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Sanchis P, Rivera R, Fortuny R, Río C, Mas-Gelabert M, Gonzalez-Freire M, Grases F, Masmiquel L. Role of Advanced Glycation End Products on Aortic Calcification in Patients with Type 2 Diabetes Mellitus. J Clin Med 2020; 9:jcm9061751. [PMID: 32516928 PMCID: PMC7356630 DOI: 10.3390/jcm9061751] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to evaluate the relationship between serum levels of advanced glycation end products (AGEs) and abdominal aortic calcification (AAC) in patients with type 2 diabetes mellitus (DM2). This was a prospective cross-sectional study. One-hundred and four consecutive patients with DM2 were given lateral lumbar X-rays in order to quantify abdominal aortic calcification (AAC). Circulating levels of AGEs and classical cardiovascular risk factors were determined. Clinical history was also registered. Patients with higher AGEs values had higher grades of aortic calcification and higher numbers of diabetic-related complications. Multivariate logistic regression analysis showed that being older, male and having high levels of AGEs and triglycerides were the independent risk factors associated to moderate-severe AAC when compared to no-mild AAC. Our results suggest that AGEs plays a role in the pathogenesis of aortic calcifications. In addition, the measurement of AGEs levels may be useful for assessing the severity of AAC in the setting of diabetic complications.
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Affiliation(s)
- Pilar Sanchis
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
- Laboratory of Renal Lithiasis Research, Deptartment of Chemistry, University of Balearic Islands, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07122 Palma of Mallorca, Spain;
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 28046 Madrid, Spain
- Correspondence: (P.S.); (L.M.)
| | - Rosmeri Rivera
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
| | - Regina Fortuny
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
- Laboratory Department, Son Llàtzer University Hospital, 07198 Palma of Mallorca, Spain
| | - Carlos Río
- Proteomics department, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma of Mallorca, Spain;
| | - Miguel Mas-Gelabert
- Radiology Department, Son Llàtzer University Hospital, 07198 Palma of Mallorca, Spain;
| | - Marta Gonzalez-Freire
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
| | - Felix Grases
- Laboratory of Renal Lithiasis Research, Deptartment of Chemistry, University of Balearic Islands, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07122 Palma of Mallorca, Spain;
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 28046 Madrid, Spain
| | - Luis Masmiquel
- Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands [IUNICS-IdISBa], 07198 Palma of Mallorca, Spain; (R.R.); (R.F.); (M.G.-F.)
- Correspondence: (P.S.); (L.M.)
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2
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Belmokhtar K, Ortillon J, Jaisson S, Massy ZA, Boulagnon Rombi C, Doué M, Maurice P, Fritz G, Gillery P, Schmidt AM, Rieu P, Touré F. Receptor for advanced glycation end products: a key molecule in the genesis of chronic kidney disease vascular calcification and a potential modulator of sodium phosphate co-transporter PIT-1 expression. Nephrol Dial Transplant 2020; 34:2018-2030. [PMID: 30778553 DOI: 10.1093/ndt/gfz012] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/05/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with increased cardiovascular mortality, frequent vascular calcification (VC) and accumulation of uraemic toxins. Advanced glycation end products and S100 proteins interact with the receptor for advanced glycation end products (RAGE). In the present work, we aimed to investigate the role(s) of RAGE in the CKD-VC process. METHODS Apoe-/- or Apoe-/-Ager (RAGE)-/- male mice were assigned to CKD or sham-operated groups. A high-phosphate diet was given to a subgroup of Apoe-/-and Apoe-/-Ager-/- CKD mice. Primary cultures of Ager+/+ and Ager-/- vascular smooth muscle cells (VSMCs) were established and stimulated with either vehicle, inorganic phosphate (Pi) or RAGE ligands (S100A12; 20 µM). RESULTS After 12 weeks of CKD we observed a significant increase in RAGE ligand (AGE and S100 proteins) concentrations in the serum of CKD Apoe-/- mice. Ager messenger RNA (mRNA) levels were 4-fold higher in CKD vessels of Apoe-/- mice. CKD Apoe-/- but not CKD Apoe-/- or Ager-/- mice displayed a marked increase in the VC surface area. Similar trends were found in the high-phosphate diet condition. mRNA levels of Runx2 significantly increased in the Apoe-/- CKD group. In vitro, stimulation of Ager+/+VSMCs with Pi or S100A12 induced mineralization and osteoblast transformation, and this was inhibited by phosphonoformic acid (Pi co-transporters inhibitor) and Ager deletion. In vivo and in vitro RAGE was necessary for regulation of the expression of Pit-1, at least in part through production of reactive oxygen species. CONCLUSION RAGE, through the modulation of Pit-1 expression, is a key molecule in the genesis of VC.
