Factors Associated with Circulating Soluble Vascular Cell Adhesion Molecule-1 Level in Hemodialysis Patients

摘要

BACKGROUND: Elevated circulating soluble vascular cell adhesion molecule-1 (sVCAM-1) predicts outcomes in chronic kidney disease. We aimed to assess the factors associated with sVCAM-1 in hemodialysis (HD).METHODS: In this cross-sectional study, we included 189 prevalent HD patients. Serum cell adhesion molecule and inflammatory cytokine levels were measured using an enzyme-linked immunosorbent assay. Circulating mononuclear cells (MNCs) were isolated from patients and used to measure superoxide production and endothelial adhesion. Ultraweak and luminal-enhanced chemiluminescence were used to estimate the superoxide generation by MNCs. MNC adhesiveness to endothelial cells was measured with an automatic fluorometer.RESULTS: In a univariate analysis, sVCAM-1 was significantly associated with age, MNC-endothelial cell adhesion, intercellular adhesion molecule 1 (ICAM-1), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), serum cholesterol, triglyceride, glucose, hemoglobin, albumin, E-selectin, MCP-1, tumor necrosis factor-a, and higher basal MNC superoxide production. Stepwise multivariate linear regression analysis showed that age, higher basal superoxide production, MNC-endothelial cell adhesion, soluble intercellular adhesion molecule-1 (sICAM-1), hs-CRP, and IL-6 were independently associated with sVCAM-1. Serum albumin was negatively associated with sVCAM-1.CONCLUSION: Along with some traditional prognostic factors including age, albumin, sICAM-1, hs-CRP, and IL-6, sVCAM-1 is strongly associated with two novel prognostic factors, basal MNC superoxide production and MNC-endothelial cell adhesion, in HD patients.