| Objective: Chronic Kidney Disease-Mineral and Bone Disorder(CKD-MBD)is a systemic syndrome caused by CKD renal function decline,bone caused by renal osteodystrophy,and osteoporosis Impaired health is one of its important characteristics,often accompanied by cardiovascular diseases related to arteriosclerosis and extensive vascular calcification(including coronary artery calcification).This study compares and analyzes the MBD characteristics of Diabetic Nephropathy(DN)dialysis patients and non-DN dialysis patients,and discovers the potential specificity of MBD in the DN dialysis population,to improve the personalized MBD management of the DN dialysis population and the prevention and treatment of cardiovascular diseases Provide new ideas.Methods:This study screened patients who underwent Maintenance Hemodialysis(MHD)in Subei People’s Hospital of Jiangsu Province from June to November 2020 and healthy people who were in the physical examination center of Subei People’s Hospital of Jiangsu Province during the same period.A total of 102 cases were divided into DN groups according to different underlying diseases.Non-DN and healthy groups.Collect fasting venous blood from patients before MHD and healthy physical examinations,and use Polymerase Chain Reaction(PCR)amplification first-generation sequencing to detect SNPs at Klotho G-395 A in the DN group and the healthy group(Single Nucleotide Polymorphism,SNP)genotype distribution;Enzyme-Linked Immuno Sorbent Assay(ELISA)was used to detect serum Klotho protein,Fibroblast Growth Factor(FGF23),and bone origin in patients in the MHD group Alkaline Phosphatases(Bone Alkaline Phosphatases,BALP),1,25-(OH)2-Vit D3.And collect the general and clinical biochemical data of the enrolled patients.First,compare and analyze the blood calcium(Ca),blood phosphorus(P),parathyroid hormone(i PTH),1,25-(OH)2-Vit D3,FGF23,hemoglobin(Hb),white blood of dialysis patients in the DN group and the non-DN group.Differences in protein(ALB),triglycerides(TG),total cholesterol(TC),and other indicators.Then explore the effect of different subtypes of Klotho G-395 A gene on MBD characteristics of dialysis patients in the DN group.All data analysis was done using SPSS 26.0 software package,the inspection level was α=0.05,and P<0.05 was statistically significant.Results:(1)Comparison of general conditions: There was no statistical difference in age and dry weight between the two groups of MHD patients.Compared with the non-DN group,the proportion of men in the DN group was higher in dialysis patients(P<0.05).The dialysis month age in the DN group was shorter than that in the non-DN group(P<0.05).(2)Comparison of MBD characteristics: Compared with non-DN group dialysis patients,DN group dialysis patients had lower blood Ca,1,25-(OH)2-Vit D3,and ALB levels before dialysis(P<0.05),while FGF23 levels Higher(P<0.05).The proportion of the DN group taking phosphorus binder and active vitamin D drugs was higher than that of the non-DN group(P<0.05).There was no significant difference in Hb,TG,TC,blood P,i PTH indexes between the two groups(P>0.05).(3)Klotho G-395 A locus genotype analysis: The genotype distribution of Klotho G-395 A locus in the DN group and the healthy group conforms to the Hardy-Weinberg equilibrium,that is,the selected samples are representative of the population.Compared with the healthy group,the A allele frequency of the DN group was higher than that of the healthy group(P<0.05).(4)Comparison of MBD characteristics among subgroups of DN dialysis patients:There were statistically significant differences in BALP,blood P,and Hb levels between patients with GG genotype and GA+AA genotype(P<0.05).Compared with the GG genotype,the BALP,blood P and Hb levels of GA+AA genotype patients were higher than those of the GG genotype.The two subgroups had no significant differences in serum Klotho protein,FGF23,i PTH,1,25-(OH)2-Vit D3,blood Ca,and ALB levels(P>0.05).(5)The relationship between MBD indicators of dialysis patients in the DN group:serum BALP levels were positively correlated with blood P levels(rs=0.493,P=0.009).Between BALP and blood Ca,i PTH,1,25-(OH)2D3 indicators,between serum Klotho protein and FGF23 levels,between Klotho protein,FGF23 and blood Ca,blood P,i PTH,1,25-(OH)2D3 indicators,There was no significant correlation between 1,25-(OH)2D3and blood Ca,P,i PTH(P>0.05).In the GA+AA genome,BALP was found to be negatively correlated with blood Ca levels(rs=-0.564,P=0.029).Between Klotho protein and FGF23 in GA+AA genome,between Klotho protein,FGF23,BALP,and blood P,Ca,i PTH,1,25-(OH)2-Vit D3,and 1,25-(OH)2-Vit D3 and blood There was no significant correlation between P,blood Ca,and i PTH(P>0.05).Conclusion 1.Dialysis patients in the DN group had lower blood Ca and 1,25-(OH)2-Vit D3 levels,higher FGF23 levels,and more serious calcium and phosphorus metabolism disorders.2.The GA+AA genotype at the G-395 A site of the Klotho gene is related to MBD of DN dialysis patients. |
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