Transforming Growth Factor Beta 1 as a Risk Factor for Cardiovascular Diseases in End-Stage Renal Disease Patients Treated With Peritoneal Dialysis

Background: The aim of the study was to evaluate the relationship between the atherosclerotic changes in the carotid arteries expressed as common carotid artery intima-media thickness (CCA-IMT) with Body Mass Index (BMI), serum lipid levels, and selected inflammatory state markers in peritoneal dialysis (PD) patients. Methods: The study included 67 patients (31 female and 36 male) on PD therapy for 30.4 +/- 24.2 months. Average age of the patients was 52.9 +/- 12.5 years (ranged from 19 to 75 years). The measurement of the CCA-IMT was performed by ultrasonography evaluation. BMI was calculated using the Quetelet formula. Serum lipid levels and hsCRP were performed using routine methods. IL-6, TGF-beta 1, TNF-alpha, and hepatic growth factor (HGF) were tested with ELISA assays. Results: In univariate analysis, the strongest factor influencing CCA-IMT was age (R = 0.54; p < 0.0001). CCA-IMT correlated positively with BMI (R = 0.39; p = 0.003). Of the inflammatory markers studied, significant correlations with CCA-IMT were shown for IL-6 (R = 0.35; p = 0.009), and TGF-beta (R = 0.31; p = 0.02). In multiple regression, only In TGF-beta 1 (partial correlation coefficient = 0.29; p = 0.04) appeared to predict CCA-DIT independently of age and BMI, while IL-6 was not significant in the analysis. The regression model including age, BMI and TGF-beta 1 as independent variables, explained 43% of CCA-IMT variance. Again, age was the strongest predictor of CCA-IMT (partial correlation coefficient = 0.50). Conclusions: Increased concentration of TGF-beta 1 may be a biomarker of the development of cardiovascular diseases in patients treated with PD, as well as a prognostic factor in the evaluation of atherosclerosis progression in this group of patients.