Decreased B Lymphocytes Subpopulations Are Associated With Higher Atherosclerotic Risk in Elderly Patients With Moderate-to-severe Chronic Kidney Diseases
Abstract Aim: Cardiovascular diseases (CVD) are the leading cause of death in patients with chronic kidney disease (CKD), and the risk of CVD increases with reductions in renal function. This study aims to investigate the potential roles of B lymphocyte populations in subclinical atherosclerosis (measured by intima-media thickness, IMT) and prognosis in elderly patients with moderate-to-severe CKD.Methods: In this study, a total of 219 patients (143 moderate-to-severe CKD patients with stage 3-4 and 76 non-CKD controls) were recruited. B cell subsets: B1 cells (CD19+CD5+) and B2 cells (CD19+CD5–) were analyzed by flow cytometry. Intima-media thickness (IMT) was measured by ultrasound. Correlations between the B cell subsets with IMT and clinical outcomes were analyzed.Results: CKD patients showed increased IMT (P=0.006). The level of B, B1 and B2 cells were decreased in CKD patients. Correlation analysis showed that IMT was positively correlated with systolic blood pressure, protein/creatinine ratio and diabetes (P<0.05), and were negatively correlated with B, B1 and B2 lymphocytes (P<0.05). IMT was increased in lower level of B (≤ 0.06 × 109 /L) and B2 cells (≤ 0.05 × 109 /L) (P<0.05). Kaplan-Meier analysis showed that patients with lower level of B, B1 and B2 cells exhibited worse survival (P<0.05).Conclusions: Our results showed that decreased B1 and B2 lymphocytes were correlated with atherosclerosis and worse survival, which indicates that B lymphocytes might involve in atherosclerosis and associated the prognosis of elderly patients with moderate-to-severe CKD.