82.46	137.36 μg/L
联合	0.903	0.851～0.954	89.68	80.70	－

指标	AUC	95%CI	敏感度(%)	特异度(%)	截断值
热休克蛋白70	0.757	0.679～0.835	57.94	85.96	27.90 ng/ml
簇集蛋白	0.859	0.819～0.884	80.95	82.46	137.36 μg/L
联合	0.903	0.851～0.954	89.68	80.70	－

影响因素	B值	标准误	Wald χ²	OR值	95%CI	P值
热休克蛋白70	1.081	0.328	10.858	2.947	1.549～5.605	0.001
簇集蛋白	1.123	0.305	13.556	3.074	1.691～5.589	<0.001
甘油三酯	0.103	0.101	1.031	1.108	0.909～1.351	0.310
甲状旁腺激素	0.111	0.147	0.566	1.117	0.837～1.490	0.452
左室射血分数	0.159	0.228	0.485	1.172	0.750～1.832	0.486

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