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Gunawan A, Fajar JK, Tamara F, Mahendra AI, Ilmawan M, Purnamasari Y, Kartini DA, Winoto ES, Saifillah ES, Wulandari DS, Krisna PA, Mayasari ED, Dantara TWI, Wicaksono RS, Soeatmadji DW. Nitride oxide synthase 3 and klotho gene polymorphisms in the pathogenesis of chronic kidney disease and age-related cognitive impairment: a systematic review and meta-analysis. F1000Res 2020; 9:252. [PMID: 34035901 PMCID: PMC8112466 DOI: 10.12688/f1000research.22989.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 12/25/2022] Open
Abstract
Background: While it has been known that the development of chronic kidney disease (CKD) and age-related cognitive impairment involves several mediators, the evidence in clinical practice only reveals nitride oxide synthase (NOS) and klotho. However, the evidence for this topic is conflicted. The aim of this study was to assess the role of NOS and klotho single nucleotide polymorphisms (SNPs) in the pathogenesis of CKD and age-related cognitive impairment. Methods: We performed a meta-analysis during October to December 2019. Paper collection was performed in major scientific websites, and we extracted information of interest from each paper. Data were analyzed using a Z-test with either random or fixed effect model. Results: Our initial assessment identified NOS3 G894T, NOS3 T786C, NOS3 4b/4a, klotho ( KL) G395A, and KL C1818T as the gene candidate for our meta-analysis. Our pooled calculation revealed that NOS3 G894T was associated with the risk of both age-related cognitive impairment and CKD. Increased susceptibility to age-related cognitive impairment was observed in the GG genotype, and increased risk of CKD was found in patients with a single T allele and TT genotype for NOS3 nucleotide 894. For NOS3 4b/4a, increased risk of CKD was only found in 4a4a genotype. For NOS3 T786C, we failed to show the association with both CKD and age-related cognitive impairment. Subsequently, for KL G395A, A allele and GA genotype were found to correlate with increased susceptibility to CKD, while its correlation to age-related cognitive impairment was failed to clarify. For KL C1818T, our analysis failed to find the correlation with the risk of CKD. Conclusions: Our results reveal that the NOS3 G894T gene polymorphism has a crucial role in the pathogenesis of both CKD and age-related cognitive impairment.
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Affiliation(s)
- Atma Gunawan
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Jonny Karunia Fajar
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Fredo Tamara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Aditya Indra Mahendra
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Yeni Purnamasari
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | | | - Eden Suryoiman Winoto
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Efriko Septananda Saifillah
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Dewi Sri Wulandari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Pratista Adi Krisna
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ema Dianita Mayasari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Tri Wahyudi Iman Dantara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ramadi Satryo Wicaksono
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Department of Internal Medicine, Rumah Sakit Umum Daerah Bangil., Pasuruan, East Java, 67153, Indonesia
| | - Djoko Wahono Soeatmadji
- Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
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Gunawan A, Fajar JK, Tamara F, Mahendra AI, Ilmawan M, Purnamasari Y, Kartini DA, Winoto ES, Saifillah ES, Wulandari DS, Krisna PA, Mayasari ED, Dantara TWI, Wicaksono RS, Soeatmadji DW. Nitride oxide synthase 3 and klotho gene polymorphisms in the pathogenesis of chronic kidney disease and age-related cognitive impairment: a systematic review and meta-analysis. F1000Res 2020; 9:252. [PMID: 34035901 PMCID: PMC8112466 DOI: 10.12688/f1000research.22989.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2020] [Indexed: 04/03/2024] Open
Abstract
