Cozzolino Mario, Biondi Maria Luisa, Galassi Andrea, Gallieni Maurizio, d'Eril Gian Vico Melzi, Brancaccio Diego
Renal Division, S. Paolo Hospital, University of Milan, Milan, Italy.
Am J Nephrol. 2007;27(6):639-42. doi: 10.1159/000108360. Epub 2007 Sep 11.
Vascular calcification (VC) and accelerated atherosclerosis are major causes of cardiovascular (CV) morbidity and mortality in haemodialysis (HD) patients. Inhibitory proteins are associated with reduced VC and may play a key role in preventing CV in chronic kidney disease (CKD) patients. Fetuin-A, also known as alpha(2)-Heremans-Schmid glycoprotein (AHSG), is a circulating plasma protein with inhibitory effects on VC that has been associated with inflammation and CV mortality in HD patients. In the present study, we investigated the associations between serum fetuin-A levels and its gene (AHSG) polymorphisms in an Italian HD population.
Ninety-six patients on stable chronic HD treatment and 57 healthy controls were genotyped for the common polymorphisms on the AHSG (T256S). In addition, serum fetuin-A levels were tested.
In this study, serum fetuin-A levels were lower in HD patients (0.35 +/- 0.11 g/l) compared with healthy controls (0.62 +/- 0.31 g/l, p < 0.05). In both HD patients and the control group, the distribution of the AHSG gene did not show significant association between low serum fetuin-A levels and the Ser/Ser genotype, known to be associated with a higher CV mortality risk in the HD population. Moreover, the distribution of AHSG gene polymorphisms in HD patients and in healthy controls was similar.
In contrast with previous reports, this study suggests that CKD patients on HD treatment have a similar polymorphism distribution of the AHSG gene compared with the normal population and that the reduction in serum fetuin-A levels in Italian HD patients is not associated with an alteration in the distribution of AHSG T256S polymorphisms.
血管钙化(VC)和动脉粥样硬化加速是血液透析(HD)患者心血管(CV)发病和死亡的主要原因。抑制性蛋白与VC减少相关,可能在预防慢性肾脏病(CKD)患者CV疾病中起关键作用。胎球蛋白-A,也称为α(2)-赫曼斯-施密德糖蛋白(AHSG),是一种循环血浆蛋白,对VC具有抑制作用,与HD患者的炎症和CV死亡率相关。在本研究中,我们调查了意大利HD人群中血清胎球蛋白-A水平与其基因(AHSG)多态性之间的关联。
对96例接受稳定慢性HD治疗的患者和57例健康对照进行AHSG(T256S)常见多态性基因分型。此外,检测血清胎球蛋白-A水平。
在本研究中,HD患者的血清胎球蛋白-A水平(0.35±0.11 g/l)低于健康对照(0.62±0.31 g/l,p<0.05)。在HD患者和对照组中,AHSG基因的分布在低血清胎球蛋白-A水平与Ser/Ser基因型之间未显示出显著关联,已知该基因型与HD人群中较高的CV死亡风险相关。此外,HD患者和健康对照中AHSG基因多态性的分布相似。
与先前报道相反,本研究表明接受HD治疗的CKD患者与正常人群相比,AHSG基因的多态性分布相似,并且意大利HD患者血清胎球蛋白-A水平的降低与AHSG T256S多态性分布的改变无关。