Correlation of Serum VASH-1 and SFRP4 levels with autologous arteriovenous fistula stenosis in hemodialysis patients

Luo Yangui; Zhu Xiaojing; Zhang Aihong; Jia Lina; Lyu Wenlu; Yi Jinjin; Xu Wanting

doi:10.11986/j.issn.1673-873X.2024.07.07

Abstract：Objective To investigate the relationship between serum levels of vasohibin 1(VASH-1)and secreted frizzled-re-lated protein 4(SFRP4)and the stenosis of autologous arteriovenous fistula(AVF)in hemodialysis patients,aiming to pro-vide a reference for predicting the risk of AVF stenosis in hemodialysis patients.Methods A total of 189 hemodialysis pa-tients treated at Xi'an People's Hospital from December 2020 to December 2023 were selected as the study group and divided into AVF stenosis group(n=65)and non-stenosis group(n=124)based on the occurrence of AVF stenosis.Additionally,145 healthy individuals who underwent physical examination during the same period were selected as the control group.Ser-um levels of VASH-1 and SFRP4 were detected by enzyme-linked immunosorbent assay within 24 hours after admission for all included participants and compared between groups.The diagnostic value of serum VASH-1 and SFRP4 for AVF steno-sis in hemodialysis patients was analyzed using the receiver operating characteristic(ROC)curve,and the factors influencing AVF stenosis in hemodialysis patients were analyzed using binary logistic stepwise regression analysis.Results The levels of serum C-reactive protein(CRP),fibrinogen(FIB),and SFRP4 in the study group were significantly higher than those in the control group,while the level of VASH-1 was significantly lower than that in the control group(P＜0.05).No statisti-cally significant differences were noted in the composition of gender,age,body mass index(BMI),smoking history,history of hypertension,history of diabetes,and levels of low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),hemoglobin(Hb),blood calcium(Ca),and blood phosphorus(P)between the two groups(P＞0.05).No statistically significant differences were observed in the levels of LDL-C,HDL-C,Hb,Ca,and P between the AVF stenosis group and the non-stenosis group(P＞0.05);however,the levels of serum CRP,FIB,and SFRP4 in the AVF stenosis group were significantly higher than those in the non-stenosis group,and the level of VASH-1 was significant-ly lower than that in the non-stenosis group(P＜0.05).The ROC curve analysis showed that the area under the curve(AUC)for diagnosing AVF stenosis in hemodialysis patients with serum VASH-1 and SFRP4 was 0.848(95％CI:0.798-0.898)and 0.851(95％CI:0.801-0.901),respectively;the AUC for diagnosing AVF stenosis combined with serum VASH-1 and SFRP4 was 0.921(95％CI:0.871-0.971).Logistic regression analysis showed that serum CRP＞25.25 mg/L(OR=1.950,95％CI:1.357-2.803),VASH-1≤315.25 ng/L(OR=3.404,95％CI:1.932-5.998),and SFRP4＞157.63 μg/L(OR=3.912,95％CI:2.126-7.196)were all risk factors for the occurrence of AVF stenosis in hemodialysis patients(P＜0.05).Conclusion The decrease in serum levels of VASH-1,and increase in SFRP4 levels of hemodialysis patients,and the changes in both levels are closely correlated with the occurrence of AVF stenosis,showing potential as auxiliary diagnostic markers for AVF stenosis in hemodialysis patients.