Kronik böbrek hastalığında kan örneklerinde DKK-3 protein düzeyleri ile nabız dalga hızı, santral kan basıncı ve diğer kardiyovasküler risk faktörleri arasındaki ilişki
Yükleniyor...
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Hücre farklılaşması, çoğalması ve apoptozdaki rolü ile yeni keşfedilen bir
glikoprotein olan DKK-3’ün serum düzeylerinin nabız dalgası analizi ile diğer
kardiyovasküler risk faktörleri ve kan-idrar parametreleri arasındaki ilişkiyi araştırmayı
amaçladık.
Materyal ve Metod: Necmettin Erbakan Üniversitesi Tıp Fakültesi nefroloji
polikliniklerinde takipte olan kronik böbrek hastalarında çalışmaya dahil edilenlerde rutin
kontroller sırasında bakılan biyokimyasal tetkiklerin yanında DKK3 ölçümü için kan
örnekleri pıhtı aktivatör içeren jelli tüplere alındı. Alınan kan örnekleri Hettich Rotina 46R
(Hettich Zentrifugen, Tuttlingen, Almanya) marka cihazda 4 ⁰C, 1.000 g hızda ve 10 dakika
santrifüj edilerek serum örnekleri ayrıldı. Dickkopf-3 analizleri çalışılıncaya kadar serum
örnekleri -80 °C’ de New Brunswick U570 (New Brunswick Scientific, New Jersey, ABD)
buzdolabında saklandı.
Çalışmaya katılanların serum örneklerindeki Dickkopf-3 analizleri Necmettin
Erbakan Üniversitesi Tıp Fakültesi Tıbbi Biyokimya Anabilim Dalı Araştırma
Laboratuvarında yapıldı. Serum Dickkopf-3 düzeyinin ölçümü için insan Dickkopf-3 ELISA
(E2065Hu, Bioassay Technology Laboratory Inc., Şanghay, Çin) kiti kullanıldı. Dickkopf-3
düzeyleri üretici talimatlarına uygun olarak çift antikor sandviç ELISA yöntemi ile ölçüldü.
ELISA kitlerinin yıkama sürecinde Biotek ELX 50 mikroplate yıkayıcı (BioTek
Instruments, Vermont, ABD) kullanıldı. Spektrofotometrik ölçümlerde Bio-rad Mikroplate
absorbans okuyucu xMark (Bio-rad Laboratories, Kaliforniya, ABD) sistemi kullanılarak
absorbans-konsantrasyon kalibrasyon grafiklerine göre Dickkopf-3 sonuçları “ng/mL”
olarak hesaplandı.
Nefroloji Polikliniğimizde rutin olarak kullandığımız Mobil Graph New Genereation
S/N C299843 cihazıyla nabız dalga hızı ve santral kan basıncı ölçümleri yapıldı. Nabız dalga
analizi ölçümü ile SKB, DKB, OAB, NB, merkezi sistolik ve diyastolik kan basıncı, Aix ve
NDH değerleri ölçülüp kaydedildi. Bu hastalarla aynı cinsiyet ve yaş grubundan ek hastalığı
ilaç kullanımı olmayan sağlıklı kontrol grubundan da benzer örnekler alınarak çalışıldı. Elde
edilen veriler “Statistical Package for the Social Sciences”(SPSS Inc, Chicago, USA) 22.0
paket programı ile değerlendirilip tanımlayıcı frekans, merkezi dağılım ve yaygınlık ölçütleri
ve karşılaştırmalar için ki kare, korelasyon analizleri yapıldı.
Bulgular: KBH grubunun DKK-3 düzeyleri ortancası (30,97 (20,92-50,35) ng/mL),
kontrol grubunun DKK-3 düzeyleri ortancasından (80,37 (40,45-90,36) ng/mL) istatistiksel
olarak anlamlı düzeyde düşüktü (p<0,001). Yapılan çok değişkenli analizde HDL
değerindeki bir birimlik arışın DKK-3 düzeyini 0,030 kat artırdığı, HbA1C değerindeki bir
birimlik artışın DKK-3 düzeyini 0,361 kat azalttığı, PWV değerindeki bir birimlik artışın
DKK-3 değerini 0,279 kat azalttığı belirlendi. Çok değişkenli analize dâhil edilen diğer
değişkenlerin DKK-3 düzeyi üzerinde anlamlı etkisi olmadığı belirlendi. Yapılan tek
değişkenli analizlerde yaştaki bir birimlik artışın PWV düzeyini 0,096 kat artırdığı,
GFR’deki bir birimlik artışın PWV düzeyini 0,032 kat azalttığı, DKK-3 düzeyindeki bir
birimlik azalışın PWV düzeyini 0,359 kat artırdığı, OAB’deki bir birimlik artışın PWV
düzeyini 0,046 kat artırdığı ve nabız basıncındaki bir birimlik artışın PWV düzeyini 0,049
kat arttırdığı belirlendi. Tek değişkenli analize dâhil edilen diğer değişkenlerin PWV düzeyi
üzerinde anlamlı etkisi olmadığı belirlendi.
