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Gao C, Gao S, Zhao R, Shen P, Zhu X, Yang Y, Duan C, Wang Y, Ni H, Zhou L, Xiang Y, Li M, Xu Z, Wang Y, Yang H, Zhao C. Association between systemic immune-inflammation index and cardiovascular-kidney-metabolic syndrome. Sci Rep 2024; 14:19151. [PMID: 39160192 PMCID: PMC11333479 DOI: 10.1038/s41598-024-69819-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 08/08/2024] [Indexed: 08/21/2024] Open
Abstract
This study aims to explore the relationship between the Systemic Immune-Inflammation Index (SII) and Cardiovascular-Kidney-Metabolic (CKM) Syndrome and its components. Data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018 were analyzed. CKM Syndrome is defined as the coexistence of Cardiometabolic Syndrome (CMS) and Chronic Kidney Disease (CKD). The SII is calculated using the formula: SII = (Platelet count × Neutrophil count)/Lymphocyte count. Weighted logistic regression models were used to examine the associations between SII and CKM, as well as its specific components. Restricted cubic splines explored non-linear relationships, and piecewise linear regression models assessed threshold effects. A consistent positive correlation was observed between elevated SII levels and the likelihood of CKM and its related diseases. In the fully adjusted Model 3, an increase of 1000 units in SII was associated with a 1.48-fold increase in the odds of CKM (95% CI 1.20-1.81, p < 0.001). Quartile analysis revealed a dose-response relationship, with the highest quartile of SII (Q4) showing the strongest association with CKM and its components. Nonlinear analyses revealed inflection points for waist circumference, triglycerides, low HDL-C, and cardiometabolic syndrome at specific SII levels, indicating a change in the direction or strength of associations beyond these points. Conversely, a linear relationship was observed between SII and chronic kidney disease. The SII is positively correlated with the risk of CKM Syndrome and its individual components, with evidence of non-linear relationships and threshold effects for some components.
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Affiliation(s)
- Chenxuan Gao
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Shizhen Gao
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Renpei Zhao
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Peimin Shen
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Xiaorui Zhu
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Yane Yang
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Conghao Duan
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Yansi Wang
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Huan Ni
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Lanping Zhou
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Yunfang Xiang
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - MeiJu Li
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Zhao Xu
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Yibing Wang
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China
| | - Haijie Yang
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China.
| | - Chuanwei Zhao
- Department of Cardiology, The Second People's Hospital of Baoshan, No.13, Zhengyang (S) Rd., Longyang Dist., Baoshan, Yunnan, China.
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Pedreañez A, Carrero Y, Vargas R, Hernández-Fonseca JP, Mosquera JA. Role of angiotensin II in cellular entry and replication of dengue virus. Arch Virol 2024; 169:121. [PMID: 38753119 DOI: 10.1007/s00705-024-06040-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 05/21/2024]
Abstract
Previous studies have demonstrated the relevance of several soluble molecules in the pathogenesis of dengue. In this regard, a possible role for angiotensin II (Ang II) in the pathophysiology of dengue has been suggested by the observation of a blockade of Ang II in patients with dengue, increased expression of molecules related to Ang II production in the plasma of dengue patients, increased expression of circulating cytokines and soluble molecules related to the action of Ang II, and an apparent relationship between DENV, Ang II effects, and miRNAs. In addition, in ex vivo experiments, the blockade of Ang II AT1 receptor and ACE-1 (angiotensin converting enzyme 1), both of which are involved in Ang II production and its function, inhibits infection of macrophages by DENV, suggesting a role of Ang II in viral entry or in intracellular viral replication of the virus. Here, we discuss the possible mechanisms of Ang II in the entry and replication of DENV. Ang II has the functions of increasing the expression of DENV entry receptors, creation of clathrin-coated vesicles, and increasing phagocytosis, all of which are involved in DENV entry. This hormone also modulates the expression of the Rab5 and Rab7 proteins, which are important in the endosomal processing of DENV during viral replication. This review summarizes the data related to the possible involvement of Ang II in the entry of DENV into cells and its replication.
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Affiliation(s)
- Adriana Pedreañez
- Cátedra de Inmunología, Escuela de Bioanálisis, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - Yenddy Carrero
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - Renata Vargas
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - Juan P Hernández-Fonseca
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
- Servicio de Microscopia Electrónica del Centro Nacional de Biotecnología (CNB- CSIC), Madrid, España
| | - Jesús Alberto Mosquera
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela.
