Relationship between urate deposition on ultrasound and coronary artery calcification score in patients undergoing hemodialysis / 中华风湿病学杂志

ABSTRACT

Objective:To investigate the relationship between urate deposition on ultrasound and coronary artery calcification score in maintenance hemodialysis (MHD) patients.Methods:A total of 100 stable MHD patients undergoing hemodialysis for at least one year were enrolled in this study. All the patients had clinical and ultrasound examination at both knees, ankles and first metatarsophalangeal joints. Subgroup analysis was done depending on whether double contour sign (DCS) or tophus was found on ultrasound. The volume of coronary artery calcification (CAC) score were determined by a 64-slice CT. Main statistical analysis methods were t test, chi-square test, Spearman correlation and logistic regression model. Results:Among these 100 patients, DCS was found in 35 (35%) patients and tophus was found in 21 (21%) patients. The serum uric acid level, serum phosphate (P), parathyroid hormone (PTH), C-reactive protein (CRP) and incidence of CAC, CAC score of the DCS positive group [(629±61) μmol/L, (2.4±0.8) mmol/L, (658±56) pg/ml, (9.5±2.1) mg/L, 83%(29/35), (276±37), n=35] was significantly higher than the DCS negative group [(569±68) μmol/L, (2.0±0.6) mmol/L, (536±49) pg/ml, (7.9±3.1) mg/L, 59% (38/65), (219±42), n=65] ( t=4.322 6, P<0.01; t=2.712 6, P<0.01; t=11.293 1, P<0.01; t=2.700 3, P<0.01; t=5.070 1, P=0.024 3; t=6.827 6, P<0.01). The serum uric acid level was positively correlated with urate deposition on ultrasound ( r=0.317, P<0.05), which was positively correlated with CAC score ( r=0.302, P<0.05). The serum uric acid level, urate deposition on ultrasound and CAC score were all positively correlated with CRP ( r=0.298, P<0.05; r=0.345 , P<0.05; r=0.336, P<0.05) . Multivariate logistic regression analysis showed that the serum uric acid level and CRP were independent risk factors for positive DCS in MHD patients [ OR=3.040, 95% CI (1.507, 6.133); OR=3.438, 95% CI(1.822,6.489)]. Positive DCS and CRP were independent risk factors for CAC [ OR=3.504, 95% CI (1.414, 9.684); OR=3.885, 95% CI(1.364, 11.063)]. Conclusion:In MHD patients, positive DCS is related with high serum uric acid level and CRP. Positive DCS and CRP are independent risk factors for CAC.