Yapılan tek değişkenli analizlerde erkeklerde proteinüri düzeyinin 795,859 birim
daha fazla olduğu, GFR’deki bir birimlik artışın proteinüri düzeyini 25,595 kat azalttığı,
OAB’deki bir birimlik artışın proteinüri düzeyini 26,581 kat artırdığı belirlendi. Tek
değişkenli analize dâhil edilen diğer değişkenlerin proteinüri düzeyi üzerinde anlamlı etkisi
olmadığı belirlendi.
Sonuç: Serum DKK-3 düzeyi KBH olan hastalarda kontrol grubuna göre anlamlı
olarak düşük bulunmuştur. Tüm grup değerlendirmesinde serum DKK3 düzeyi ile PWV ve
proteinüri arasında negatif yönde korelasyon görülmüştür.
Aim: We aimed to investigate the relationship between pulse wave analysis of serum levels of DKK3, a glycoprotein recently discovered for its role in cell differentiation, proliferation and apoptosis, and other cardiovascular risk factors and blood-urine parameters. Materials and Methods: Blood samples were collected in gel tubes containing clot activator for DKK3 measurement in addition to biochemical tests performed during routine controls in patients with chronic kidney disease who were followed up in Necmettin Erbakan University Faculty of Medicine nephrology outpatient clinics. Blood samples were centrifuged at 4 ⁰C, 1,000 g for 10 minutes in a Hettich Rotina 46R (Hettich Zentrifugen, Tuttlingen, Germany) and serum samples were separated. Serum samples were stored in a New Brunswick U570 (New Brunswick Scientific, New Jersey, USA) refrigerator at -80 °C until Dickkopf-3 analyses were performed. Dickkopf-3 analyses in serum samples of the study participants were performed in the Research Laboratory of the Department of Medical Biochemistry, Faculty of Medicine. Human Dickkopf-3 ELISA (E2065Hu, Bioassay Technology Laboratory Inc., Shanghai, China) kit was used for the measurement of serum Dickkopf-3 levels. Dickkopf-3 levels were measured by double antibody sandwich ELISA method according to the manufacturer's instructions. Biotek ELX 50 microplate washer (BioTek Instruments, Vermont, USA) was used for washing the ELISA kits. In spectrophotometric measurements, Dickkopf-3 results were calculated as "ng/mL" according to absorbance-concentration calibration graphs using Bio-rad Microplate absorbance reader xMark (Bio-rad Laboratories, California, USA) system. Pulse wave velocity and central blood pressure measurements were performed with Mobil Graph New Genereation S/N C299843 device which is routinely used in our Nephrology Outpatient Clinic. With pulse wave analysis measurement, SDB, DBP, OAB, NB, central systolic and diastolic blood pressure, CPP, Aix and NDH values were measured and recorded. Similar samples were taken from a healthy control group of the same gender and age group with no comorbidities and drug use. The data obtained were evaluated with the "Statistical Package for the Social Sciences" (SPSS Inc, Chicago, USA) 22.0 package programme and descriptive frequency, central dispersion and prevalence measures and chi-square and correlation analyses were performed for comparisons. Results: The median DKK-3 level of the CKD group (30.97 (20.92-50.35) ng/mL) was statistically significantly lower than the median DKK-3 level of the control group (80.37 (40.45-90.36) ng/mL) (p<0.001). In the multivariate analysis, it was determined that a oneunit increase in HDL value increased DKK-3 level by 0.030 fold, a one-unit increase in HbA1C value decreased DKK-3 level by 0.361 fold, and a one-unit increase in PWV value decreased DKK-3 level by 0.279 fold. Other variables included in the multivariate analysis had no significant effect on the level of LCD-3. In the univariate analyses, it was determined that a one-unit increase in age increased PWV level by 0.096 fold, a one-unit increase in GFR decreased PWV level by 0.032 fold, a one-unit decrease in DKK-3 level increased PWV level by 0.359 fold, a one-unit increase in OAB increased PWV level by 0.046 fold and a one-unit increase in pulse pressure increased PWV level by 0.049 fold. Other variables included in the univariate analysis had no significant effect on PWV level. In univariate analyses, it was determined that the proteinuria level was 795,859 units higher in men, one unit increase in GFR decreased the proteinuria level 25,595 times, and one unit increase in OAB increased the proteinuria level 26,581 times. Other variables included in the univariate analysis had no significant effect on proteinuria level. Conclusion: Serum DKK-3 level was found to be significantly lower in patients with CKD compared to the control group. In the whole group evaluation, a negative correlation was observed between serum DKK3 level and PWV and proteinuria.
