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Mei Z, Yin MT, Sharma A, Wang Z, Peters BA, Chandran A, Weber KM, Ross RD, Gustafson D, Zheng Y, Kaplan RC, Burk RD, Qi Q. Gut microbiota and plasma metabolites associated with bone mineral density in women with or at risk of HIV infection. AIDS 2023; 37:149-159. [PMID: 36205320 PMCID: PMC9742192 DOI: 10.1097/qad.0000000000003400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate gut microbiota (GMB) alterations and metabolite profile perturbations associated with bone mineral density (BMD) in the context of HIV infection. DESIGN Cross-sectional studies of 58 women with chronic HIV infection receiving antiretroviral therapy and 33 women without HIV infection. METHODS We examined associations of GMB and metabolites with BMD among 91 women. BMD was measured by dual-energy X-ray absorptiometry (DXA), and T -scores of lumbar spine or total hip less than -1 defined low BMD. GMB was measured by 16S rRNA V4 region sequencing on fecal samples, and plasma metabolites were measured by liquid chromatography-tandem mass spectrometry. Associations of GMB with plasma metabolites were assessed in a larger sample (418 women; 280 HIV+ and 138 HIV-). RESULTS Relative abundances of five predominant bacterial genera ( Dorea , Megasphaera , unclassified Lachnospiraceae, Ruminococcus , and Mitsuokella ) were higher in women with low BMD compared with those with normal BMD (all linear discriminant analysis (LDA) scores >2.0). A distinct plasma metabolite profile was identified in women with low BMD, featuring lower levels of several metabolites belonging to amino acids, carnitines, caffeine, fatty acids, pyridines, and retinoids, compared with those with normal BMD. BMD-associated bacterial genera, especially Megasphaera , were inversely associated with several BMD-related metabolites (e.g. 4-pyridoxic acid, C4 carnitine, creatinine, and dimethylglycine). The inverse association of Megasphaera with dimethylglycine was more pronounced in women with HIV infection compared with those without HIV infection ( P for interaction = 0.016). CONCLUSION Among women with and at risk of HIV infection, we identified altered GMB and plasma metabolite profiles associated with low BMD.
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Affiliation(s)
- Zhendong Mei
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
| | - Michael T Yin
- Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Zheng Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
| | - Brandilyn A Peters
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
| | - Aruna Chandran
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Ryan D Ross
- Department of Anatomy & Cell Biology, Rush University Medical Center, Chicago, Illinois
| | - Deborah Gustafson
- Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Robert D Burk
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
- Department of Pediatrics, Albert Einstein College of Medicine
- Department of Microbiology and Immunology, and Department of Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
- Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Galhardas L, Raimundo A, Del Pozo-Cruz J, Marmeleira J. Physical and Motor Fitness Tests for Older Adults Living in Nursing Homes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5058. [PMID: 35564453 PMCID: PMC9105463 DOI: 10.3390/ijerph19095058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/09/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
This systematic review aimed to identify the physical/motor fitness tests for nursing home residents and to examine their psychometric properties. Electronic databases were searched for articles published between January 2005 and October 2021 using MeSh terms and relevant keywords. Of the total of 4196 studies identified, 3914 were excluded based on title, abstracts, or because they were duplicates. The remaining 282 studies were full-text analyzed, and 41 were excluded, resulting in 241 studies included in the review. The most common physical component assessed was muscle strength; 174 (72.2%) studies assessed this component. Balance (138 studies, 57.3%) and agility (102 studies, 42.3%) were the second and third components, respectively, most widely assessed. In this review, we also describe the most used assessment tests for each physical/motor component. Some potentially relevant components such as manual dexterity and proprioception have been little considered. There are few studies assessing the psychometric properties of the tests for nursing home residents, although the data show that, in general, they are reliable. This review provides valuable information to researchers and health-care professionals regarding the physical/motor tests used in nursing home residences, helping them select the screening tools that could most closely fit their study objectives.
