The relationship between AASI and arterial atherosclerosis in ESRD patients

Figures & data

Table 1. The general information of ESRD patients in this study.

General situation	Total ( ± SD)	MHD ( ± SD)	Predialysis ( ± SD)
Age (years)	55.8 ± 15.5	54.8 ± 16.1	57.8 ± 15.5
Weight (kg)	61.2 ± 12.1	61.4 ± 12.5	61.0 ± 11.9
BMI (kg/m^2)	22.4 ± 3.2	22.4 ± 3.4	22.4 ± 3.2
Abdomen circumference (cm)	85.9 ± 10.5	87.8 ± 11.1	83.8 ± 9.4
hs-CRP (mg/L)	6.9 ± 11.3	7.3 ± 9.9	6.5 ± 12.7
Albumin (g/L)	37.1 ± 5.7	39.3 ± 4.7	34.0 ± 5.7
Prealbumin (g/L)	0.30 ± 0.13	0.30 ± 0.13	0.30 ± 0.12
Hemoglobin (g/L)	93.2 ± 24.9	103.6 ± 25.5	81.4 ± 18.4
Serum creatinine (µmol/L)	806.6 ± 323.2	873.2 ± 318.4	684.8 ± 294.5
Urea (mmol/L)	24.7 ± 9.0	23.2 ± 8.7	27.2 ± 9.0
Uric acid (mmol/L)	468.1 ± 153.3	402.7 ± 105.1	557.6 ± 167.1
Total cholesterol (mmol/L)	4.6 ± 1.3	4.5 ± 1.3	4.7 ± 1.3
Triglycerides (mmol/L)	1.4 ± 1.6	1.6 ± 1.3	1.3 ± 0.8
High-density lipoprotein (mmol/L)	1.1 ± 0.4	1.1 ± 0.4	1.2 ± 0.4
Low-density lipoprotein (mmol/L)	2.8 ± 0.9	2.8 ± 0.9	2.8 ± 0.9
Plasma fibrinogen (g/L)	3.7 ± 1.3	3.7 ± 0.9	3.9 ± 1.2
Transferrin (g/L)	1.9 ± 0.5	1.9 ± 0.6	1.9 ± 0.4
eGFR (mL/min.1.73 m^2)	6.2 ± 2.5	5.6 ± 2.3	7.5 ± 2.5
HOMA-IR	0.16 ± 0.45	0.18 ± 0.49	0.13 ± 0.37
Homocysteine (µmol/L)	23.5 ± 9.7	24.7 ± 10.6	21.7 ± 8.0

Notes: MHD, maintenance hemodialysis; BMI, body mass index; hs-CRP, high-sensitivity C-reactive protein; eGFR, estimated glomerular filtration rate; and HOMA-IR, homeostasis model assessment of insulin resistance.

Table 2. Comparison of ambulatory blood pressure (ABP) parameters between MHD and predialysis group.

ABP parameters	MHD	Predialysis	p Values
Daytime SBP load (%)	55.2 ± 39.8	57.2 ± 39.2	0.802
Nighttime SBP load (%)	71.2 ± 37.1	74.0 ± 36.3	0.705
24-h SBP (mmHg)	137.3 ± 19.4	137.6 ± 20.8	0.954
Daytime SBP (mmHg)	138.5 ± 19.8	139.0 ± 21.4	0.915
Nighttime SBP (mmHg)	132.3 ± 19.4	133.9 ± 22.1	0.702
24-h DBP (mmHg)	81.5 ± 15.1	83.5 ± 13.5	0.465
Daytime DBP (mmHg)	82.4 ± 15.4	84.2 ± 13.9	0.530
Nighttime DBP (mmHg)	78.7 ± 14.9	81.2 ± 14.0	0.369
24-h PP (mmHg)	63.7 ± 19.5	62.8 ± 20.7	0.817
Daytime PP (mmHg)	56.1 ± 17.1	54.6 ± 14.8	0.627
Nighttime PP (mmHg)	53.7 ± 16.5	52.6 ± 14.8	0.733
Nocturnal BP drop (%)	4.4 ± 5.0	3.7 ± 5.2	0.462
24-h SBPV	6.7 ± 1.5	6.5 ± 1.2	0.662
24-h DBPV	5.6 ± 1.4	5.5 ± 0.9	0.865
Morning peak of SBP (mmHg)	30.7 ± 9.4	31.2 ± 9.5	0.849
Morning peak of DBP (mmHg)	14.9 ± 5.8	15.9 ± 5.3	0.501
Morning peak of PP (mmHg)	16.8 ± 5.2	16.7 ± 5.7	0.963
AASI	0.51 ± 0.11	0.50 ± 0.09	0.505
SBP/PP	0.40 ± 0.09	0.38 ± 0.07	0.192

Notes: DBP, diastolic blood pressure; SBP, systolic blood pressure; PP, pulse pressure; SBPV, systolic blood pressure variability; DBPV, diastolic blood pressure variability; and AASI, Ambulatory Arterial Stiffness Index.

Compared all the ambulatory blood pressure parameters between predialysis group and MHD group, no statistical difference was found.

Table 3. Comparison ambulatory blood pressure (ABP) parameters between atherosclerosis group and negative group.