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Affiliation(s)
- Karim Belmokhtar
- Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France.,Laboratoire de Néphrologie, Univesrity of Reims, Faculté de Médecine, Reims, France
| | - Jeremy Ortillon
- Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France.,Laboratoire de Néphrologie, Univesrity of Reims, Faculté de Médecine, Reims, France
| | - Stéphane Jaisson
- Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France.,University Hospital of Reims, Maison Blanche Hospital, Laboratory of Pediatric Biology and Research, Reims, France
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré Hospital, APHP, Versailles Saint-Quentin-en-Yvelines University (Paris-Ile-de-France-Ouest University), UVSQ, Boulogne Billancourt/Paris, France.,Inserm U1018, Team5, CESP, Paris Saclay Unioversityand Versailles Saint-Quentin-en-Yvelines University (Paris-Ile-de-France-Ouest University, UVSQ), Villejuif, France
| | - Camille Boulagnon Rombi
- Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France.,CHU Reims, Division of Anatomopathology, Reims, France
| | - Manon Doué
- Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France
| | - Pascal Maurice
- Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France
| | - Günter Fritz
- Institute of Neuropathology, University of Freiburg, Germany
| | - Philippe Gillery
- Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France.,University Hospital of Reims, Maison Blanche Hospital, Laboratory of Pediatric Biology and Research, Reims, France
| | | | - Philippe Rieu
- Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France.,Laboratoire de Néphrologie, Univesrity of Reims, Faculté de Médecine, Reims, France.,CHU Reims, Division of Nephrology, Reims, France
| | - Fatouma Touré
- Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France.,Laboratoire de Néphrologie, Univesrity of Reims, Faculté de Médecine, Reims, France.,CHU Reims, Division of Nephrology, Reims, France
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3
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Egaña-Gorroño L, López-Díez R, Yepuri G, Ramirez LS, Reverdatto S, Gugger PF, Shekhtman A, Ramasamy R, Schmidt AM. Receptor for Advanced Glycation End Products (RAGE) and Mechanisms and Therapeutic Opportunities in Diabetes and Cardiovascular Disease: Insights From Human Subjects and Animal Models. Front Cardiovasc Med 2020; 7:37. [PMID: 32211423 PMCID: PMC7076074 DOI: 10.3389/fcvm.2020.00037] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/25/2020] [Indexed: 12/21/2022] Open
Abstract
Obesity and diabetes are leading causes of cardiovascular morbidity and mortality. Although extensive strides have been made in the treatments for non-diabetic atherosclerosis and its complications, for patients with diabetes, these therapies provide less benefit for protection from cardiovascular disease (CVD). These considerations spur the concept that diabetes-specific, disease-modifying therapies are essential to identify, especially as the epidemics of obesity and diabetes continue to expand. Hence, as hyperglycemia is a defining feature of diabetes, it is logical to probe the impact of the specific consequences of hyperglycemia on the vessel wall, immune cell perturbation, and endothelial dysfunction-all harbingers to the development of CVD. In this context, high levels of blood glucose stimulate the formation of the irreversible advanced glycation end products, the products of non-enzymatic glycation and oxidation of proteins and lipids. AGEs accumulate in diabetic circulation and tissues and the interaction of AGEs with their chief cellular receptor, receptor for AGE or RAGE, contributes to vascular and immune cell perturbation. The cytoplasmic domain of RAGE lacks endogenous kinase activity; the discovery that this intracellular domain of RAGE binds to the formin, DIAPH1, and that DIAPH1 is essential for RAGE ligand-mediated signal transduction, identifies the specific cellular means by which RAGE functions and highlights a new target for therapeutic interruption of RAGE signaling. In human subjects, prominent signals for RAGE activity include the presence and levels of two forms of soluble RAGE, sRAGE, and endogenous secretory (es) RAGE. Further, genetic studies have revealed single nucleotide polymorphisms (SNPs) of the AGER gene (AGER is the gene encoding RAGE) and DIAPH1, which display associations with CVD. This Review presents current knowledge regarding the roles for RAGE and DIAPH1 in the causes and consequences of diabetes, from obesity to CVD. Studies both from human subjects and animal models are presented to highlight the breadth of evidence linking RAGE and DIAPH1 to the cardiovascular consequences of these metabolic disorders.
