Serum brain-derived neurotrophic factor reflects the lower inflammation, lipid level, and major adverse cardiac and cerebrovascular events risk in maintenance hemodialysis patients

Abstract

Brain-derived neurotrophic factor (BDNF) serves an anti-inflammation and anti-atherosclerosis role in vitro and in vivo, which also acts as a biomarker for the prognosis of cardio/cerebral vascular diseases; however, its clinical value in maintenance hemodialysis (MHD) patients’ management is few reported. Hence, this study aimed to evaluate the role of BDNF in estimating the major adverse cardiac and cerebrovascular events (MACCE) risk in MHD patients. A total of 490 MHD patients and 100 healthy controls (HCs) were enrolled. Subsequently, their serum BDNF levels were assessed using an enzyme-linked immunosorbent assay. Our study shows that BDNF was notably (more than two folds) decreased in MHD patients compared with that in HCs (median (interquartile range) value: 5.5 (3.1–9.4) vs. 13.2 (9.4–19.1) ng/mL). BDNF negatively correlated with diabetes history, hemodialysis duration, C-reactive protein, total cholesterol, and low-density lipoprotein cholesterol in MHD patients. During a median follow-up period of 17.4 months, accumulating MACCE rate was calculated, which disclosed that high BDNF was correlated with decreased accumulating MACCE rate in MHD patients. In detail, the 1-year/2-year/3-year/4-year accumulating MACCE rates in MHD patients with low BDNF were 11.6%/24.9%/31.2%/50.3%, respectively, while these rates were 5.9%/12.7%/22.7%/37.6% in MHD patients with high BDNF, separately. Furthermore, the correlation between BDNF and accumulating MACCE risk was subsequently validated in a multivariate cox’s regression analysis (hazard ratio: 0.602, 95% confidential interval: 0.399–0.960). In conclusion, Serum BDNF decreases in MHD patients, which would reflect the lower inflammation, and lipid level, especially forecasting the decreased MACCE risk in those patients.