Acute-phase proteins as promoters of abdominal aortic calcification in chronic dialysis patients

Abstract

The aim of this study was to find a correlation between acute-phase proteins (APPs) and abdominal aortic calcification (AAC) as well as the impact APPs on AAC in chronic dialysis patients (CDPs). Native lateral lumbar radiography and biochemical analysis were performed in 112 CDPs (aged 60.0 ± 5.43 years) to estimate and score AAC and biochemical values of APPs. The mean AAC score was 8.39 ± 5.43. We detected 16 (14.28%) CDPs without AAC and 96 (85.71%) CDPs with AAC (10 ± 5.43). The number of CDPs with AAC ≤4 was 34 (30.36%) with mean AAC score of 1.85 ± 1.94. By multiple regression analysis, we found positive correlation between AAC and ferritin (β = 0.004398, P = 0.0085) and AAC and C-reactive protein [(CRP), β = 0.1972, P = 0.0178]. Sensitivity/specificity pairs and criterion variables (CrVs) were as follows: for CRP: 44.21%, 100%, and CrV ≥6 and for ferritin: 83.16%, 56.25%, and CrV ≥196.32. The area under curve (AUC) for CRP and ferritin was 0.721 (P <0.0001) and 0.730 (P <0.0026), respectively. Fibrinogen and serum iron AUC in the prediction of AAC were 0.533 (P = 0.5749) and 0.618 (P = 0.0795), respectively. CRP and ferritin were the most powerful APPs involved in the promotion of AAC; serum iron and fibrinogen were shown as lower activity promoters in CDPs. Serum albumin showed inverse activity on AAC.