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BACKGROUND: Vascular calcification (VC) is a risk factor for cardiovascular morbidity and mortality in maintenance hemodialysis (MHD) patients. The effect of alpha2-Heremans Schmid glycoprotein (AHSG) Thr256Ser gene polymorphism toward serum fetuin-A levels as one of the VC inhibitors in MHD patients is still unclear.&#x0D;OBJECTIVE: This study aims to investigate the relationship between AHSG Thr256Ser gene polymorphism toward serum fetuin-A levels in MHD patients in Indonesia.&#x0D;METHODS: The research study design used was cross-sectional. Serum fetuin-A levels were assessed by enzyme-linked immunosorbent assay method, and polymerase chain reaction-restriction fragment length polymorphism determined AHSG Thr256Ser gene polymorphism. Multivariate linear regression analysis was used to analyze the factors related to serum fetuin-A levels. p &lt; 0.05 was considered as statistically significant.&#x0D;RESULTS: Median value of serum fetuin-A levels was 235.0 pg/ml (ranging 78–756) with mean 259.99 ± 119.36 pg/ml. Out of 106 patients involved, the distribution of AHSG Thr256Ser genotype frequency was 54 (50.9%) respondents had CG genotype, 46.2% had CC genotype, and the others (2.8%) had GG genotype. Patients with homozygous C allele (CC genotype) were 0.1 times more protected (CI 95%: 0.1–0.3) to have low serum fetuin-A levels, compared with patients with G allele either in a homozygote (GG genotype) or in the heterozygote (CG genotype). From the multivariate analysis results, it can be obtained a formulation in predicting serum fetuin-A level, which is: Serum fetuin-A level prediction = 276,59 + 150,49 DM - 0,26 serum interleukin -6 level - 43,58 AHSG Thr256Ser gene polymorphism&#x0D;CONCLUSIONS: AHSG Thr256Ser gene polymorphism had a significant relationship with serum fetuin-A levels in MHD patients in Indonesia. Subjects with G allele (CG and GG genotypes) had lower serum fetuin-A levels than those with CC genotype.

AHSG Thr256Ser Gene Polymorphism as a Predictor of Low Serum Fetuin-A Levels in Indonesian Maintenance Hemodialysis Patients