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Mosquera-Sulbaran JA, Pedreañez A, Carrero Y, Hernandez-Fonseca JP. Angiotensin II and post-streptococcal glomerulonephritis. Clin Exp Nephrol 2024; 28:359-374. [PMID: 38170299 DOI: 10.1007/s10157-023-02446-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Post-streptococcal glomerulonephritis (PSGN) is a consequence of the infection by group A beta-hemolytic streptococcus. During this infection, various immunological processes generated by streptococcal antigens are triggered, such as the induction of antibodies and immune complexes. This activation of the immune system involves both innate and acquired immunity. The immunological events that occur at the renal level lead to kidney damage with chronic renal failure as well as resolution of the pathological process (in most cases). Angiotensin II (Ang II) is a molecule with vasopressor and pro-inflammatory capacities, being an important factor in various inflammatory processes. During PSGN some events are defined that make Ang II conceivable as a molecule involved in the inflammatory processes during the disease. CONCLUSION This review is focused on defining which reported events would be related to the presence of this hormone in PSGN.
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Affiliation(s)
- Jesus A Mosquera-Sulbaran
- Facultad de Medicina, Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Universidad del Zulia, Apartado Postal: 23, MaracaiboZulia, 4001-A, Venezuela.
| | - Adriana Pedreañez
- Facultad de Medicina, Cátedra de Inmunología, Escuela de Bioanálisis, Universidad del Zulia, Maracaibo, Venezuela
| | - Yenddy Carrero
- Facultad de Medicina, Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Universidad del Zulia, Apartado Postal: 23, MaracaiboZulia, 4001-A, Venezuela
| | - Juan Pablo Hernandez-Fonseca
- Facultad de Medicina, Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Universidad del Zulia, Apartado Postal: 23, MaracaiboZulia, 4001-A, Venezuela
- Servicio de Microscopia Electrónica del Centro Nacional de Biotecnología, CNB-CSIC, Madrid, Spain
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Floyd WN, Beavers DP, Jensen ET, Washburn LK, South AM. Association of antenatal corticosteroids with kidney function in adolescents born preterm with very low birth weight. J Perinatol 2023; 43:1038-1044. [PMID: 37160975 PMCID: PMC10524661 DOI: 10.1038/s41372-023-01688-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/15/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE Investigate if antenatal corticosteroids (ANCS) are associated with worse kidney function in adolescence and if greater adiposity magnifies this association. STUDY DESIGN Prospective cohort of 162 14-year-olds born preterm with very low birth weight (<1500 g). Outcomes were estimated glomerular filtration rate (eGFR) and first-morning urine albumin-to-creatinine ratio (UACR). We used adjusted generalized linear models, stratified by waist-to-height ratio (WHR) ≥ 0.5. RESULTS Fifty-five percent had ANCS exposure and 31.3% had WHR ≥ 0.5. In adjusted analyses of the entire cohort, ANCS was not significantly associated with eGFR or UACR. However, the ANCS-eGFR association was greater in those with WHR ≥ 0.5 (β -16.8 ml/min/1.73 m2, 95% CL -31.5 to -2.1) vs. WHR < 0.5: (β 13.9 ml/min/1.73 m2, 95% CL -0.4 to 28.1), interaction term p = 0.02. CONCLUSION ANCS exposure was not associated with worse kidney function in adolescence, though ANCS may be associated with lower eGFR if children develop obesity by adolescence.
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Affiliation(s)
- Whitney N Floyd
- Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA
| | - Daniel P Beavers
- Department of Statistical Sciences, Wake Forest University, Winston-Salem, NC, 27101, USA
| | - Elizabeth T Jensen
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA
| | - Lisa K Washburn
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA
| | - Andrew M South
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA.
- Department of Pediatrics, Section of Nephrology, Brenner Children's, Wake Forest University School of Medicine, Winston Salem, NC, USA.
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Mosquera-Sulbaran JA, Pedreañez A, Hernandez-Fonseca JP, Hernandez-Fonseca H. Angiotensin II and dengue. Arch Virol 2023; 168:191. [PMID: 37368044 DOI: 10.1007/s00705-023-05814-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/09/2023] [Indexed: 06/28/2023]
Abstract
Dengue is a disease caused by a flavivirus that is transmitted principally by the bite of an Aedes aegypti mosquito and represents a major public-health problem. Many studies have been carried out to identify soluble factors that are involved in the pathogenesis of this infection. Cytokines, soluble factors, and oxidative stress have been reported to be involved in the development of severe disease. Angiotensin II (Ang II) is a hormone with the ability to induce the production of cytokines and soluble factors related to the inflammatory processes and coagulation disorders observed in dengue. However, a direct involvement of Ang II in this disease has not been demonstrated. This review primarily summarizes the pathophysiology of dengue, the role of Ang II in various diseases, and reports that are highly suggestive of the involvement of this hormone in dengue.
