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Enmar Ali Jassim Aljalawee
Gholamreza Dehghan
Hamid Tayebi Khosroshahi


Matrix Gla protein, Fat-soluble vitamins, Parathyroid hormone, Fibroblast growth factor-23


Introduction: Vitamin K-dependent matrix Gla protein (MGP) acts as a calcification inhibitor in vitro and in vivo. Chronic kidney disease (CKD) patients have an extremely high risk for developing vascular disease as most CKD patient’s exhibit vitamin K intake lower than recommended levels. Since MGP is an extracellular protein responsible for inhibiting mineralization and it inhibits osteoblast mineralization and bone formation by regulating the deposition of bone matrix, therefore, the proposed research aims to the evaluation of the relationship between MGP and bone markers (parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF23) in hemodialysis patients and healthy individuals.

Methods: In this research, 54 hemodialysis (HD) patients and 30 age-matched healthy subjects were enrolled. Vitamin D, vitamin K, MGP, and FGF-23 were determined by ELISA kit and compared with control subjects.  All values were expressed as mean ± standard deviation (SD), and the Shapiro-Wilk test was performed to check data distribution. Kruskal Wallis was done for comparing groups.

Results: According to the results the vitamin K level (0.47±0.16 ng/ml versus 1.25±0.28 ng/ml, P<0.0001) was significantly lower and total MGP (257.20±40.65 ng/ml versus 153.93±39.89 ng/ml, P<0.0001), i-PTH (461.57±336.29 pg/ml versus 33.23±12.05 pg/ml, P<0.0001) and FGF-23 (9077.09±2116.03 RU/ml versus 95.93±37.86 RU/ml, P<0.0001) were significantly higher in CKD patients. However, there is no significant difference in the level of vitamin D between the studied groups.

Conclusion: Plasma total MGP increased progressively in CKD patients and was associated with the severity of vascular calcification. Also, since total MGP has a significant positive association with FGF-23, therefore, controlling the level of MGP may have a clinical improvement on dysregulated FGF-23.

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