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Affiliation(s)
- Luis Galhardas
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Jesús Del Pozo-Cruz
- Department of Physical Education and Sports, University of Seville, 41013 Sevilla, Spain;
- Epidemiology of Physical Activity and Fitness across Lifespan Research Group (EPAFit), University of Seville, 41013 Sevilla, Spain
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
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Li P, Sundh D, Ji B, Lappa D, Ye L, Nielsen J, Lorentzon M. Metabolic Alterations in Older Women With Low Bone Mineral Density Supplemented With Lactobacillus reuteri. JBMR Plus 2021; 5:e10478. [PMID: 33869994 PMCID: PMC8046097 DOI: 10.1002/jbm4.10478] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022] Open
Abstract
Osteoporosis and its associated fractures are highly prevalent in older women. Recent studies have shown that gut microbiota play important roles in regulating bone metabolism. A previous randomized controlled trial (RCT) found that supplementation with Lactobacillus reuteri ATCC PTA 6475 (L.reuteri) led to substantially reduced bone loss in older women with low BMD. However, the total metabolic effects of L. reuteri supplementation on older women are still not clear. In this study, a post hoc analysis (not predefined) of serum metabolomic profiles of older women from the previous RCT was performed to investigate the metabolic dynamics over 1 year and to evaluate the effects of L. reuteri supplementation on human metabolism. Distinct segregation of the L. reuteri and placebo groups in response to the treatment was revealed by partial least squares‐discriminant analysis. Although no individual metabolite was differentially and significantly associated with treatment after correction for multiple testing, 97 metabolites responded differentially at any one time point between L. reuteri and placebo groups (variable importance in projection score >1 and p value <0.05). These metabolites were involved in multiple processes, including amino acid, peptide, and lipid metabolism. Butyrylcarnitine was particularly increased at all investigated time points in the L. reuteri group compared with placebo, indicating that the effects of L. reuteri on bone loss are mediated through butyrate signaling. Furthermore, the metabolomic profiles in a case (low BMD) and control population (high BMD) of elderly women were analyzed to confirm the associations between BMD and the identified metabolites regulated by L. reuteri supplementation. The amino acids, especially branched‐chain amino acids, showed association with L. reuteri treatment and with low BMD in older women, and may serve as potential therapeutic targets. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Peishun Li
- Department of Biology and Biological Engineering Chalmers University of Technology Gothenburg Sweden
| | - Daniel Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Boyang Ji
- Department of Biology and Biological Engineering Chalmers University of Technology Gothenburg Sweden
| | - Dimitra Lappa
- Department of Biology and Biological Engineering Chalmers University of Technology Gothenburg Sweden
| | - Lingqun Ye
- Department of Biology and Biological Engineering Chalmers University of Technology Gothenburg Sweden
| | - Jens Nielsen
- Department of Biology and Biological Engineering Chalmers University of Technology Gothenburg Sweden.,Novo Nordisk Foundation Center for Biosustainability Technical University of Denmark Kgs. Lyngby Denmark.,BioInnovation Institute Copenhagen Denmark
| | - Mattias Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.,Region Västra Götaland, Geriatric Medicine Clinic Sahlgrenska University Hospital Mölndal Sweden.,Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Victoria Australia
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Mangano KM, Noel SE, Lai CQ, Christensen JJ, Ordovas JM, Dawson-Hughes B, Tucker KL, Parnell LD. Diet-derived fruit and vegetable metabolites show sex-specific inverse relationships to osteoporosis status. Bone 2021; 144:115780. [PMID: 33278656 PMCID: PMC7856195 DOI: 10.1016/j.bone.2020.115780] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/18/2020] [Accepted: 11/27/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The impact of nutrition on the metabolic profile of osteoporosis (OS) is unknown. OBJECTIVE Identify biochemical factors driving the association of fruit and vegetable (FV) intakes with OS prevalence using an untargeted metabolomics approach. DESIGN Cross-sectional dietary, anthropometric and plasma metabolite data were examined from the Boston Puerto Rican Osteoporosis Study, n = 600 (46-79 yr). METHODS Bone mineral density was assessed by DXA. OS was defined by clinical standards. A culturally adapted FFQ assessed usual dietary intake. Principal components analysis (PCA) of 42 FV items created 6 factors. Metabolomic profiles derived from plasma samples were assessed on a commercial platform. Differences in levels of 525 plasma metabolites between disease groups (OS vs no-OS) were compared using logistic regression; and associations with FV intakes by multivariable linear regression, adjusted for covariates. Metabolites significantly associated with OS status or with total FV intake were analyzed for enrichment in various biological pathways using Mbrole 2.0, MetaboAnalyst, and Reactome, using FDR correction of P-values. Correlation coefficients were calculated as Spearman's rho rank correlations, followed by hierarchical clustering of the resulting correlation coefficients using PCA FV factors and sex-specific sets of OS-associated metabolites. RESULTS High FV intake was inversely related to OS prevalence (Odds Ratio = 0.73; 95% CI = 0.57, 0.94; P = 0.01). Several biological processes affiliated with the FV-associating metabolites, including caffeine metabolism, carnitines and fatty acids, and glycerophospholipids. Important processes identified with OS-associated metabolites were steroid hormone biosynthesis in women and branched-chain amino acid metabolism in men. Factors derived from PCA were correlated with the OS-associated metabolites, with high intake of dark leafy greens and berries/melons appearing protective in both sexes. CONCLUSIONS These data warrant investigation into whether increasing intakes of dark leafy greens, berries and melons causally affect bone turnover and BMD among middle-aged and older adults at risk for osteoporosis via sex-specific metabolic pathways, and how gene-diet interactions alter these sex-specific metabolomic-osteoporosis links. ClinicalTrials.gov Identifier: NCT01231958.
