ASSOCIATION OF FETUIN-A AND OSTEOCALCIN WITH RENAL FUNCTION AND OTHER BIOMARKERS IN CHRONIC KIDNEY DISEASE PATIENTS FROM BAGHDAD
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Objective: Chronic kidney disease is a condition that results in the gradual decline of kidney function, often leading to renal replacement therapy such as transplantation or dialysis. This investigation aims to determine if a correlation existed between the levels of Osteocalcin, Fetuin-A, and other biochemical markers, such as urea, creatinine, albumin, calcium, phosphate, vitamin D, and PTH, in patients with CKD compared to healthy people as controls. Fetuin-A is a glycoprotein that is involved in regulating calcium and phosphate metabolism, while osteocalcin is a protein that is involved in bone formation and remodeling. Both of these biomarkers have been studied in chronic kidney disease, and their levels are altered in patients with this condition. This information could help to better understand the pathophysiology of chronic kidney disease and potentially identify new targets for treatment or control progressions of the disease. Methods: one hundred eighty samples divided into one hundred twenty chronic kidney disease patients in end-stage (G5) and sixty healthy controls were taken between November 2022 and March 2023 from three major hospitals in Baghdad: Baghdad Teaching Hospital/Iraqi Center for Dialysis, National Center for Teaching Laboratories, and Ghazi AL-Hariri Surgical Specialties Hospital/Kidney Diseases and Transplantation Center. Chronic kidney disease was diagnosed using symptoms, biochemical testing, history, and clinical examination by specialized nephrologists. The blood urea, serum creatinine, calcium, Albumin, and phosphate were measured by an automated spectrophotometer (Roche Cobas C111). Furthermore, an automated spectrophotometer (Beckman coulter au480) was used to measure serum sodium and potassium levels. on the other hand, vitamin D3 level and PTH were measured by spectrophotometer (Roche Cobas E411). Moreover, Osteocalcin and Fetuin-A were done by ELISA technique. Results: The present study found that the male patients are more than females, (70) were men and (50) were women and the highest percentage of CKD cases were found in the age group of 50-59 years, with 55 out of 120 cases (45.8%). also indicates that the percentage of females with CKD was higher in the age group of 50-59 years, with 30 out of 50 cases (60.0%) compared to males in some age groups, where only 25 out of 70 males (35.7%). Also, the study results showed that the control group had a mean GFR of 92.58±1.98ml/min, while the chronic kidney disease stage 5 group had a significantly lower mean GFR of 5.61±0.20ml/min. The study found that out of 120 CKD patients, 37 cases (30.8%) were overweight with a BMI of 25-29.9 (Kg/m2), 18 cases (15.0%) suffered from obesity with BMI values >30 (Kg/m2), 57 cases (47.5%) had normal weight with BMI values between 18.5 to 24.9 (Kg/m2) (Kg/m2), and 8 cases (6.7%) were underweighted. this study indicates that there were significant differences in the levels of PTH, Fetuin-A, and Osteocalcin among CKD patients and the control p-values associated with these differences are all ≤0.001. also, indicates a strong positively correlated between the levels of Fetuin-A and GFR. while a moderate positively correlated between the levels of Fetuin-A with S. Ca, and Albumin. On the other hand, there is a weak positively correlated between the levels of Fetuin-A with BMI and Vit-D. Furthermore, the levels of Fetuin-A were found to be moderately negatively correlated with the levels of PTH and S.po4. also found that there is a strong negative correlation between the levels of Fetuin-A with creatinine, urea, and Osteocalcin, moreover, a strong negatively correlated between the level of Osteocalcin with GFR and Fetuin-A, also a moderate negatively correlated between the level of Osteocalcin with S. Ca and S. albumin. Furthermore, there is a weak negatively correlated between the levels of Osteocalcin with BMI and Vit-D. while a moderate positively correlated between the levels of Osteocalcin with S.po4 and PTH. the study also found that there is a strong positively correlated between the levels of Osteocalcin with blood urea and serum creatinine. Conclusion: Fetuin-A and Osteocalcin are two proteins that have been studied with CKD and its associated complications. While decreased Fetuin-A concentrations have been linked to increased calcification in the vasculature and mortality, increased Osteocalcin levels in CKD may not confer a protective effect against bone disorders. Further investigation is required to fully understand the roles of these proteins in CKD and to develop strategies for their clinical Use in the managing of CKD patients.
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