Study of correlation between calcification regulatory factors and cognitive impairment in maintenance hemodialysis patients

ObjectiveTo evaluate the correlation of serum dephosphorylated uncarboxylated matrix Gla protein （dp-ucMGP） and bone morphogenetic protein-2 （BMP-2） with cognitive impairment （CI） in maintenance hemodialysis （MHD） patients.MethodsTwo hundred and fifty-four MHD patients in the First Affiliated Hospital of Shihezi University and Shihezi People's Hospital from June 1， 2021 to April 30， 2023 were selected. The general and laboratory data of the patients were collected. Cognitive function was evaluated with the Chinese version of Montreal Cognitive Assessment Scale （C-MoCA）. Enzyme-linked immunosorbent assay （ELISA） was used to measure serum dp-ucMGP and BMP-2.ResultsAmong the 254 patients included， 192 patients with CI were screened by the C-MoCA scale. Patients in the CI group had significantly older age ［57.0（50.0，67.7）years vs 48.0（35.0，54.0）years］， higher systolic blood pressure ［SBP， 137（129，148）mmHg vs 134（125，142）mmHg， 1 mmHg=0.133 kPa］， female proportion （40.1% vs 22.6%）， proportion of hypertension （76.6% vs 45.2%）， years of education （≤6 years： 30.7% vs 4.8%； >6， ≤9 years： 41.2% vs 27.4%）， serum dp-ucMGP ［9.05（7.81，10.71）μg/L vs 5.95（4.43，7.21）μg/L］， and serum BMP-2［114.72（101.07，140.44）ng/L vs 89.65（74.17，101.74）ng/L］， but lower proportion of high education level （>9， <13 years： 20.3% vs 45.2%； ≥13 years： 7.8% vs 22.6%） than those in the non-CI group （P<0.05）. Binary Logistic regression analysis suggested that age， SBP and serum dp-ucMGP and BMP-2 were significantly correlated with CI in MHD patients （P<0.05）. Spearman correlation analysis showed that serum dp-ucMGP was negatively correlated with the C-MoCA score， and the scores of visuospatial/executive， attention， language， abstraction， delayed recall and orientation dimensions（P<0.05）. Serum BMP-2 was negatively correlated with the C-MoCA score， and the scores of visuospatial/executive， naming， attention， language， abstraction and delayed recall dimensions（P<0.05）.ConclusionSerum dp-ucMGP and BMP-2 are risk factors for CI in MHD patients， and their levels may be related to the severity of CI.