De la Cruz-Ahumada Claudia Jackelin, Topete-Reyes Jorge Fernando, Mena-Ramírez Juan Pablo, Guzmán-Flores Juan Manuel, Guzmán-González Jesúa Ivan, Ramírez-De Los Santos Saúl
Laboratorio de Investigación en Biociencias, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47620, Jalisco, Mexico.
Instituto Mexicano del Seguro Social, HGR 46, Guadalajara 44910, Jalisco, Mexico.
J Pers Med. 2023 Aug 27;13(9):1311. doi: 10.3390/jpm13091311.
Hemodialysis deteriorates patients' physical, metabolic, and mental status. Clinical outcomes derived from inflammation determine a worse status but are less frequently identified. The objective of the study was to identify inflammatory determinants and the effect of SNP-related serum IL-6 and IL-10 levels on associated morbidity in hemodialysis. A sample of hemodialysis patients at IMSS Regional Hospital No.46 in Guadalajara ( = 85) were tested using the Malnutrition Inflammation Score (MIS) and Patient Health Questionnaire-9 (PHQ-9) to assess the associated morbidity. Serum cytokine levels were quantified by enzyme-linked immunosorbent assay (ELISA). The restriction fragment length polymorphism (RFLP) technique was used for analysis of -572C/G and -1082A/G. Using data visualization methods, we identified relevant determinants of inflammation. A simple regression model was constructed between predictors and targets with genotypes as covariates. Results showed malnutrition in 85.9% of patients and depressive symptoms in 50.6%. IL-10 was the most relevant inflammatory determinant, with regression coefficients (R) between 0.05 and 0.11. The GG genotype of -1082 A/G evinced small effect on both clinical outcomes (δ of 0.35 and 0.37, respectively). Hemodialysis increases the associated morbidity, cytokines act as inflammatory determinants, and genetic variability contributes to the severity of clinical outcomes. Further studies need to refine the causal relationship between inflammation and CKD.
血液透析会使患者的身体、代谢和精神状态恶化。由炎症导致的临床结果预示着更差的状态，但这种情况较少被识别出来。本研究的目的是确定炎症的决定因素以及单核苷酸多态性（SNP）相关的血清白细胞介素-6（IL-6）和白细胞介素-10（IL-10）水平对血液透析相关发病率的影响。对瓜达拉哈拉第46号IMSS地区医院的85例血液透析患者样本，使用营养不良炎症评分（MIS）和患者健康问卷-9（PHQ-9）来评估相关发病率。通过酶联免疫吸附测定（ELISA）对血清细胞因子水平进行定量。采用限制性片段长度多态性（RFLP）技术分析-572C/G和-1082A/G。使用数据可视化方法，我们确定了炎症的相关决定因素。以基因型作为协变量，在预测因子和目标之间构建了一个简单回归模型。结果显示，85.9%的患者存在营养不良，50.6%的患者有抑郁症状。IL-10是最相关的炎症决定因素，回归系数（R）在0.05至0.11之间。-1082 A/G的GG基因型对两种临床结果的影响均较小（分别为δ为0.35和0.37）。血液透析会增加相关发病率，细胞因子是炎症的决定因素，基因变异性会导致临床结果的严重程度增加。进一步的研究需要明确炎症与慢性肾脏病（CKD）之间的因果关系。