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Affiliation(s)
- Lander Egaña-Gorroño
- Diabetes Research Program, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University School of Medicine, New York, NY, United States
| | - Raquel López-Díez
- Diabetes Research Program, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University School of Medicine, New York, NY, United States
| | - Gautham Yepuri
- Diabetes Research Program, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University School of Medicine, New York, NY, United States
| | - Lisa S Ramirez
- Department of Chemistry, University of Albany, State University of New York, Albany, NY, United States
| | - Sergey Reverdatto
- Department of Chemistry, University of Albany, State University of New York, Albany, NY, United States
| | - Paul F Gugger
- Diabetes Research Program, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University School of Medicine, New York, NY, United States
| | - Alexander Shekhtman
- Department of Chemistry, University of Albany, State University of New York, Albany, NY, United States
| | - Ravichandran Ramasamy
- Diabetes Research Program, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University School of Medicine, New York, NY, United States
| | - Ann Marie Schmidt
- Diabetes Research Program, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University School of Medicine, New York, NY, United States
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4
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Hassan MG, Morise F, Osman NA, Salam LA, Yehia H, Hamdi M, El Husseiny NM, NasrAllah MM. Micro RNA-192 Is Negatively Associated With Cardiovascular Events Among Wait-Listed Potential Kidney Transplant Recipients on Hemodialysis Over a 5-year Follow-up Period. Transplant Proc 2019; 51:2237-2240. [PMID: 31399202 DOI: 10.1016/j.transproceed.2019.02.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/29/2019] [Accepted: 02/17/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Patients with chronic renal disease are susceptible to accelerated vascular calcification and cardiovascular morbidity and mortality. Micro RNAs (miRNAs) have been linked to the pathogenesis of cardiovascular diseases in the general population. AIM This study was carried out to evaluate the link between miRNA 192 and vascular calcification, pre-existing as well as newly occurring major adverse cardiovascular events, and mortality among hemodialysis patients who are also considered to be potential kidney transplant recipients. METHODS We screened 64 potential transplant recipients on hemodialysis at our university hospital. Pre-existing overt cardiovascular disease was recorded; new adverse cardiovascular events and all causes of death over an observational period of 5 years were prospectively followed. Vascular calcification was measured in the aorta using computerized tomography scans, and micro RNA 192 was measured. RESULTS The final study population included 55 patients followed for 63 months. Micro RNA 192 was significantly lower in patients who had preexisting cardiovascular disease (P = .015) as well and in all patients who had experienced any event by the end of the observational period (P = .012). A multiregression analysis model including micro RNA, age, dialysis vintage, intradialytic hypotension, vascular calcification, diabetes, systolic blood pressure, and smoking found the only independently correlating factor to cardiovascular events in this model to be micro RNA (β = -0.286, P = .05). CONCLUSIONS MiRNA 192 levels are significantly lower among patients experiencing cardiovascular events while on hemodialysis awaiting kidney transplantation.
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Affiliation(s)
- Mona G Hassan
- Department of Nephrology & Department of Internal Medicine, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Fadia Morise
- Department of Nephrology & Department of Internal Medicine, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Noha A Osman
- Department of Nephrology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Lobna Abdel Salam
- Genome Unit, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Hesham Yehia
- Department of Cardiology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Hamdi
- Department of Critical Care, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Noha M El Husseiny
- Department of Internal Medicine, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - M M NasrAllah
- Department of Nephrology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
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5
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Wadén JM, Dahlström EH, Elonen N, Thorn LM, Wadén J, Sandholm N, Forsblom C, Groop PH. Soluble receptor for AGE in diabetic nephropathy and its progression in Finnish individuals with type 1 diabetes. Diabetologia 2019; 62:1268-1274. [PMID: 31127314 PMCID: PMC6559996 DOI: 10.1007/s00125-019-4883-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/26/2019] [Indexed: 01/11/2023]
Abstract
AIMS/HYPOTHESIS Activation of the receptor for AGE (RAGE) has been shown to be associated with diabetic nephropathy. The soluble isoform of RAGE (sRAGE) is considered to function as a decoy receptor for RAGE ligands and thereby protects against diabetic complications. A possible association between sRAGE and diabetic nephropathy is still, however, controversial and a more comprehensive analysis of sRAGE with respect to diabetic nephropathy in type 1 diabetes is therefore warranted. METHODS sRAGE was measured in baseline serum samples from 3647 participants with type 1 diabetes from the nationwide multicentre Finnish Diabetic Nephropathy (FinnDiane) Study. Associations between sRAGE and diabetic nephropathy, as well as sRAGE and diabetic nephropathy progression, were evaluated by regression, competing risks and receiver operating characteristic curve analyses. The non-synonymous SNP rs2070600 (G82S) was used to test causality in the Mendelian randomisation analysis. RESULTS Baseline sRAGE concentrations were highest in participants with diabetic nephropathy, compared with participants with a normal AER or those with microalbuminuria. Baseline sRAGE was associated with progression from macroalbuminuria to end-stage renal disease (ESRD) in the competing risks analyses, but this association disappeared when eGFR was entered into the model. The SNP rs2070600 was strongly associated with sRAGE concentrations and with progression from macroalbuminuria to ESRD. However, Mendelian randomisation analysis did not support a causal role for sRAGE in progression to ESRD. CONCLUSIONS/INTERPRETATION sRAGE is associated with progression from macroalbuminuria to ESRD, but does not add predictive value on top of conventional risk factors. Although sRAGE is a biomarker of diabetic nephropathy, in light of the Mendelian randomisation analysis it does not seem to be causally related to progression from macroalbuminuria to ESRD.
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Affiliation(s)
- Jenny M Wadén
- Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, 00014, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Emma H Dahlström
- Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, 00014, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Nina Elonen
- Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, 00014, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Lena M Thorn
- Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, 00014, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Johan Wadén
- Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, 00014, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Niina Sandholm
- Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, 00014, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Carol Forsblom
- Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, 00014, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Per-Henrik Groop
- Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, 00014, Helsinki, Finland.