Background: While it has been known that the development of chronic kidney disease (CKD) and age-related cognitive impairment involves several mediators, the evidence in clinical practice only reveals nitride oxide synthase (NOS) and klotho. However, the evidence for this topic is conflicted. The aim of this study was to assess the role of NOS and klotho single nucleotide polymorphisms (SNPs) in the pathogenesis of CKD and age-related cognitive impairment. Methods: We performed a meta-analysis during October to December 2019. Paper collection was performed in major scientific websites, and we extracted information of interest from each paper. Data were analyzed using a Z-test with either random or fixed effect model. Results: Our initial assessment identified NOS3 G894T, NOS3 T786C, NOS3 4b/4a, klotho ( KL) G395A, and KL C1818T as the gene candidate for our meta-analysis. Our pooled calculation revealed that NOS3 G894T was associated with the risk of both age-related cognitive impairment and CKD. Increased susceptibility to age-related cognitive impairment was observed in the GG genotype, and increased risk of CKD was found in patients with a single T allele and TT genotype for NOS3 nucleotide 894. For NOS3 4b/4a, increased risk of CKD was only found in 4a4a genotype. For NOS3 T786C, we failed to show the association with both CKD and age-related cognitive impairment. Subsequently, for KL G395A, A allele and GA genotype were found to correlate with increased susceptibility to CKD, while its correlation to age-related cognitive impairment was failed to clarify. For KL C1818T, our analysis failed to find the correlation with the risk of CKD. Conclusions: Our results reveal that the NOS3 G894T gene polymorphism has a crucial role in the pathogenesis of both CKD and age-related cognitive impairment.
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Affiliation(s)
- Atma Gunawan
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Jonny Karunia Fajar
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Fredo Tamara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Aditya Indra Mahendra
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Yeni Purnamasari
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | | | - Eden Suryoiman Winoto
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Efriko Septananda Saifillah
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Dewi Sri Wulandari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Pratista Adi Krisna
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ema Dianita Mayasari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Tri Wahyudi Iman Dantara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ramadi Satryo Wicaksono
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Department of Internal Medicine, Rumah Sakit Umum Daerah Bangil., Pasuruan, East Java, 67153, Indonesia
| | - Djoko Wahono Soeatmadji
- Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
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George C, Yako YY, Okpechi IG, Matsha TE, Kaze Folefack FJ, Kengne AP. An African perspective on the genetic risk of chronic kidney disease: a systematic review. BMC MEDICAL GENETICS 2018; 19:187. [PMID: 30340464 PMCID: PMC6194564 DOI: 10.1186/s12881-018-0702-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 10/02/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Individuals of African ethnicity are disproportionately burdened with chronic kidney disease (CKD). However, despite the genetic link, genetic association studies of CKD in African populations are lacking. METHODS We conducted a systematic review to critically evaluate the existing studies on CKD genetic risk inferred by polymorphism(s) amongst African populations in Africa. The study followed the HuGE handbook and PRISMA protocol. We included studies reporting on the association of polymorphism(s) with prevalent CKD, end-stage renaldisease (ESRD) or CKD-associated traits. Given the very few studies investigating the effects of the same single nucleotide polymorphisms (SNPs) on CKD risk, a narrative synthesis of the evidence was conducted. RESULTS A total of 30 polymorphisms in 11 genes were investigated for their association with CKD, ESRD or related traits, all using the candidate-gene approach. Of all the included genes, MYH9, AT1R and MTHFR genes failed to predict CKD or related traits, while variants in the APOL1, apoE, eNOS, XPD, XRCC1, renalase, ADIPOQ, and CCR2 genes were associated with CKD or other related traits. Two SNPs (rs73885319, rs60910145) and haplotypes (G-A-G; G1; G2) of the apolipoprotein L1 (APOL1) gene were studied in more than one population group, with similar association with prevalent CKD observed. The remaining polymorphisms were investigated in single studies. CONCLUSION According to this systematic review, there is currently insufficient evidence of the specific polymorphisms that poses African populations at an increased risk of CKD. Large-scale genetic studies are warranted to better understand susceptibility polymorphisms, specific to African populations.