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Affiliation(s)
- Kelsey M Mangano
- Department of Biomedical and Nutritional Sciences and Center for Population Health, University of Massachusetts Lowell, 3 Solomont Way, 01854 Lowell, MA, USA.
| | - Sabrina E Noel
- Department of Biomedical and Nutritional Sciences and Center for Population Health, University of Massachusetts Lowell, 3 Solomont Way, 01854 Lowell, MA, USA
| | - Chao-Qiang Lai
- USDA Agricultural Research Service, Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA
| | - Jacob J Christensen
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Forskningsveien 2B, 0373 Oslo, Norway; Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0315 Oslo, Norway
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, 02111 Boston, MA, USA
| | - Bess Dawson-Hughes
- Bone Metabolism Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, 02111 Boston, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences and Center for Population Health, University of Massachusetts Lowell, 3 Solomont Way, 01854 Lowell, MA, USA
| | - Laurence D Parnell
- USDA Agricultural Research Service, Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA
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Karetnikova ES, Jarzebska N, Markov AG, Weiss N, Lentz SR, Rodionov RN. Is Homoarginine a Protective Cardiovascular Risk Factor? Arterioscler Thromb Vasc Biol 2020; 39:869-875. [PMID: 30866658 DOI: 10.1161/atvbaha.118.312218] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A series of recent epidemiological studies have implicated the endogenous nonproteinogenic amino acid l-homoarginine as a novel candidate cardiovascular risk factor. The association between homoarginine levels and the risk of adverse cardiovascular outcomes is inverse (ie, high cardiovascular risk is predicted by low rather than high homoarginine levels), which makes it plausible to normalize systemic homoarginine levels via oral supplementation. The emergence of homoarginine as a potentially treatable protective cardiovascular risk factor has generated a wave of hope in the field of cardiovascular prevention. Herein, we review the biochemistry, physiology, and metabolism of homoarginine, summarize the strengths and weaknesses of the epidemiological evidence linking homoarginine to cardiovascular disease and its potential protective cardiovascular effects, and identify priorities for future research needed to define the clinical utility of homoarginine as a prognostic factor and therapeutic target in cardiovascular disease.
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Affiliation(s)
- Ekaterina S Karetnikova
- From the Department of Physiology, Saint-Petersburg State University, Russia (E.S.K., A.G.M.)
| | - Natalia Jarzebska
- Division of Angiology, Department of Internal Medicine III, University Center for Vascular Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Germany (N.J., N.W., R.N.R.)
| | - Alexander G Markov
- From the Department of Physiology, Saint-Petersburg State University, Russia (E.S.K., A.G.M.)
| | - Norbert Weiss
- Division of Angiology, Department of Internal Medicine III, University Center for Vascular Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Germany (N.J., N.W., R.N.R.)
| | - Steven R Lentz
- Department of Internal Medicine, University of Iowa Carver College of Medicine (S.R.L.)
| | - Roman N Rodionov
- Division of Angiology, Department of Internal Medicine III, University Center for Vascular Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Germany (N.J., N.W., R.N.R.).,Flinders University, Adelaide, Australia (R.N.R.)
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Zinellu A, Paliogiannis P, Carru C, Mangoni AA. Homoarginine and all-cause mortality: A systematic review and meta-analysis. Eur J Clin Invest 2018; 48:e12960. [PMID: 29806958 DOI: 10.1111/eci.12960] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/24/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Homoarginine, a basic amino acid and analogue of L-arginine, has been shown to exert salutary effects on vascular homoeostasis, possibly through interaction with the enzymes nitric oxide synthase and arginase. This might translate into improved survival outcomes, particularly in subjects with moderate-high cardiovascular risk. We conducted a systematic review and meta-analysis to investigate the association between circulating homoarginine concentrations and all-cause mortality in observational studies of human cohorts. MATERIALS AND METHODS Studies reporting baseline circulating homoarginine concentrations and all-cause mortality as outcome were searched using the MEDLINE, Scopus and Cochrane databases until January 2018. Hazard ratios (HRs) with 95% confidence intervals (CIs) derived from multivariate Cox's proportional-hazards analysis were extracted from individual studies. RESULTS A total of 13 studies in 11 964 participants were included in the final analysis. Homoarginine concentrations were inversely associated with all-cause mortality (HR 0.64, 95% CI 0.57-0.73). This association remained significant in participant sub-groups with predominant cardiovascular disease (HR 0.64, 95% CI 0.55-0.76) and renal disease (HR 0.60, 95% CI 0.46-0.68). CONCLUSIONS This meta-analysis of observational studies showed an inverse association between circulating homoarginine concentrations and all-cause mortality. Further research is warranted to investigate the direct effects of homoarginine on cardiovascular homoeostasis, the associations between homoarginine and all-cause mortality in other population groups, and the effects of interventions on homoarginine concentrations on clinical outcomes.