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia.
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6
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Abdulle A, Inman CK, Saleh A, Noshi M, Galani D, Abdelwareth L, Alsafar H, Elfatih A, Al Shamsi H, Ali R, Li H, Ramasamy R, Schmidt AM, Benbarka MM, Hassan MH. Metabolic dysfunction in Emirati subjects in Abu Dhabi: Relationship to levels of soluble RAGEs. J Clin Transl Endocrinol 2019; 16:100192. [PMID: 31080742 PMCID: PMC6503160 DOI: 10.1016/j.jcte.2019.100192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 01/07/2019] [Accepted: 04/22/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The United Arab Emirates is experiencing increasing rates of type 2 diabetes (T2D) and its complications. As soluble levels of the receptor for advanced glycation end products, (sRAGE), and endogenous secretory RAGE (esRAGE), the latter an alternatively spliced form of AGER (the gene encoding RAGE), have been reported to be associated with T2D and its complications, we tested for potential relationships between these factors and T2D status in Emirati subjects. METHODS In a case-control study, we recruited Emirati subjects with T2D and controls from the Sheikh Khalifa Medical City in Abu Dhabi. Anthropomorphic characteristics, levels of plasma sRAGE and esRAGE, and routine chemistry variables were measured. RESULTS Two hundred and sixteen T2D subjects and 215 control subjects (mean age, 57.4 ± 12.1 vs. 50.7 ± 15.4 years; P < 0.0001, respectively) were enrolled. Univariate analyses showed that levels of sRAGE were significantly lower in the T2D vs. control subjects (1033.9 ± 545.3 vs. 1169.2 ± 664.1 pg/ml, respectively; P = 0.02). Multivariate analyses adjusting for age, sex, systolic blood pressure, pulse, body mass index, Waist/Hip circumference ratio, fasting blood glucose, HDL, LDL, insulin, triglycerides, Vitamin D and urea levels revealed that the difference in sRAGE levels between T2D and control subjects remained statistically-significant, P = 0.03, but not after including estimated glomerular filtration rate in the model, P = 0.14. There were no significant differences in levels of esRAGE. Levels of plasma insulin were significantly higher in the control vs. the T2D subjects (133.6 ± 149.9 vs. 107.6 ± 93.3 pg/L. respectively; P = 0.01, after adjustment for age and sex). CONCLUSION/DISCUSSION Levels of sRAGE, but not esRAGE, were associated with T2D status in Abu Dhabi, but not after correction for eGFR. Elevated levels of plasma insulin in both control and T2D subjects suggests the presence of metabolic dysfunction, even in subjects without diabetes.
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Key Words
- ADAM10, a disintegrin and metalloproteinase domain-containing protein 10
- AGEs, advanced glycation endproducts
- ARIC, Atherosclerosis Risk in Communities
- BMI, body mass index
- CARDS, Collaborative Atorvastatin Diabetes Study
- CV, coefficient of variation
- DBP, diastolic blood pressure
- ELISA, enzyme-linked immunosorbent assay
- ESRD, end stage renal disease
- FBG, fasting blood glucose
- HDL, high density lipoprotein
- HbA1c, glycosylated hemoglobin
- Insulin resistance
- Kidney function
- LADA, latent autoimmune diabetes of the adult
- LDL, low density lipoprotein
- MMP, matrix metalloproteinase
- RAGE, receptor for advanced glycation endproducts
- Receptor for advanced glycation endproducts (RAGE)
- SBP, systolic blood pressure
- SKMC, Sheikh Khalifa Medical City
- Soluble RAGE (sRAGE)
- T2D, type 2 diabetes
- TG, triglycerides
- Type 2 diabetes
- UAE, United Arab Emirates
- UAEHFS, United Arab Emirates Healthy Futures Study
- W/H ratio, Waist/Hip circumference ratio
- eGFR, estimated glomerular filtration rate
- esRAGE (endogenous secretory RAGE)
- esRAGE, endogenous secretory RAGE
- hsCRP, high sensitivity C-reactive protein
- sRAGE, soluble RAGE
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Affiliation(s)
- Abdishakur Abdulle
- Public Health Research Center, New York University Abu Dhabi, United Arab Emirates
| | - Claire K. Inman
- Public Health Research Center, New York University Abu Dhabi, United Arab Emirates
| | - Abdelkarim Saleh
- Department of Medicine, Sheikh Khalifa Medical City, United Arab Emirates
| | - Mohamed Noshi
- Department of Medicine, Sheikh Khalifa Medical City, United Arab Emirates
| | - Divya Galani
- Public Health Research Center, New York University Abu Dhabi, United Arab Emirates
| | - Laila Abdelwareth
- Department of Pathology, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Habiba Alsafar
- Center for Biotechnology, Khalifa University of Science & Technology, Abu Dhabi, United Arab Emirates
- Department of Biomedical Engineering, Khalifa University of Science & Technology, Abu Dhabi, United Arab Emirates
| | - Abubaker Elfatih
- Department of Medicine, Sheikh Khalifa Medical City, United Arab Emirates
| | - Hefsa Al Shamsi
- Department of Medicine, Sheikh Khalifa Medical City, United Arab Emirates
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, United Arab Emirates
| | - Huilin Li
- Department of Population Health, New York University School of Medicine, NY, USA
| | | | - Ann Marie Schmidt
- Department of Medicine, New York University School of Medicine, NY, USA
| | | | - Mohamed H. Hassan