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Affiliation(s)
- Cindy George
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Parow Valley, PO Box 19070, Cape Town, South Africa.
| | - Yandiswa Y Yako
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Ikechi G Okpechi
- Department of Medicine, Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.,Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Tandi E Matsha
- Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Bellville, Cape Town, South Africa
| | - Francois J Kaze Folefack
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Medicine Unit, Yaounde University Teaching Hospital, Yaounde, Cameroon
| | - Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Parow Valley, PO Box 19070, Cape Town, South Africa
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İlhan N, Ateş K, İlhan N, Kaman D, Çeliker H. eNOS Glu298Asp Polymorphism and Endothelial Dysfunction in Patients with and without End-stage Renal Disease. Balkan Med J 2016; 33:128-37. [PMID: 27403380 DOI: 10.5152/balkanmedj.2016.16566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/20/2015] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Chronic kidney diseases are known to influence nitric oxide metabolites (NOx) and asymmetric dimethylarginine (ADMA), though the exact mechanism is still poorly understood. AIMS The purpose of the present study was to examine eNOS Glu298Asp gene polymorphism, plasma NOx and ADMA concentration in subjects with and without End-stage Renal Disease. STUDY DESIGN Case-control study. METHODS In this study, genotype distributions of Glu-298Asp in exon 7 of the eNOS gene polymorphisms in 130 hemodialysis and 64 peritoneal dialysis patients were compared with 92 controls. NOx was measured by using the Griess reaction while arginine, ADMA and SDMA measurements were performed by HPLC. Genotyping for eNOS Glu298Asp polymorphism was detected with the polymerase chain reaction and/or polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. RESULTS When the genotype frequencies of TT and GT genes were compared between both groups, there was no detected statistically important difference, even-though a TT genotype frequency was 27 (20.8%) versus 17 (26.6%), GT heterozygote genotype frequency was 52 (40%) versus 22 (34.4%), and GG homozygote genotype frequency was 51 (39.2%) versus 25 (39.1%), respectively (p>0.05). NOx, SDMA and ADMA concentrations were significantly elevated in subjects with hemodialysis patients as compared to their corresponding controls. Whereas nitrite was found to be significantly decreased in the patient with peritoneal dialysis. CONCLUSION Not observed any connection between the Glu298Asp polymorphism in the eNOS gene and end-stage Renal Diseases in our study population under different dialysis treatments. However, higher ADMA and SDMA concentrations in subjects with ESRD support the existing hypothesis that NOx overproduction affects endothelial dysfunction. Thus, the reduction of ADMA and SDMA concentrations might play a protective role in ESRD patients.
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Affiliation(s)
- Nevin İlhan
- Department of Medical Biochemistry, Fırat University School of Medicine, Elazığ, Turkey
| | - Kadir Ateş
- Department of Medical Biochemistry, Fırat University School of Medicine, Elazığ, Turkey
| | - Necip İlhan
- Department of Medical Biochemistry, Fırat University School of Medicine, Elazığ, Turkey
| | - Dilara Kaman
- Department of Medical Biochemistry, Fırat University School of Medicine, Elazığ, Turkey
| | - Hüseyin Çeliker
- Department of Nephrology, Fırat University Hospital, Elazığ, Turkey
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Yun Z, Yu-Ping Y, Zong-Wu T, Yang S, Fang Y, Fang S. Association of endothelial nitric oxide synthase gene polymorphisms with end-stage renal disease: a systematic review and meta-analysis. Ren Fail 2014; 36:987-93. [DOI: 10.3109/0886022x.2014.900601] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Bochud M, Burnier M, Guessous I. Top Three Pharmacogenomics and Personalized Medicine Applications at the Nexus of Renal Pathophysiology and Cardiovascular Medicine. CURRENT PHARMACOGENOMICS AND PERSONALIZED MEDICINE 2011; 9:299-322. [PMID: 23049672 PMCID: PMC3460365 DOI: 10.2174/187569211798377135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 10/08/2011] [Accepted: 10/13/2011] [Indexed: 12/18/2022]
Abstract