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Quality Control Unit, University Hospital (AOUSS), Sassari, Italy
| | - Arduino A Mangoni
- Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
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Da Boit M, Tommasi S, Elliot D, Zinellu A, Sotgia S, Sibson R, Meakin JR, Aspden RM, Carru C, Mangoni AA, Gray SR. Sex Differences in the Associations between L-Arginine Pathway Metabolites, Skeletal Muscle Mass and Function, and their Responses to Resistance Exercise, in Old Age. J Nutr Health Aging 2018; 22:534-540. [PMID: 29582894 DOI: 10.1007/s12603-017-0964-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The current study was designed to explore the associations between L-arginine metabolites and muscle mass and function in old age, which are largely unknown. DESIGN The study used a randomised, double-blind, placebo-controlled design. SETTING The study was carried out in a laboratory setting. PARTICIPANTS 50 healthy older adults [median age 70 years (IQR 67-73); 27 males]. INTERVENTION Participants undertook an 18-week resistance exercise program, and a nutritional intervention (fish oil vs. placebo). MEASUREMENTS Serum homoarginine, ornithine, citrulline, asymmetric dimethylarginine (ADMA), NG-monomethyl-L-arginine (L-NMMA), and symmetric dimethylarginine (SDMA), maximal voluntary contraction (MVC) and isokinetic torque of the knee extensors at 30° s-1 (MIT), muscle cross sectional area (MCSA) and quality (MQ) were measured at baseline and after the intervention. RESULTS No significant exercise-induced changes were observed in metabolite concentrations. There were significant sex differences in the associations between metabolites and muscle parameters. After adjusting for age, glomerular filtration rate and fish oil intervention, citrulline (P=0.002) and ornithine (P=0.022) were negatively associated with MCSA at baseline in males but not females. However, baseline citrulline was negatively correlated with exercise-induced changes in MVC (P=0.043) and MQ (P=0.026) amongst females. Furthermore, amongst males, baseline homoarginine was positively associated with exercise-induced changes in MVC (P=0.026), ADMA was negatively associated with changes in MIT (P=0.026), L-NMMA (p=0.048) and ornithine (P<0.001) were both positively associated with changes in MCSA, and ornithine was negatively associated with changes in MQ (P=0.039). CONCLUSION Therefore, barring citrulline, there are significant sex differences in the associations between L-arginine metabolites and muscle mass and function in healthy older adults. These metabolites might enhance sarcopenia risk stratification, and the success of exercise programs, in old age.
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Affiliation(s)
- M Da Boit
- Dr Stuart Gray, BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, G12 8TA, United Kingdom. Tel: 0141 330 2569
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Pye SR, Vanderschueren D, Boonen S, Gielen E, Adams JE, Ward KA, Lee DM, Bartfai G, Casanueva FF, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean ME, Pendleton N, Punab M, Wu FC, O'Neill TW. Low heel ultrasound parameters predict mortality in men: results from the European Male Ageing Study (EMAS). Age Ageing 2015; 44:801-7. [PMID: 26162912 PMCID: PMC4547925 DOI: 10.1093/ageing/afv073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 02/02/2015] [Indexed: 11/24/2022] Open
Abstract
Background: low bone mineral density measured by dual-energy x-ray absorptiometry is associated with increased mortality. The relationship between other skeletal phenotypes and mortality is unclear. The aim of this study was to determine the relationship between quantitative heel ultrasound parameters and mortality in a cohort of European men. Methods: men aged 40–79 years were recruited for participation in a prospective study of male ageing: the European Male Ageing Study (EMAS). At baseline, subjects attended for quantitative ultrasound (QUS) of the heel (Hologic—SAHARA) and completed questionnaires on lifestyle factors and co-morbidities. Height and weight were measured. After a median of 4.3 years, subjects were invited to attend a follow-up assessment, and reasons for non-participation, including death, were recorded. The relationship between QUS parameters (broadband ultrasound attenuation [BUA] and speed of sound [SOS]) and mortality was assessed using Cox proportional hazards model. Results: from a total of 3,244 men (mean age 59.8, standard deviation [SD] 10.8 years), 185 (5.7%) died during the follow-up period. After adjusting for age, centre, body mass index, physical activity, current smoking, number of co-morbidities and general health, each SD decrease in BUA was associated with a 20% higher risk of mortality (hazard ratio [HR] per SD = 1.2; 95% confidence interval [CI] = 1.0–1.4). Compared with those in higher quintiles (2nd–5th), those in the lowest quintile of BUA and SOS had a greater mortality risk (BUA: HR = 1.6; 95% CI = 1.1–2.3 and SOS: HR = 1.6; 95% CI = 1.2–2.2). Conclusion: lower heel ultrasound parameters are associated with increased mortality in European men.
