Correlation of serum Irisin and Adropin with adverse cardiovascular events in elderly patients with chronic kid-ney disease stages 3-5

LYU Mei-yue; WANG Ling; WU Yu; SUN Hao-yuan; ZHANG Lin

doi:10.13820/j.cnki.gdyx.20231409

Abstract：Objective To study the serum levels of Irisin and Adropin in elderly patients with chronic kidney dis-ease(CKD)stages 3-5 and analyze their relationship with major adverse cardiovascular events(MACE).Methods 156 elderly patients with CKD stages 3-5 from February 2017 to February 2020 were included as CKD group,while 80 healthy individuals from routine health check-ups were included as control group.Serum Irisin and Adropin levels were measured using enzyme-linked immunosorbent assay.The CKD group was divided into MACE group(n=111)and non-MACE group(n=45)based on the occurrence of MACE during follow-up.Pearson correlation analysis was used to assess the correlations between various indicators.Multiple-factor logistic regression analysis was performed to identify risk factors for MACE occurrence in elderly patients with CKD stages 3-5.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of various indicators for MACE occurrence in elderly CKD patients.Results In the CKD group,Irisin and Adropin levels were lower than those in the control group[(3.04± 0.36)mg/L vs.(7.24±1.30)mg/L;(150.11±9.40)ng/L vs.(180.40±10.13)ng/L],and the differences were statistically significant(t=37.698,22.819,both P＜0.05).Serum Irisin and Adropin leves in the CKD group were sig-nificantly negatively correlated with blood creatinine,blood urea nitrogen,24-hour urine protein quantification,and C-reactive protein(P＜0.05),and positively correlated with estimated glomerular filtration rat(eGFR)and serum albumin(P＜0.05).eGFR,Irisin,and Adropin were independent protective factors for the occurrence of MACE in elderly CKD stages 3-5 patients,while 24-hour urine protein quantification was an independent risk factor.The combined detection of eGFR,24-hour urine protein quantification,Irisin,and Adropin had a higher predictive efficiency for MACE occur-rence in elderly CKD stages 3-5 patients,with an area under the ROC curve of 0.850,which was significantly larger than those of single indicator detection(0.778,0.752,0.716,0.798;Z=2.753,5.136,6.023,2.697,P=0.006、0.000、0.000、0.007).Conclusion Serum Irisin and Adropin levels are reduced in elderly patients with CKD stages 3-5.The combined detection of eGFR,24-hour urine protein quantification,Irisin,and Adropin has a high predictive val-ue for the occurrence of MACE in elderly CKD stages 3-5 patients.