ABP parameters	Negative group	Atherosclerosis group	t/z value	p Values
Daytime SBP load (%)	55.1 ± 41.3	57.3 ± 39.5	−0.281	0.808
Nighttime SBP load (%)	69.2 ± 39.5	73.9 ± 37.0	−0.460	0.589
24-h SBP (mmHg)	136.5 ± 18.9	138.2 ± 21.2	−0.363	0.708
Daytime SBP (mmHg)	138.8 ± 19.8	138.7 ± 21.4	0.025	0.980
Nighttime SBP (mmHg)	131.2 ± 18.3	134.4 ± 22.4	−0.679	0.499
24-h DBP (mmHg)	88.4 ± 12.7	79.1 ± 14.4	3.000	0.004*
Daytime DBP (mmHg)	89.5 ± 13.4	79.6 ± 14.7	3.152	0.002*
Nighttime DBP (mmHg)	84.7 ± 12.7	77.3 ± 14.9	2.383	0.019*
24-h PP (mmHg)	54.1 ± 17.3	67.9 ± 20.7	−3.009	0.004*
Daytime PP (mmHg)	49.1 ± 13.5	59.0 ± 16.7	−2.822	0.006*
Nighttime PP (mmHg)	46.4 ± 12.0	57.1 ± 16.7	−3.149	0.002*
Nocturnal BP drop (%)	5.4 ± 4.5	3.2 ± 5.0	1.968	0.051
24-h SBPV	6.6 ± 1.0	6.7 ± 1.6	−0.198	0.844
24-h DBPV	5.7 ± 0.9	5.5 ± 1.4	0.541	0.591
Morning peak of SBP (mmHg)	31.8 ± 10.5	30.5 ± 8.8	0.474	0.638
Morning peak of DBP (mmHg)	16.6 ± 6.0	14.4 ± 5.0	1.424	0.161
Morning peak of PP (mmHg)	16.4 ± 5.6	17.5 ± 5.6	−0.652	0.517
AASI	0.45 ± 0.06	0.53 ± 0.11	−3.778	< 0.001*
SBP/PP	0.35 ± 0.06	0.42 ± 0.08	−3.508	0.001*

Notes: This table compared the ambulatory blood pressure parameters between atherosclerosis group and negative group. The results showed that a series of ABPM parameters (*) related well to atherosclerosis. DBP, diastolic blood pressure; SBP, systolic blood pressure; PP, pulse pressure; SBPV, systolic blood pressure variability; DBPV, diastolic blood pressure variability; and AASI, Ambulatory Arterial Stiffness Index.

*p < 0.05.

Table 4. Single factor analysis of AASI-related risk factors.

Parameters	Correlation coefficients (r value)	p Values
Age (years)	0.586	< 0.001*
Weight (kg)	0.070	0.503
BMI (kg/m^2)	0.137	0.182
Abdomen circumference (cm)	0.127	0.221
hs-CRP (mg/L)	−0.194	0.059
Education degree	0.108	0.401
Albumin (g/L)	−0.282	0.006*
Prealbumin (g/L)	−0.372	0.003*
Hemoglobin (g/L)	−0.130	0.210
Serum creatinine (µmol/L)	−0.296	0.004*
Serum urea (mmol/L)	−0.137	0.182
Uric acid (mmol/L)	−0.052	0.616
Total cholesterol (mmol/L)	0.024	0.814
Triglycerides (mmol/L)	−0.090	0.387
High-density lipoprotein cholesterol (mmol/L)	0.036	0.731
Low density lipoprotein (mmol/L)	0.004	0.969
Plasma fibrinogen (g/L)	0.225	0.030*
Serum transferrin (g/L)	0.002	0.988
eGFR (mL/min 1.73 m^2)	0.127	0.234
HOMA-IR	−0.018	0.873
Homocysteine (µmol/L)	−0.196	0.225

Notes: BMI, body mass index; hs-CRP, high-sensitivity C-reactive protein; eGFR, estimated glomerular filtration rate; and HOMA-IR, homeostasis model assessment of insulin resistance.

*p < 0.05.

The single factor analysis of AASI related risk factors found that age, serum albumin, serum prealbumin and plasma fibrinogen were associated with AASI.

Table 5. Multiple regression analysis of AASI related risk factors.

Variables	Regression coefficients	Standardized coefficients	p Value
Age (years)	0.004	0.591	< 0.001*
Plasma fibrinogen (g/L)	0.093	0.256	0.009*
Albumin (g/L)	−0.003	−0.241	0.022*

Notes: *p < 0.05.

The multiple regression analysis of AASI-related risk factors found that the growth of the age, elevated plasma fibrinogen and reduced serum albumin were the independent risk factors of AASI.

Table 6. AASI and cardiac remodeling.

	AASI
Cardiac structural parameters	Correlation coefficients (r value)	p Value
LVDd (mm)	0.241	0.028*
IVST (mm)	0.060	0.590
LVPWT (mm)	0.160	0.148
EF %	−0.050	0.660
LVM (g)	0.200	0.070
LVMI (g/m^2)	0.192	0.082

Notes: LVDd, left ventricular end diastolic diameter; IVST, interventricular septal thickness; LVPWT, left ventricular posterior wall thickness; EF, left ventricular ejection fraction; LVM, left ventricular mass; and LVMI, left ventricular mass index.

*p < 0.05.

AASI positively correlated with left ventricular end diastolic diameter (LVDd), while the correlation with LVM and LVMI was just close to statistical significance.

Figure 1. The average level of AASI in the three CACI rating groups.

Table 7. AASI and prognostic parameter.

Prognostic parameters	Correlation coefficients (r value)	p Value
CCI	0.489	< 0.001*
CACI	0.568	< 0.001*

CCI, Charlson Comorbidity Index and CACI, Charlson-Age Comorbidity Index.

*p < 0.05.

AASI was significantly positively correlated with CCI and CACI.