Study On The Correlation Between Serum TNF-α, Homocysteine With Thyroid Hormone In CKD Patient

Objectives: To investigate the affecting factors which lead to changes of serumtumor necrosis factor (TNF-α) level, serum homocysteine (Hcy) and serum thyroidhormone level in chronic kidney disease (CKD) patients, to discuss the relation ofserum creatinine (Scr) with TNF-α, Hcy and thyroid hormone, to provide theclinical thinking that researcher deeply investigate the relation of chronicmicro-inflammation, nutrient status and disease progression in CKD patients, thatprevention and treatment of CKD and cardiovascular complications.Methods: Study object, who from the target population participated in theSecond Affiliated Hospital of Nanchang University in January2012to December2013, was screened according to the inclusion and exclusion criteria. And weselected randomly a certain number of healthy subjects at the same time. SandwichABC-ELISA was used to detect the level of TNF-αin blood samples and testedrelating biochemical indexes in laboratory. According to the method of stage CKD,all the subjects were divided into four groups. SPSS19.0software was used toanalyze statistical data. Relating factors in different groups are compared by usingvariance analysis method and relevance was analyzed by using Pearson analysis orlinear regression analysis.Results:1. Total of282objects were screened out (30CKD patients andnormal controls252cases).20cases were selected randomly in each group and80blood specimen concentrations of TNF-α were obtained.2. Through correlationanalysis and linear regression analysis, the result showed a positive relationshipbetween concentrations of TNF-α (pg/ml) with concentrations of Scr (umol/l) inCKD patients. The linear regression equation was Y=0.07X+106.44(Y was theconcentration of TNF-α, X was the concentration of Scr) and the correlationcoefficient was0.365(P <0.01).Through variance analysis method, CKD4groupand CKD5group were found them significantly different with the normal controlgroup. However, there was no significant difference between CKD1-3and normal group. The result displayed albumin and Scr obviously influenced on theconcentration of TNF-α using multiple linear regression analysis method, andcoefficient of determination was0.16.3. The concentration of serum freetriiodothyronine (FT3)(pg/ml) was negatively correlated with concentration of Scr(umol/l) in CKD patients, and the linear regression equation was Y=-0.0003X+2.883(Y was the concentration of FT3, X was the concentration of Scr) and the correlationcoefficient was-0.210(P <0.01). Comparing the different groups of FT3level, therefound CKD4group and CKD5group was different with the normal control group.Multiple linear regression analysis showed that two factors (superoxide dismutase,C-reactive protein) had a significant effect on the concentration of FT3, andcoefficient of determination was0.148.4. The result showed a positive relationshipbetween concentrations of Hcy (mmol/l) with concentrations of Scr (umol/l) in CKDpatients and linear regression equation was Y=0.013X+15.739(Y was theconcentration of Hcy, X was the concentration of Scr) and the correlation coefficientwas0.350(P <0.01).Conclusions: In CKD patients, with glomerular filtration rate decreasing andScr increasing, the level of serum TNF-α and Hcy increased gradually and the levelof serum FT3decreased gradually. There was significant correlation between level ofserum TNF-α, Hcy and FT3.