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Affiliation(s)
- Stephen R Pye
- Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester, UK
| | - Dirk Vanderschueren
- Department of Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Steven Boonen
- Leuven University Division of Geriatric Medicine and Centre for Metabolic Bone Diseases, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Evelien Gielen
- Leuven University Division of Geriatric Medicine and Centre for Metabolic Bone Diseases, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Judith E Adams
- Radiology and Manchester Academic Health Science Centre, The Royal Infirmary, The University of Manchester, Manchester, UK
| | - Kate A Ward
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK
| | - David M Lee
- Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester, UK
| | - György Bartfai
- Department of Obstetrics, Gynaecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary
| | - Felipe F Casanueva
- Santiago de Compostela University, Complejo Hospitalario, Universitario de Santiago (CHUS), A Coruña, Spain
| | - Joseph D Finn
- Andrology Research Unit, Developmental and Regenerative Biomedicine Research Group, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK
| | | | | | - Thang S Han
- Royal Free and University College Hospital Medical School, London, UK
| | | | | | | | - Neil Pendleton
- Geriatric Medicine, Salford Royal Hospital NHS Trust, Manchester, UK
| | - Margus Punab
- United Laboratories of Tartu University Clinics, Tartu, Estonia
| | - Frederick C Wu
- Andrology Research Unit, Developmental and Regenerative Biomedicine Research Group, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK
| | - Terence W O'Neill
- Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester, UK
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Association of homoarginine and methylarginines with liver dysfunction and mortality in chronic liver disease. Amino Acids 2015; 47:1817-26. [PMID: 25952253 DOI: 10.1007/s00726-015-2000-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 04/27/2015] [Indexed: 01/18/2023]
Abstract
Previous studies on arginine metabolites reported an association of asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) with liver dysfunction and an inverse relation of homoarginine (hArg) with cardiovascular risk. The aim of the present study was to investigate the relationships between hArg, ADMA, SDMA, and the dimethylarginine score (DAS, i.e., ADMA + SDMA) and liver dysfunction and survival in chronic liver disease. In 94 consecutive cirrhotic patients admitted to our outpatient liver clinic, serum levels of hArg, ADMA, and SDMA were measured by HPLC at baseline. Patients were followed with respect to mortality. In the entire study cohort (age 58.5 ± 11.2 years; 31 % females), the serum concentrations were 1.94 ± 0.90 µM for homoarginine, 0.90 ± 0.22 µM for ADMA, and 0.70 (0.60-0.93) µM for SDMA. ADMA correlated with both Child-Pugh and MELD scores, while SDMA, DAS, and hArg correlated with MELD score only. Thirty patients (32 %) died during a median follow-up of 3.5 years. Age- and sex-adjusted Cox proportional hazard ratios (HR) per µM (with 95 % confidence intervals) showed that hArg was associated with decreased mortality [HR 0.59 (0.37-0.96)], whereas mortality was increased in patients with higher ADMA [HR 3.78 (0.98-14.60)], SDMA [HR 6.54 (3.15-13.59)] and DAS [HR 4.13 (2.26-7.56)]. Only SDMA and DAS remained significantly associated with mortality after additional adjustments for either Child-Pugh stage or MELD score. In conclusion, in cirrhotic patients seen in an outpatient liver clinic, hArg as well as the dimethylarginines ADMA and SDMA was related to long-term mortality. In particular, SDMA predicts mortality independently of both Child-Pugh stage and MELD score.