- Department of Medicine, Sheikh Khalifa Medical City, United Arab Emirates
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7
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Du R, Zhang RY, Lu L, Shen Y, Pu LJ, Zhu ZB, Zhang Q, Hu J, Yang ZK, Ding FH, Zhang JS, Shen WF. Increased glycated albumin and decreased esRAGE levels in serum are related to negative coronary artery remodeling in patients with type 2 diabetes: an Intravascular ultrasound study. Cardiovasc Diabetol 2018; 17:149. [PMID: 30482197 PMCID: PMC6258438 DOI: 10.1186/s12933-018-0792-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 11/21/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Negative coronary artery remodeling is frequent in patients with diabetes, but its mechanism remains unclear. We here evaluated the association of serum levels of glycated albumin (GA) and endogenous secretory receptor for advanced glycation end products (esRAGE) with coronary artery remodeling in type 2 diabetic patients. METHODS Serum levels of GA and esRAGE were measured and intravascular ultrasound was performed in 136 consecutive diabetic patients with 143 coronary intermediate lesions. The remodeling index (RI) was calculated as the ratio between external elastic membrane (EEM) area at the lesion site and EEM area at the reference segment. Negative remodeling (NR) was defined as an RI < 0.95 and intermediate or positive remodeling as an RI ≥ 0.95. RESULTS Mean plaque burden at the lesion site was 70.96 ± 9.98%, and RI was 0.96 ± 0.18. Negative coronary arterial remodeling existed in 81 (56.6%) lesions. RI correlated closely with serum esRAGE level (r = 0.236, P = 0.005) and was inversely related to serum GA level (r = - 0.240, P = 0.004) and plasma low-density lipoprotein cholesterol (LDL-C) (r = - 0.206, P = 0.014) and total cholesterol levels (r = - 0.183, P = 0.028). Generalized estimating equations logistic regression analysis identified esRAGE (OR 0.037; 95% CI 0.012-0.564, P = 0.021), GA (OR 1.093; 95% CI 1.013-1.179, P = 0.018) and LDL-C (OR 1.479; 95% CI 1.072-2.835, P = 0.023) as independent predictors for negative remodeling. CONCLUSIONS In diabetic patients, negative coronary artery remodeling is associated with increased GA and decreased esRAGE levels in serum.
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Affiliation(s)
- Run Du
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Rui Yan Zhang
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Lin Lu
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Ying Shen
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Li Jin Pu
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Zheng Bin Zhu
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Qi Zhang
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Jian Hu
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Zhen Kun Yang
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Feng Hua Ding
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Jian Sheng Zhang
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Wei Feng Shen
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.
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NasrAllah MM, Nassef A, Elshaboni TH, Morise F, Osman NA, Sharaf El Din UA. Comparing different calcification scores to detect outcomes in chronic kidney disease patients with vascular calcification. Int J Cardiol 2016; 220:884-9. [PMID: 27400189 DOI: 10.1016/j.ijcard.2016.06.064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/19/2016] [Indexed: 02/09/2023]
Abstract
BACKGROUND There is no consensus on the most appropriate technique to diagnose vascular calcification in chronic kidney disease. This is primarily because of the absence of direct comparisons of predictive values of the various calcification scores, especially outside the coronary vascular beds, to detect clinical outcomes. METHODS We included 93 haemodialysis patients and performed 6 vascular calcification scores: two scores utilised simple X-rays of abdominal aorta and peripheral vessels. CT scans of the thoracic, upper abdominal and lower abdominal aorta were performed to calculate the aortic calcification index and CT of the pelvis for calcification of iliac vessels. Patients were followed for 63months (mean 46.8months) for first major cardiovascular events and mortality. RESULTS Nineteen cardiovascular events and 28 deaths occurred. Calcification was detected more sensitively in central and peripheral beds using CT scans compared to X-rays (p<0.001). CT scans detected calcification more frequently in distal than proximal vascular beds (p<0.001). Calcification of the pelvic vessels and lower abdominal aorta were most predictive of events including pre-existing cardiovascular disease O.R. 6.5 (95% C.I. 2-22; p=0.001) and O.R. 3 (95% C.I. 1.1-9; p=0.035); new major cardiovascular events H.R. 4.2 (95% C.I. 1.5-11; p=0.006) and H.R. 2 (95% C.I. 0.8-5.3; p=0.1) as well as mortality H.R. 2.8 (95% C.I. 1.3-6; p=0.01) and H.R. 2.2 (95% C.I. 1.04-5; p=0.04) respectively. CONCLUSIONS CT based techniques are more sensitive than plain X-rays at detecting peripheral and aortic vascular calcifications. Distal CT scans of the aorta and pelvic vessels have the highest predictive value for cardiovascular events and mortality.