Pharmacogenomics is a field with origins in the study of monogenic variations in drug metabolism in the 1950s. Perhaps because of these historical underpinnings, there has been an intensive investigation of 'hepatic pharmacogenes' such as CYP450s and liver drug metabolism using pharmacogenomics approaches over the past five decades. Surprisingly, kidney pathophysiology, attendant diseases and treatment outcomes have been vastly under-studied and under-theorized despite their central importance in maintenance of health, susceptibility to disease and rational personalized therapeutics. Indeed, chronic kidney disease (CKD) represents an increasing public health burden worldwide, both in developed and developing countries. Patients with CKD suffer from high cardiovascular morbidity and mortality, which is mainly attributable to cardiovascular events before reaching end-stage renal disease. In this paper, we focus our analyses on renal function before end-stage renal disease, as seen through the lens of pharmacogenomics and human genomic variation. We herein synthesize the recent evidence linking selected Very Important Pharmacogenes (VIP) to renal function, blood pressure and salt-sensitivity in humans, and ways in which these insights might inform rational personalized therapeutics. Notably, we highlight and present the rationale for three applications that we consider as important and actionable therapeutic and preventive focus areas in renal pharmacogenomics: 1) ACE inhibitors, as a confirmed application, 2) VDR agonists, as a promising application, and 3) moderate dietary salt intake, as a suggested novel application. Additionally, we emphasize the putative contributions of gene-environment interactions, discuss the implications of these findings to treat and prevent hypertension and CKD. Finally, we conclude with a strategic agenda and vision required to accelerate advances in this under-studied field of renal pharmacogenomics with vast significance for global public health.
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Affiliation(s)
- Murielle Bochud
- Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Michel Burnier
- Service of Nephrology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Idris Guessous
- Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
- Unit of Population Epidemiology, Division of Primary Care medicine, Department of Community Medicine and Primary Care and Emergency Medicine, Geneva University Hospital, Geneva, Switzerland
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Endothelial nitric oxide synthase gene intron4 VNTR polymorphism in patients with chronic kidney disease. Blood Coagul Fibrinolysis 2011; 22:487-92. [DOI: 10.1097/mbc.0b013e328346ef71] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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El-Din Bessa SS, Hamdy SM. Impact of nitric oxide synthase Glu298Asp polymorphism on the development of end-stage renal disease in type 2 diabetic Egyptian patients. Ren Fail 2011; 33:878-84. [PMID: 21854353 DOI: 10.3109/0886022x.2011.605978] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Nitric oxide is an important regulator of renal hemodynamics. This study aimed to investigate the role of endothelial nitric oxide synthase (eNOS) gene polymorphism in type 2 diabetic patients with end-stage renal disease (ESRD) and to elucidate any alteration of nitric oxide synthase (NOS) activity caused by this polymorphism. METHODS The study included 80 patients with type 2 diabetes of >10 years duration (40 with diabetes-derived ESRD, 40 without nephropathy) and 20 healthy controls. Plasma nitrate/nitrite level, and serum NOS activity were measured and eNOS Glu298Asp genotypes were determined. RESULTS The frequency of Glu/Glu (GG) genotype in diabetics with ESRD was lower than controls. However, the frequency of Asp/Asp (TT) genotype was increased in diabetics with ESRD as compared to those without nephropathy and controls. Diabetics with ESRD had significantly lower nitrate/nitrite level and NOS activity than those without nephropathy. Diabetic patients with TT genotype are at a significant risk for ESRD. Moreover, subjects carrying TT genotype had lower nitrate/nitrite level and NOS activity than those carrying GG genotype. In diabetics with ESRD, creatinine clearance was positively correlated with both nitrate/nitrite level and NOS activity. CONCLUSIONS These results imply that TT genotype of eNOS may be associated with an increased risk of ESRD in Egyptian type 2 diabetics. It could represent a useful genetic marker to identify diabetics at high risk for the development of ESRD. However, larger future prospective studies are required to confirm the role of eNOS gene polymorphism in the progression of diabetic nephropathy to ESRD.