Aim: We aimed to investigate the relationship between pulse wave analysis of serum levels of DKK3, a glycoprotein recently discovered for its role in cell differentiation, proliferation and apoptosis, and other cardiovascular risk factors and blood-urine parameters. Materials and Methods: Blood samples were collected in gel tubes containing clot activator for DKK3 measurement in addition to biochemical tests performed during routine controls in patients with chronic kidney disease who were followed up in Necmettin Erbakan University Faculty of Medicine nephrology outpatient clinics. Blood samples were centrifuged at 4 ⁰C, 1,000 g for 10 minutes in a Hettich Rotina 46R (Hettich Zentrifugen, Tuttlingen, Germany) and serum samples were separated. Serum samples were stored in a New Brunswick U570 (New Brunswick Scientific, New Jersey, USA) refrigerator at -80 °C until Dickkopf-3 analyses were performed. Dickkopf-3 analyses in serum samples of the study participants were performed in the Research Laboratory of the Department of Medical Biochemistry, Faculty of Medicine. Human Dickkopf-3 ELISA (E2065Hu, Bioassay Technology Laboratory Inc., Shanghai, China) kit was used for the measurement of serum Dickkopf-3 levels. Dickkopf-3 levels were measured by double antibody sandwich ELISA method according to the manufacturer's instructions. Biotek ELX 50 microplate washer (BioTek Instruments, Vermont, USA) was used for washing the ELISA kits. In spectrophotometric measurements, Dickkopf-3 results were calculated as "ng/mL" according to absorbance-concentration calibration graphs using Bio-rad Microplate absorbance reader xMark (Bio-rad Laboratories, California, USA) system. Pulse wave velocity and central blood pressure measurements were performed with Mobil Graph New Genereation S/N C299843 device which is routinely used in our Nephrology Outpatient Clinic. With pulse wave analysis measurement, SDB, DBP, OAB, NB, central systolic and diastolic blood pressure, CPP, Aix and NDH values were measured and recorded. Similar samples were taken from a healthy control group of the same gender and age group with no comorbidities and drug use. The data obtained were evaluated with the "Statistical Package for the Social Sciences" (SPSS Inc, Chicago, USA) 22.0 package programme and descriptive frequency, central dispersion and prevalence measures and chi-square and correlation analyses were performed for comparisons. Results: The median DKK-3 level of the CKD group (30.97 (20.92-50.35) ng/mL) was statistically significantly lower than the median DKK-3 level of the control group (80.37 (40.45-90.36) ng/mL) (p<0.001). In the multivariate analysis, it was determined that a oneunit increase in HDL value increased DKK-3 level by 0.030 fold, a one-unit increase in HbA1C value decreased DKK-3 level by 0.361 fold, and a one-unit increase in PWV value decreased DKK-3 level by 0.279 fold. Other variables included in the multivariate analysis had no significant effect on the level of LCD-3. In the univariate analyses, it was determined that a one-unit increase in age increased PWV level by 0.096 fold, a one-unit increase in GFR decreased PWV level by 0.032 fold, a one-unit decrease in DKK-3 level increased PWV level by 0.359 fold, a one-unit increase in OAB increased PWV level by 0.046 fold and a one-unit increase in pulse pressure increased PWV level by 0.049 fold. Other variables included in the univariate analysis had no significant effect on PWV level. In univariate analyses, it was determined that the proteinuria level was 795,859 units higher in men, one unit increase in GFR decreased the proteinuria level 25,595 times, and one unit increase in OAB increased the proteinuria level 26,581 times. Other variables included in the univariate analysis had no significant effect on proteinuria level. Conclusion: Serum DKK-3 level was found to be significantly lower in patients with CKD compared to the control group. In the whole group evaluation, a negative correlation was observed between serum DKK3 level and PWV and proteinuria.
Açıklama
Anahtar Kelimeler
serum DKK3, chronic kidney disease, proteinüri, kronik böbrek hastalığı, pulse wave velocity, nabız dalga hızı, proteinuri
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Bilen, E. A. (2024). Kronik böbrek hastalığında kan örneklerinde DKK-3 protein düzeyleri ile nabız dalga hızı, santral kan basıncı ve diğer kardiyovasküler risk faktörleri arasındaki ilişki. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