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Affiliation(s)
- Mohamed M NasrAllah
- Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt.
| | - Amr Nassef
- Kasr AlAiny School of Medicine, Cairo University, Radiology, Cairo, Egypt
| | - Tarik H Elshaboni
- Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt
| | - Fadia Morise
- Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt
| | - Noha A Osman
- Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt
| | - Usama A Sharaf El Din
- Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt
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9
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Abstract
Arteriovenous fistulas (AVFs) are essential for patients and clinicians faced with end-stage renal disease (ESRD). While this method of vascular access for hemodialysis is preferred to others due to its reduced rate of infection and complications, they are plagued by intimal hyperplasia. The pathogenesis of intimal hyperplasia and subsequent thrombosis is brought on by uremia, hypoxia, and shear stress. These forces upregulate inflammatory and proliferative cytokines acting on leukocytes, fibroblasts, smooth muscle cells, and platelets. This activation begins initially with the progression of uremia, which induces platelet dysfunction and primes the body for an inflammatory response. The vasculature subsequently undergoes changes in oxygenation and shear stress during AVF creation. This propagates a strong inflammatory response in the vessel leading to cellular proliferation. This combined response is then further subjected to the stressors of cannulation and dialysis, eventually leading to stenosis and thrombosis. This review aims to help interventional radiologists understand the biological changes and pathogenesis of access failure.
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Affiliation(s)
- Akshaar Brahmbhatt
- Vascular and Interventional Radiology Translational Laboratory, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Sanjay Misra
- Vascular and Interventional Radiology Translational Laboratory, Department of Radiology, Mayo Clinic, Rochester, Minnesota; Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota
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Circulating S100A12 Levels Are Associated with Progression of Abdominal Aortic Calcification in Hemodialysis Patients. PLoS One 2016; 11:e0150145. [PMID: 26914918 PMCID: PMC4768003 DOI: 10.1371/journal.pone.0150145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/09/2016] [Indexed: 11/19/2022] Open
Abstract
Vascular calcification is an important factor associated with mortality in dialysis patients. Recently, soluble receptor for advanced glycation end product (sRAGE) and extracellular RAGE binding protein S100A12 (EN-RAGE) have been reported to be involved in the process of vascular calcification. Therefore, we investigated whether sRAGE and S100A12 are useful indicators of progression of abdominal aortic calcification in hemodialysis (HD) patients. We analyzed annual changes in vascular calcification score (VCS) for up to 4 years, compared to clinical and biological parameters in 149 HD patients. VCS was assessed annually using plain X-ray images of the lateral lumbar spine. The progression group was defined as patients with an increase in VCS more than 1 point each year on average during the observation period. Time-averaged concentrations were also evaluated to examine the association between biological parameters and changes in VCS. The patients had a mean age of 58.59 ± 12.93 years; 53.7% were male, and 45% were diabetic. The VCS increased in 55 patients; the mean increase was 1.60 ± 2.91 points. In a stepwise multivariate logistic analysis, we found that higher levels of S100A12 were significantly associated with progression of VCS (odds ratio [OR], 2.622; 95% confidence interval [CI], 1.371–5.016; P = 0.004). The relationship between sRAGE and VCS was not statistically significant (OR, 0.644; 95% CI, 0.302–1.374; P = 0.255). Our findings suggest that serum levels of S100A12 are associated with progression of abdominal aortic calcification in HD patients, independent of sRAGE level.
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11
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Kim HS, Chung W, Kim AJ, Ro H, Chang JH, Lee HH, Jung JY. Circulating levels of soluble receptor for advanced glycation end product are inversely associated with vascular calcification in patients on haemodialysis independent of S100A12 (EN-RAGE) levels. Nephrology (Carlton) 2014; 18:777-82. [PMID: 24124651 DOI: 10.1111/nep.12166] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2013] [Indexed: 12/11/2022]
Abstract
AIM The receptor for advanced glycation end products (RAGE) has emerged as a central regulator of vascular inflammation and atherosclerosis. Soluble RAGE (sRAGE) has an anti-inflammatory effect by quenching ligands for RAGE. On the other hand, extracellular RAGE-binding protein S100A12 (EN-RAGE) shows a pro-inflammatory effect in a way, but may play pleiotropic roles related to inflammatory process. Therefore, we determined the levels of sRAGE and S100A12 in haemodialysis (HD) patients and evaluated their relationship with vascular calcification. METHODS We performed a cross-sectional study with 199 HD patients. Plain X-ray images of the lateral lumbar spine from all subjects were studied to calculate semiquantitative vascular calcification scores (VCS), as described by Kauppila. Commercially available enzyme linked immunosorbent assay (ELISA) kits were used to quantify the serum concentration of sRAGE and S100A12. RESULTS The patients were 57.1 ± 13.7 years of age; 54.3% were male, 49.2% were diabetic, and 36.2% had a history of cardiovascular disease. In a univariate analysis, serum sRAGE was negatively associated with VCS (log sRAGE, r=-0.208, P=0.003), whereas S100A12 showed a positive tendency (log S100A12, r=0.235, P=0.085). Even after adjustments for confounding risk factors, sRAGE was independently associated with VCS (β=-1.679, P=0.002). CONCLUSION This study demonstrated that the circulating sRAGE level was inversely associated with VCS in HD patients independent of the S100A12 level and the severity of systemic inflammation.
