Association Between Vascular Calcification With Serum Fetuin A And Inflammatory Cytokines In Type2Diabetic Nephropathy Patients

Objective: To investigate the relationship between serum fetuin A leveland vascular calcification (VC), inflammatory factors in type2diabeticnephropathy patients.Method: two hundred type2diabetic nephropathy (T2DN) admitted to theendocrinology department of our hospital were seleted into our studygroup during the period of January2011to December2013. Meanwhile, fiftycases of healthy subjects were choosed as control group matched with sex,age, body mass index (BMI) and so on as.The fasting blood glucose (FPG),serum albumin (Alb),total cholesterol(TC),low densitylipoprotein(LDL-C), triglyceride (TG),serum calcium (Ca2+),serumphosphorus (P3-), and C-reactive protein (CRP) were measured, and thenthe ELISA method was used to detect the concentrations of serum FetuinA, IL-1β and IL-6. The carotid artery was also detected to look for theplaue with Ultrasound Doppler.Result:(1) The serum Fetuin A levels at the stages of Ⅲ, IV and V T2DNwere significantly lower than that in the control group (P＜0.05). Therewas no statistically significant difference among the stages of ⅠandⅡT2DN and the control group (P＞0.05).(2) Of the200T2DN,143(71.5%)were found to have the carotid artery calcification, and only2casesin the control group (4%). There was significant difference betweenthem(P＜0.05). The rate of carotid artery calcification at the stage Vnephropathy was remarkly higher than that at the stages of Ⅰand Ⅱnephropathy(P＜0.05). There was no statistical difference among thestages of III, IV and V nephropathy(P＞0.05).(3) The serum Fetuin Alevels in the group of carotid artery calcification were lower than thatin the group of non-calcification between which the difference was statistically significant (P＜0.05), and the calcium-phosphorus productand CRP had significant difference between the two groups(P＜0.05).With pearson correlation analysis,it was found that the relationship ofFetuin A with ALB and TG was positive(r=0.43,r=0.31,P＜0.05), and therewas negative correlation between Fetuin A and Ca2*P3-as well as CRP(r=-0.28，r=-0.34，P＜0.05).(4) There was significant difference at thelevels of IL-1β and IL-6between T2DN and control group(P＜0.05). Theseverity of the nephropathy was positive correlation with the levels ofserum IL-1β and IL-6, and with the nephropathy deteriorating, the levelswere increased step by step (R2=0.9712，R2=0.9831，P＜0.05). The serumIL-1β, IL-6levels in the calcification group was higher than noncalcification group (P＜0.05).(5) With pearson correlationanalysis,it was found that the relationship of Fetuin A with IL-1βandIL-6was negative（r=-0.57，r=-0.73，P＜0.05）.Conclusion:(1) The serum Fetuin A levels were decreased in the stagesof Ⅲ, IV and V T2DN. It was indicated that the Fetuin A was one of thediagnosed index in T2DN.(2)The Fetuin A played a certain role in theprocess of carotid artery calcification.（3）Type2diabetic nephropathyexist micro-inflammation.