Study on the correlation between serum levels of oxidative stress regulatory factors and CaOx kidney stones

Abstract

Background This study revealed the role of serum oxidative stress regulators such as sKL, Nrf2 and GSK3β, in the formation of calcium oxalate (CaOx) kidney stones. Methods Clinical data and blood samples were collected from 148 patients with CaOx kidney stones and 151 healthy persons.The levels of sKL, Nrf2, NQO-1, HO-1 and GSK3β in serum were determined by enzyme-linked immunosorbent assay (ELISA).The independent sample t test and rank sum test were used to compare the two sets of data.Spearman correlation analysis was used to evaluate the correlation between serum sKL and levels of Nrf2, NQO-1, HO-1 and GSK3β in patients with CaOx kidney stones.Logistic regression analysis was used to determine the factors affecting the occurrence of CaOx kidney stones. ROC curve was used to evaluate the value of oxidative stress markers in the diagnosis of CaOx kidney stones. Results There were statistically significant differences in age, BMI, serum levels of sKL, Nrf2, HO-1, NQO-1, GSK3β, potassium, sodium and magnesium between healthy group and CaOx group (P<0.05).Correlation analysis showed that serum sKL level was positively correlated with NQO-1 (r = 0.207, P = 0.011) and serum Ca²⁺ (r = 0.17, P = 0.13), and negatively correlated with GSK3β (r=-0.206, P = 0.012).Logistic regression showed that increased serum HO-1 and NQO-1 levels were protective factors for the occurrence of CaOx kidney stones (P<0.05), and increased BMI and serum GSK3β levels were risk factors for the occurrence of CaOx kidney stones(P<0.05).The combined ROC curve analysis of the three indexes showed that the combined sensitivity (0.85), specificity (0.70) and AUC (0.84) of serum HO-1 + NQO-1 + GSK3β were significantly higher than the combined detection of single or two indexes, and the difference was statistically significant (P<0.05). Conclusion The serum levels of sKL, Nrf2, HO-1, NQO-1 are decreased in patients with CaOx kidney stones, and the serum levels of GSK3β are increased.Serum sKL level was positively correlated with NQO-1 and negatively correlated with GSK3β.The elevated levels of serum HO-1 and NQO-1 are protective factors and GSK3β and BMI are risk factors for the development of CaOx kidney stones.Serum HO-1 + NQO-1 + GSK3β is a suitable combination for the serologic diagnosis of CaOx kidney stones.