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Affiliation(s)
- Hyung Soo Kim
- Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea
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12
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Two soluble isoforms of receptors for advanced glycation end products (RAGE) in carotid atherosclerosis: the difference of soluble and endogenous secretory RAGE. J Stroke Cerebrovasc Dis 2014; 23:2540-2546. [PMID: 25282185 DOI: 10.1016/j.jstrokecerebrovasdis.2014.05.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 05/26/2014] [Accepted: 05/29/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Advanced glycation end products (AGEs) promote atherosclerosis through binding to their receptor, RAGE. Since soluble RAGE (sRAGE) and endogenous secretory RAGE (esRAGE) may suppress AGEs-RAGE signaling, we examined the usefulness of sRAGE and esRAGE as biomarkers of early-stage atherosclerosis. METHODS Serum sRAGE and esRAGE levels were measured in 284 subjects with no history of atherothrombotic diseases. The subjects were divided into high-sRAGE and low-sRAGE groups and high-esRAGE and low-esRAGE groups based on respective median values. We investigated the relationships between these parameters and the following factors: number of metabolic components, maximum intima-media thickness of the common carotid artery (IMT Cmax), carotid plaque calcification, and asymptomatic cerebral white matter lesions. RESULTS The low-sRAGE and low-esRAGE groups exhibited significantly more components of metabolic syndrome than the high-sRAGE and high-esRAGE groups, respectively. IMT Cmax was significantly higher in the low-sRAGE and low-esRAGE groups. Low-sRAGE levels were significantly associated with carotid plaque calcification. Multiple linear regression analysis identified body mass index (BMI), age, and high-sensitivity C-reactive protein as determinants of sRAGE, whereas only BMI was identified as a determinant of esRAGE. CONCLUSIONS We demonstrated that sRAGE and esRAGE are associated with atherosclerotic risk factors in early-stage atherosclerosis, suggesting that their levels evolve in correlation with those of metabolic components and inflammation. Interestingly, low-sRAGE and esRAGE levels are associated with high IMT Cmax, but only low-sRAGE levels were associated with carotid plaque calcification. Thus, sRAGE and esRAGE may reflect different aspects of atherosclerosis in its early stage.
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NasrAllah MM, Osman NA. Fasting during the month of Ramadan among patients with chronic kidney disease: renal and cardiovascular outcomes. Clin Kidney J 2014; 7:348-353. [PMID: 25349694 PMCID: PMC4208786 DOI: 10.1093/ckj/sfu046] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 04/25/2014] [Indexed: 11/28/2022] Open
Abstract
Background Fasting during the month of Ramadan is a religious obligation for Muslims who represent 20% of the world population. This study explores the safety of fasting for a whole month among patients with chronic kidney disease (CKD) with the possible risk of dehydration and hyperviscosity leading to deterioration of kidney functions and vascular thrombosis. Methods We followed CKD patients with stable kidney function who chose to fast during the month of Ramadan. A group of nonfasting CKD patients served as controls. Serum creatinine was recorded at the beginning of the month, after 1 week of fasting, at the end of the month and 3 months later. Patients were followed for major adverse cardiovascular events (MACE). Results A total of 131 CKD patients were recruited and included in two groups: fasting and nonfasting (mean baseline estimated glomerular filtration rate 27.7, SD 13 and 21.5, SD 11.8 mL/min/1.73 m2, respectively). A rise of serum creatinine was noted during fasting in 60.4% of patients by Day 7 and was associated with intake of renin angiotensin aldosterone system antagonists [relative risk (RR) 2, P = 0.002]. Adverse cardiovascular events were observed in six patients in the fasting cohort and were associated with a rise of serum creatinine after 1 week of fasting (P = 0.009) and the presence of pre-existing cardiovascular disease (RR 15, P = 0.001); the latter association was confirmed by logistic regression analysis. Only one event was recorded in the nonfasting group, P = 0.036. Conclusions MACE occurred more frequently among fasting CKD patients with pre-existing cardiovascular disease and were predicted by an early rise of serum creatinine.
