Association of plasma neutrophil gelatinase-associated lipocalin and thoracic aorta calcification in maintenance hemodialysis patients with and without diabetes

BMC Nephrol. 2022 Apr 22;23(1):156. doi: 10.1186/s12882-022-02773-z.

Abstract

Background: Neutrophil gelatinase-associated lipocalin (NGAL) is not only a bone-derived factor involved in metabolism, but also a biomarker of kidney disease and cardiovascular pathophysiology. We conducted this cross-sectional observational study to explore relationships between plasma NGAL and thoracic aorta calcification (TAC) in maintenance hemodialysis (MHD) patients with and without diabetes.

Methods: Plasma NGAL was measured by ELISA, TAC was evaluated via computed tomography scan using a 3D quantification method or chest radiography aortic arch calcification score. Spearman correlation, Logistic regression and Partial correlation analysis were used to describe the correlations between NGAL and TAC.

Results: Plasma NGAL levels were lower in MHD patients with diabetes compared to those without diabetes (49.33(42.37, 55.48) vs 56.78(44.37, 674.13) ng/mL, P = 0.026). In MHD patients without diabetes, lg (NGAL) was positively correlated with ARC value(R = 0.612, P = 0.003) analyzed by Spearman correlation; for partial correlation analysis, lg (NGAL) was positively correlated with ARC value, after adjusting for age and sex (R = 0.550, P = 0.015), adjusting for age, sex and CHD (R = 0.565, P = 0.015), adjusting for age, sex, CHD and Alb (R = 0.536, P = 0.027), or adjusting for age, sex, CHD, Alb, and dialyzer membrane (polysulfone) (R = 0.590, P = 0.016); however, when adjusting for age, sex, CHD, Alb and Ca, the correlation between lg (NGAL) and ARC value disappeared. Positive correlation were found between NGAL and Ca (R = 0.644, P < 0.001), Ca and ACR (R = 0.534, P = 0.013) in Spearman coefficient analysis.

Conclusion: There were positive correlations among plasma NGAL, serum Ca and ARC in MHD patients without diabetes; which suggests that NGAL is possibly a participant in cardiovascular calcification, in non-diabetic MHD.

Keywords: Diabetes; Maintenance hemodialysis; Neutrophil gelatinase-associated lipocalin; Thoracic aorta calcification.

Publication types

  • Observational Study

MeSH terms

  • Aorta, Thoracic* / diagnostic imaging
  • Aortic Diseases* / blood
  • Aortic Diseases* / complications
  • Aortic Diseases* / pathology
  • Biomarkers
  • Calcinosis* / blood
  • Calcinosis* / complications
  • Cross-Sectional Studies
  • Diabetes Complications
  • Diabetes Mellitus
  • Humans
  • Kidney Failure, Chronic* / blood
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / therapy
  • Lipocalin-2* / blood
  • Renal Dialysis

Substances

  • Biomarkers
  • LCN2 protein, human
  • Lipocalin-2