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10
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Homoarginine in the renal and cardiovascular systems. Amino Acids 2015; 47:1703-13. [DOI: 10.1007/s00726-015-1993-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 04/18/2015] [Indexed: 10/23/2022]
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Atzler D, Gore MO, Ayers CR, Choe CU, Böger RH, de Lemos JA, McGuire DK, Schwedhelm E. Homoarginine and Cardiovascular Outcome in the Population-Based Dallas Heart Study. Arterioscler Thromb Vasc Biol 2014; 34:2501-7. [DOI: 10.1161/atvbaha.114.304398] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Dorothee Atzler
- From the Departments of Clinical Pharmacology and Toxicology (D.A., R.H.B., E.S.) and Neurology, Experimental Neuropediatrics (C.U.C.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Partner Site Hamburg/Kiel/Lübeck, Germany (D.A., R.H.B., E.S.); and Division of Cardiology, Department of Internal Medicine (M.O.G., J.A.d.L., D.K.M.) and Department of Clinical Sciences (C.R.A., D.K.M.), University of Texas Southwestern Medical
| | - M. Odette Gore
- From the Departments of Clinical Pharmacology and Toxicology (D.A., R.H.B., E.S.) and Neurology, Experimental Neuropediatrics (C.U.C.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Partner Site Hamburg/Kiel/Lübeck, Germany (D.A., R.H.B., E.S.); and Division of Cardiology, Department of Internal Medicine (M.O.G., J.A.d.L., D.K.M.) and Department of Clinical Sciences (C.R.A., D.K.M.), University of Texas Southwestern Medical
| | - Colby R. Ayers
- From the Departments of Clinical Pharmacology and Toxicology (D.A., R.H.B., E.S.) and Neurology, Experimental Neuropediatrics (C.U.C.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Partner Site Hamburg/Kiel/Lübeck, Germany (D.A., R.H.B., E.S.); and Division of Cardiology, Department of Internal Medicine (M.O.G., J.A.d.L., D.K.M.) and Department of Clinical Sciences (C.R.A., D.K.M.), University of Texas Southwestern Medical
| | - Chi-un Choe
- From the Departments of Clinical Pharmacology and Toxicology (D.A., R.H.B., E.S.) and Neurology, Experimental Neuropediatrics (C.U.C.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Partner Site Hamburg/Kiel/Lübeck, Germany (D.A., R.H.B., E.S.); and Division of Cardiology, Department of Internal Medicine (M.O.G., J.A.d.L., D.K.M.) and Department of Clinical Sciences (C.R.A., D.K.M.), University of Texas Southwestern Medical
| | - Rainer H. Böger
- From the Departments of Clinical Pharmacology and Toxicology (D.A., R.H.B., E.S.) and Neurology, Experimental Neuropediatrics (C.U.C.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Partner Site Hamburg/Kiel/Lübeck, Germany (D.A., R.H.B., E.S.); and Division of Cardiology, Department of Internal Medicine (M.O.G., J.A.d.L., D.K.M.) and Department of Clinical Sciences (C.R.A., D.K.M.), University of Texas Southwestern Medical
| | - James A. de Lemos
- From the Departments of Clinical Pharmacology and Toxicology (D.A., R.H.B., E.S.) and Neurology, Experimental Neuropediatrics (C.U.C.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Partner Site Hamburg/Kiel/Lübeck, Germany (D.A., R.H.B., E.S.); and Division of Cardiology, Department of Internal Medicine (M.O.G., J.A.d.L., D.K.M.) and Department of Clinical Sciences (C.R.A., D.K.M.), University of Texas Southwestern Medical
| | - Darren K. McGuire
- From the Departments of Clinical Pharmacology and Toxicology (D.A., R.H.B., E.S.) and Neurology, Experimental Neuropediatrics (C.U.C.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Partner Site Hamburg/Kiel/Lübeck, Germany (D.A., R.H.B., E.S.); and Division of Cardiology, Department of Internal Medicine (M.O.G., J.A.d.L., D.K.M.) and Department of Clinical Sciences (C.R.A., D.K.M.), University of Texas Southwestern Medical
| | - Edzard Schwedhelm
- From the Departments of Clinical Pharmacology and Toxicology (D.A., R.H.B., E.S.) and Neurology, Experimental Neuropediatrics (C.U.C.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Partner Site Hamburg/Kiel/Lübeck, Germany (D.A., R.H.B., E.S.); and Division of Cardiology, Department of Internal Medicine (M.O.G., J.A.d.L., D.K.M.) and Department of Clinical Sciences (C.R.A., D.K.M.), University of Texas Southwestern Medical