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Marson BP, Dickel S, Ishizawa MH, Metzger IF, Izidoro-Toledo T, da Costa BEP, Poli-de-Figueiredo CE, Tanus-Santos JE. Endothelial Nitric Oxide Genotypes and Haplotypes Are Not Associated with End-Stage Renal Disease. DNA Cell Biol 2011; 30:55-9. [DOI: 10.1089/dna.2010.1106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bernardo P. Marson
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Samantha Dickel
- Faculty of Medicine/IPB/HSL of Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marília H. Ishizawa
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Ingrid F. Metzger
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | | | | | | | - Jose E. Tanus-Santos
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
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Synergistic effects of the MTHFR C677T and A1298C polymorphisms on the increased risk of micro- and macro-albuminuria and progression of diabetic nephropathy among Iranians with type 2 diabetes mellitus. Clin Biochem 2010; 43:1333-9. [PMID: 20800057 DOI: 10.1016/j.clinbiochem.2010.08.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 08/11/2010] [Accepted: 08/14/2010] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To find whether polymorphisms of methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C are risk factors for diabetic nephropathy (DN) among type 2 diabetes mellitus (T2DM) patients from Western Iran. DESIGN AND METHODS The MTHFR polymorphisms were detected in 72 microalbuminuric, 68 macroalbuminuric and 72 normoalbuinuric T2DM patients by PCR-RFLP. RESULTS The possession of both MTHFR 677T and 1298C alleles increase the risk of microalbuminuria to 4.3-fold (p=0.007) in T2DM patients. The presence of either MTHFR 677T, 1298C allele is sufficient to increase the risk of macroalbuminuria in T2DM patients by 4.1 and 5.5 times (p=0.027, and p=0.006, respectively). The concomitant presence of both 677T and 1298C alleles act in synergy to increase the risk of macroalbuminuria by 20.4-fold (p<0.001) and progression of DN from microalbuminuria to macroalbuminuria (OR=4.73, p=0.01). CONCLUSION Both MTHFR 677T and 1298C alleles increased the susceptibility to the onset and progression of DN in Iranians with T2DM.
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Nishiyama Y, Ueda M, Katsura KI, Otsuka T, Abe A, Nagayama H, Katayama Y. Asymmetric dimethylarginine (ADMA) as a possible risk marker for ischemic stroke. J Neurol Sci 2010; 290:12-5. [PMID: 20060545 DOI: 10.1016/j.jns.2009.12.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 12/15/2009] [Accepted: 12/18/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Asymmetric dimethylarginine (ADMA) affects vascular function by blocking nitric oxide synthesis. We examined the relationship of ADMA concentration to vascular risk factors in subjects who have undergone annual medical check-up. METHODS ADMA concentration, lipid profile and vascular risk factors were assessed during an annual medical examination in 116 subjects (mean age 58.7years). Univariate and multivariate analyses were carried out to assess factors associated with ADMA concentration. ADMA concentration was also assessed in 50 age-matched patients with ischemic stroke. RESULTS Mean serum ADMA concentration was significantly higher in the ischemic stroke patients than the medical check-up subjects (0.461+/-0.076 versus 0.433+/-0.056mumol/l; P=0.022). Univariate analysis showed that ADMA concentration in the medical check-up subjects was significantly associated with age, hypertension, dyslipidemia, fasting blood glucose, total and LDL cholesterol concentrations. Multiple stepwise linear regression analysis showed that hypertension (beta=0.25, P=0.008) and dyslipidemia (beta=0.19, P =0.048) were significant independent determinants of ADMA concentration. ADMA concentration increased progressively with number of vascular risk factors, with a significant (P=0.001) difference between subjects with no risk factors and subjects with > or =2 risk factors. CONCLUSIONS Serum ADMA concentration was significantly associated with vascular risk factors in subjects undergoing routine medical check-up. ADMA concentration warrants further examination as a possible marker of future development of ischemic stroke.
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