Omentin-1 Levels In Patients With Chronic Kidney Disease And Its Associateds With Micro Inflammatory State

Objective:Chronic kidney disease was a public health problem that threaten the whole world,the morbidity and mortality is increasing in the world.The risk factors of chronic kidney disease and its main complications of cardiovascular events in addition to diabetes and hypertension,micro inflammatory state became more and more attention.The main path- ophysiologic mechanism underlying the high mortality of CKD was premature atherosclerosis and chronic inflammation.Micro inflammation state showed the continued low levels of the inflammatory state,but no signs of local or systemic acute infection,could predict future cardiovascular events,the main feature was that inflammatory protein and inflammatory factors mild elevated in the circulation,its characteristic was continued and occult.Micro infla- mmation state was enssencial the immune inflammation.Tumor necrosis factor alpha(TNF-α) and high sensitive C reactive protein(hs-CRP),IL-6 was currently recognised the main inflammatory putative markers.The studies had shown that micro inflammation state played an important role in the occurrence and development of cardiovascular events,malnutrition,anemia and other complicationsin patients with chronic kidney disease,which was also the important factors in patients with elevated mortality.Adipose tissue have been recognized to have endocrine function and secretes a variety of hormones called adipokines,many kinds of adipokines have an important influence on the pathogenesis of chronic kidney disease.Omentin was a novel adipokine found in adipose tissue,it was expressed especilly in omental adipose tissue,which played an important role in diabetes,obesity,metabolic syndrome,rheumatoid arthritis,coronary heart disease,hypertension disease et al and disorder’s occurrence and development,it could enhance the insulin sensitivity, promote endothelial dependent vasodilation, inhibited infla- mmation,atherosclerosis,and immune accommodation and other cells and inflammatory factor.This experiment aims to discuss the level of serum Omentin of patients with CKD and its relationship with micro inflammation state.Methods:the experiment group:all patients secleted from the department of nephrology, the second hospital of Hebei Medical University. We chosen 80 cases(41 males and 39 females, mean age 49.60±12.50 years old) diagnosed chronic kidney disease without renal replacement therapy during the period January 2014 to July 2014. According to the National Kidney Foundation, guidelines definition of chronic kidney disease in 2012. The patients were divided into CKD1-2 group(20 cases, 11 males, 9 females);CKD3 group(20 cases, 8 males, 12 females);CKD4 group(20 cases, 13 males,7 females) and CKD5 group(20 cases, 9 males, 11 females). Exclusion criteria included the following:diabetes, connective tissue disease, liver disease, various acute and chronic infectious diseases, various tumors, without the occurrence of acute cardiovascular events within 3 months,without operation within 3 months. Control group:select the same health examination inour hospital in 20 cases as control group, 11 males, 9 females,mean age 50.05±15.00 years old. The two groups in sex, age and otheraspects ofno significant difference(P > 0.05). Using enzyme linked immunosorbent assay(ELISA)testing serum Omentin,TNF-α concentration. Record the general condition of the patient and related clinical indexes,age,sex, height, weight, body mass index(BMI), blood pressure, serum creatinine(Scr), uric acid(UA), albumin(ALB), total cholesterol(CHOL), triglyceride(TG), low densitylipoprotein-C(LDL-C), high density apolipoprotein-C(HDL-C), apolipoprotein A(Lpa), urine protein(24h UPro) and glomerular filtration rate(e GFR),high sensitive C reactive protein(hs CRP),fasting glucose,insulin,IR was examined with the homeostasis model assessment of insulin resistance index(HOMA-IR) by using the following formula?[fasting insulin(m IU/m L)×fasting glucose(mmol/L) /22.5]. All data analyses were performed using Statistical package for social sciences(SPSS) 15.0 for Windows.Continuous variabes are expressed as mean±standard( x ±s).Multiple group sample mean comparison of homogeneity of variance test,using the single factor variance analysis.The homogeneity of variance in two compared with LSD method,homogeneity of variance for Kruskal-Wallis H test.Pearson’s correlation test was used to identify whether there was any correlation among variables or not.A p value of less than 0.05 was considered statistical significance.Results:1 The clinical data:The CKD1-2 group of 20 cases,11 males,9 females;The CKD3 group of 20 cases,8 males,12 females;The CKD4 group of 20 cases,13 males,7 females;the CKD5 group of 20 cases,9 males,11 females;The control group of 20 cases,11 males,9 females.No significant difference of groups in age,sex(P>0.05),including 61 cases of primary glomerulonephritis,13 cases of hypertensive renal damage,vesicoureteral reflux in 3 cases,3 cases of polycystic kidney.2 Omentin levels in research groups:The level of omentin patients was significantly higher than the control group(P<0.05),and with the worsening of renal function,serum retinal peptide level in patients with increased gradually, with significant difference(P<0.05).3 hs-CRP level in research groups:The level of hs-CRP patients was significantly higher than the control group(P<0.05),and with the worsening of renal function,serum retinal peptide level in patients with increased gradually, with significant difference(P<0.05).4 TNF-α level in research groups:The level of TNF-α patients was significantly higher than the control group(P<0.05),and with the worsening of renal function,serum retinal peptide level in patients with increased gradually, with significant difference(P<0.05).5 Correlation analysis: Serum omentin level and age,gender,BMI had no statistical significance(P>0.05),but with Scr,hs-CRP,TNF-α,HOMA-IR showed a positive correlation(P<0.05),and negatively correlated withConclusion:1 Serum Omentin level in patients with chronic kidney disease was elevated from CKD1,with the deterioration of the disease significantly increased gradually.2 Serum hs-CRP,TNF-α levels in chronic kidney disease patients were increased from CKD1,with the deterioration of renal function gradually aggravate,once again confirmed the presence of micro inflammatory state in patients with CKD.3 The level of Omentin showed a positive correlation with hs-CRP,TNF-α in chronic kidney disease, the level of omentin predict micro in-flammation state accurately.