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Pilz S, Teerlink T, Scheffer PG, Meinitzer A, Rutters F, Tomaschitz A, Drechsler C, Kienreich K, Nijpels G, Stehouwer CDA, März W, Dekker JM. Homoarginine and mortality in an older population: the Hoorn study. Eur J Clin Invest 2014; 44:200-8. [PMID: 24251815 DOI: 10.1111/eci.12208] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 11/15/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Homoarginine is an amino acid that may be involved in nitric oxide and energy metabolism. Previous studies in patient populations showed that low homoarginine levels indicate an increased risk of mortality and cardiovascular disease. We evaluated whether low plasma levels of homoarginine are associated with elevated, overall and cause-specific mortality. MATERIALS AND METHODS The Hoorn study is a population-based study among older men and women. We calculated Cox proportional hazard ratios (HRs) for overall and cause-specific mortality according to sex-specific homoarginine quartiles. RESULTS We included 606 study participants (51·3% women; 70·0 ± 6·6 years). Homoarginine concentrations were higher in men (1·63 ± 0·51 μM), compared with women (1·30 ± 0·44 μM; P < 0·001). After a median follow-up time of 7·8 years, 112 study participants died, including 31 deaths due to cardiovascular diseases and 30 due to cancer. Associations between homoarginine levels and mortality showed a threshold effect with a significant risk increase from the second to the first quartile. Compared with the upper three quartiles, the age-, sex- and BMI-adjusted HR (with 95% CI) in the first quartile was 2·26 (1·52-3·32) for overall mortality, 4·20 (2·03-8·69) for cardiovascular mortality and 1·25 (0·55-2·85) for cancer mortality. These associations remained materially unchanged after multivariate adjustments. CONCLUSIONS Low plasma concentrations of homoarginine are a risk marker for overall mortality and especially for cardiovascular mortality in the older general population. Further studies are warranted to elucidate the underlying pathophysiological mechanisms.
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Affiliation(s)
- Stefan Pilz
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands; Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Opposite associations of plasma homoarginine and ornithine with arginine in healthy children and adolescents. Int J Mol Sci 2013; 14:21819-32. [PMID: 24192823 PMCID: PMC3856037 DOI: 10.3390/ijms141121819] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/20/2013] [Accepted: 10/09/2013] [Indexed: 11/17/2022] Open
Abstract
Homoarginine, a non-proteinogenic amino acid, is formed when lysine replaces ornithine in reactions catalyzed by hepatic urea cycle enzymes or lysine substitutes for glycine as a substrate of renal arginine:glycine amidinotransferase. Decreased circulating homoarginine and elevated ornithine, a downstream product of arginase, predict adverse cardiovascular outcome. Our aim was to investigate correlates of plasma homoarginine and ornithine and their relations with carotid vascular structure in 40 healthy children and adolescents aged 3–18 years without coexistent diseases or subclinical carotid atherosclerosis. Homoarginine, ornithine, arginine, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) were measured by liquid chromatography-tandem mass spectrometry with stable isotope-labeled internal standards. Intima-media thickness (IMT) and extra-medial thickness (EMT) of common carotid arteries were estimated by B-mode ultrasound. Homoarginine correlated with arginine (r = 0.43, p = 0.005), age (r = 0.42, p = 0.007) and, weakly, with an increased arginine-to-ornithine ratio, a putative measure of lower arginase activity (r = 0.31, p = 0.048). Ornithine correlated inversely with arginine (r = −0.64, p < 0.001). IMT, EMT or their sum were unrelated to any of the biochemical parameters (p > 0.12). Thus, opposite associations of plasma homoarginine and ornithine with arginine may partially result from possible involvement of arginase, an enzyme controlling homoarginine degradation and ornithine synthesis from arginine. Age-dependency of homoarginine levels can reflect developmental changes in homoarginine metabolism. However, neither homoarginine nor ornithine appears to be associated with carotid vascular structure in healthy children and adolescents.
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Kleber ME, Seppälä I, Pilz S, Hoffmann MM, Tomaschitz A, Oksala N, Raitoharju E, Lyytikäinen LP, Mäkelä KM, Laaksonen R, Kähönen M, Raitakari OT, Huang J, Kienreich K, Fahrleitner-Pammer A, Drechsler C, Krane V, Boehm BO, Koenig W, Wanner C, Lehtimäki T, März W, Meinitzer A. Genome-Wide Association Study Identifies 3 Genomic Loci Significantly Associated With Serum Levels of Homoarginine. ACTA ACUST UNITED AC 2013; 6:505-13. [DOI: 10.1161/circgenetics.113.000108] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background—
Low serum levels of the amino acid derivative, homoarginine, have been associated with increased risk of total and cardiovascular mortality. Homoarginine deficiency may be related to renal and heart diseases, but the pathophysiologic role of homoarginine and the genetic regulation of its serum levels are largely unknown.