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Affiliation(s)
- Mohamed M NasrAllah
- Department of Nephrology , Kasr AlAiny School of Medicine Cairo University , Cairo , Egypt
| | - Noha A Osman
- Department of Nephrology , Kasr AlAiny School of Medicine Cairo University , Cairo , Egypt
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14
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Nasrallah MM, El-Shehaby AR, Osman NA, Fayad T, Nassef A, Salem MM, Sharaf El Din UAA. The Association between Fibroblast Growth Factor-23 and Vascular Calcification Is Mitigated by Inflammation Markers. NEPHRON EXTRA 2013; 3:106-112. [PMID: 24348506 PMCID: PMC3843931 DOI: 10.1159/000356118] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Fibroblast growth factor-23 (FGF-23) has been linked to vascular calcification, ventricular hypertrophy and mortality in chronic kidney disease (CKD), although these links may not be direct and independent. Similar grave outcomes are associated with inflammation and oxidative stress in CKD. Recently, accumulating evidence has linked components of phosphate homeostasis to inflammation and oxidative stress. The interaction between the triad of inflammation, FGF-23 and cardiovascular outcomes is underinvestigated. METHODS We studied 65 patients with stage 5 CKD on hemodialysis. Serum levels of FGF-23, high-sensitivity C-reactive protein (hsCRP), endogenous soluble receptor of advanced glycation end products (esRAGE), advanced oxidation protein products (AOPP), parathormone, lipids, calcium and phosphorous were measured. The aortic calcification index (ACI) was determined using non-contrast CT scans of the abdominal aorta. RESULTS FGF-23 was elevated (mean: 4,681 pg/ml, SD: 3,906) and correlated with hsCRP, esRAGE, AOPP, dialysis vintage and phosphorus in univariate analysis. In multiple regression analysis, hsCRP, AOPP and phosphorus but not esRAGE were all significantly correlated to FGF-23 (R2 = 0.7, p < 0.001). In univariate analysis, ACI correlated with hsCRP, esRAGE, FGF-23, dialysis vintage, systolic blood pressure (BP) and serum cholesterol. In multiple regression analysis not including inflammation markers, ACI was associated with FGF-23. However, inclusion of inflammation markers in another multiple regression analyses showed that ACI correlated with hsCRP, BP, dialysis vintage and esRAGE but not with FGF-23 (R2 = 0.65, p < 0.001). CONCLUSION FGF-23 is strongly correlated to various markers of inflammation and oxidative stress in hemodialysis patients. The association between FGF-23 and vascular calcification was mitigated when corrected for inflammation markers.
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Affiliation(s)
- Mohamed M Nasrallah
- Department of Nephrology, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Amal R El-Shehaby
- Department of Medical Biochemistry, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Noha A Osman
- Department of Nephrology, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Tarek Fayad
- Department of Nephrology, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Amr Nassef
- Department of Radiology, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Mona M Salem
- Department of Endocrinology, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
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van Eupen MGA, Schram MT, Colhoun HM, Scheijen JLJM, Stehouwer CDA, Schalkwijk CG. Plasma levels of advanced glycation endproducts are associated with type 1 diabetes and coronary artery calcification. Cardiovasc Diabetol 2013; 12:149. [PMID: 24134530 PMCID: PMC4015708 DOI: 10.1186/1475-2840-12-149] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 10/02/2013] [Indexed: 12/17/2022] Open
Abstract
Background Advanced glycation endproducts (AGEs) may play a role in the development of coronary artery calcification (CAC) in type 1 diabetes (T1DM). We studied plasma AGEs in association with T1DM and CAC, and whether or not the latter association could be explained by low-grade inflammation (LGI) or endothelial dysfunction (ED). Methods We studied 165 individuals with and 169 without T1DM. CAC was quantified in a CAC score based on CT-scanning. Plasma levels of protein-bound pentosidine, Nϵ-(carboxymethyl)lysine (CML) and Nϵ-(carboxyethyl)lysine (CEL) were measured with HPLC/UPLC with fluorescence detection or tandem-mass spectrometry. Tetrahydropyrimidine (THP) was measured with ELISA, as were HsCRP, and sVCAM-1 and vWF, as markers for LGI and ED, respectively. Associations were analyzed with ANCOVA and adjusted for age, sex, BMI, waist-to-hip ratio, smoking, blood pressure, lipid profile, eGFR and T1DM. Results Individuals with T1DM had higher plasma levels of pentosidine, CML and THP compared with controls; means (95% CI) were 0.69 (0.65-0.73) vs. 0.51 (0.48-0.54) nmol/mmol LYS, p < 0.001; 105 (102–107) vs. 93 (90–95) nmol/mmol LYS, p < 0.001; and 126 (118–134) vs. 113 (106–120) U/mL, p = 0.03, respectively. Levels of pentosidine were higher in individuals with T1DM with a moderate to high compared with a low CAC score, means (95% CI) were 0.81 (0.70-0.93) vs. 0.67 (0.63-0.71) nmol/mmol LYS, p = 0.03, respectively. This difference was not attenuated by adjustment for LGI or ED. Conclusions We found a positive association between pentosidine and CAC in T1DM. These results may indicate that AGEs are possibly involved in the development of CAC in individuals with T1DM.
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Affiliation(s)
| | | | | | | | | | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Centre (MUMC) and Cardiovascular Research Institute Maastricht (CARIM), Universiteitssingel 50, Maastricht 6200, MD, the Netherlands.
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