Methods and Results—
In 3041 patients of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study referred for coronary angiography and 2102 participants of the Young Finns Study (YFS), we performed a genome-wide association study to identify genomic loci associated with homoarginine serum levels and tested for associations of identified single-nucleotide polymorphisms with mortality in LURIC. We found genome-wide significant associations with homoarginine serum levels on chromosome 2 at the carbamoyl phosphate synthetase I locus, on chromosome 5 at the alanine-glyoxylate aminotransferase 2 locus, and on chromosome 15 at the glycine amidinotransferase locus, as well as a suggestive association on chromosome 6 at the Homo sapiens mediator complex subunit 23 gene/arginase I locus. All loci harbor enzymes located in the mitochondrium are involved in arginine metabolism. The strongest association was observed for rs1153858 at the glycine amidinotransferase locus with a
P
value of 1.25E-45 in the combined analysis and has been replicated in both the Die Deutsche Diabetes Dialyse Studie (4D study) and the Graz Endocrine Causes of Hypertension (GECOH) study.
Conclusions—
In our genome-wide association study, we identified 3 chromosomal regions significantly associated with serum homoarginine and another region with suggestive association, providing novel insights into the genetic regulation of homoarginine.
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Drechsler C, Kollerits B, Meinitzer A, März W, Ritz E, König P, Neyer U, Pilz S, Wanner C, Kronenberg F. Homoarginine and progression of chronic kidney disease: results from the Mild to Moderate Kidney Disease Study. PLoS One 2013; 8:e63560. [PMID: 23691067 PMCID: PMC3655120 DOI: 10.1371/journal.pone.0063560] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 04/04/2013] [Indexed: 11/19/2022] Open
Abstract
Background Homoarginine is an amino acid derivative mainly synthesized in the kidney. It is suggested to increase nitric oxide availability, enhance endothelial function and to protect against cardiovascular diseases. We aimed to investigate the relation between homoarginine, kidney function and progression of chronic kidney disease (CKD). Methods We measured plasma homoarginine concentrations in baseline samples of the Mild to Moderate Kidney Disease (MMKD) Study, a prospective cohort study of 227 patients with CKD in Europe. Homoarginine concentrations were available in 182 of the baseline samples and in 139 of the prospectively-followed patients. We correlated homoarginine concentrations to parameters of kidney function. The association between homoarginine and progression of CKD was assessed during a follow-up of up to seven years (median 4.45 years, interquartile range 2.54–5.19) using Cox regression analysis. Progression of CKD was defined as doubling of baseline serum creatinine and/or end-stage renal disease. Results Study participants were at baseline on average 47±13 years old and 65% were male. Mean±standard deviation of homoarginine concentrations were 2.5±1.1 µmol/L and concentrations were incrementally lower at lower levels of GFR with mean concentrations of 2.90±1.02 µmol/L (GFR>90 ml/min), 2.64±1.06 µmol/L (GFR 60–90 ml/min), 2.52±1.24 µmol/L (GFR 30–60 ml/min) and 2.05±0.78 µmol/L (GFR<30 ml/min), respectively (p = 0.002). The age- and sex-adjusted risk to reach the renal endpoint was significantly higher by 62% with each decrease by one standard deviation (1.1 µmol/L) of homoarginine (HR 1.62, 95% CI 1.16–2.27, p = 0.005). This association was independent of proteinuria (HR 1.56, 95% CI 1.11–2.20, p = 0.01), and was slightly attenuated when adjusting for GFR (HR 1.40 (95% CI 0.98–1.98, p = 0.06). Conclusions Homoarginine concentrations are directly correlated with kidney function and are significantly associated with the progression of CKD. Low homoarginine concentrations might be an early indicator of kidney failure and a potential target for the prevention of disease progression which needs further investigations.
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Affiliation(s)
- Christiane Drechsler
- Division of Nephrology, Department of Medicine, University of Würzburg, Würzburg, Germany
| | - Barbara Kollerits
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Innsbruck Medical University, Innsbruck, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Winfried März
- Department of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Eberhard Ritz
- Department of Internal Medicine, Division of Nephrology, Ruprecht-Karls-University, Heidelberg, Germany
| | - Paul König
- Innsbruck University Hospital, Department of Clinical Nephrology, Innsbruck, Austria
| | - Ulrich Neyer
- Department of Nephrology and Dialysis, Academic Teaching Hospital, Feldkirch, Austria
| | - Stefan Pilz
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - Christoph Wanner
- Division of Nephrology, Department of Medicine, University of Würzburg, Würzburg, Germany
| | - Florian Kronenberg
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Innsbruck Medical University, Innsbruck, Austria
- * E-mail:
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