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Affiliation(s)
- Jesus A Mosquera-Sulbaran
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, 4001-A, Venezuela.
| | - Adriana Pedreañez
- Cátedra de Inmunología, Escuela de Bioanálisis, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - Juan Pablo Hernandez-Fonseca
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, 4001-A, Venezuela
- Servicio de Microscopia Electronica del Centro Nacional de Biotecnologia (CNB- CSIC) Madrid, Madrid, España
| | - Hugo Hernandez-Fonseca
- Department of Anatomy, Physiology and Pharmacology, School of Veterinary Medicine, Saint George's University, True Blue, West Indies, Grenada
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Weingarten N, Iyengar A, Herbst DA, Helmers M, Rekhtman D, Song C, Kim ST, Atluri P. Heart-kidney transplant versus heart transplant in the obese: a propensity-matched analysis. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY : OFFICIAL JOURNAL OF THE EUROPEAN ASSOCIATION FOR CARDIO-THORACIC SURGERY 2022; 63:6935784. [PMID: 36534819 DOI: 10.1093/ejcts/ezac563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/17/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The decision to perform simultaneous heart-kidney transplant (HKT) rather than isolated heart transplant (IHT) for patients with advanced kidney disease is challenging. Limited data exist to guide this decision in obese patients. We sought to compare mortality after HKT and IHT in obese patients with non-dialysis-dependent kidney disease. METHODS The United Network for Organ Sharing was queried for data on adult heart transplant recipients from 2000 to 2022. Inclusion criteria were obesity, estimated glomerular filtration rate <45 ml/min/1.73 m2 and no pretransplant dialysis. HKT and IHT recipients were propensity matched. Morbidity was compared using chi-squared, Fisher's exact and McNemar's tests. Survival was assessed with Kaplan-Meier estimation. Risk factors for mortality were examined with Cox regression. RESULTS A total of 289 HKT and 1920 IHT recipients met inclusion criteria. Heart-kidney recipients had higher baseline creatinine and rates of intensive care unit disposition than IHT recipients (both standardized mean differences >0.10). Propensity matching resulted in 239 pairs of HKT and IHT recipients with minimal differences in baseline characteristics. Heart-kidney recipients had higher 5- and 10-year survival than IHT recipients on unmatched (77% vs 69%, P = 0.011 and 58% vs 48%, P = 0.008) and propensity matched analyses (77% vs 68%, P = 0.026 and 57% vs 39%, P = 0.007). Heart-kidney transplantation was protective against 10-year mortality on multivariable regression (hazard ratio 0.585, P = 0.002). CONCLUSIONS In obese patients with non-dialysis-dependent kidney disease, HKT may decrease long-term mortality relative to IHT and should be strongly considered as a preferred treatment.
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Affiliation(s)
- Noah Weingarten
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Amit Iyengar
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - David Alan Herbst
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Helmers
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - David Rekhtman
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Cindy Song
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Samuel T Kim
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Pavan Atluri
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
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Mosquera-Sulbarán J, Ryder E, Pedreáñez A, Vargas R. Angiotensin II and human obesity. A narrative review of the pathogenesis. INVESTIGACIÓN CLÍNICA 2022. [DOI: 10.54817/ic.v63n4a09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Angiotensin II (Ang II) is a hormone and the main effector of the renin-angiotensin system (RAS). This peptide has crucial pathophysiologi-cal effects on hypertension, cardiac hypertrophy, endothelial proliferation, in-flammation and tissue remodelling through G protein-coupled receptors. The pro-inflammatory role of Ang II has been reported in various inflammatory pro-cesses. Obesity is linked to a chronic inflammatory process which in turn is the cause of some of its morbidities. Ang II is related to the comorbidities related to the comorbidities of obesity, which include alterations in the heart, kid-ney, hypertension and coagulation. In this regard, activation of AT1 receptors by Ang II can induce an inflammatory process mediated by the transcription factor NF-kB, triggering inflammation in various systems that are related to the comorbidities observed in obesity. The aim of this review was to highlight the pro-inflammatory effects of Ang II and the alterations induced by this hor-mone in various organs and systems in obesity. The search was done since 1990 through Medline, EMBASE and PubMed, using the keywords: angiotensin II; an-giotensin II, obesity; angiotensin II, kidney, obesity; angiotensin II, coagulation, obesity; angiotensin II, inflammation, obesity; angiotensin II, adipose tissue, obesity; angiotensin II, hypertension, obesity; angiotensin II, insulin resistance, obesity; angiotensin II, adiponectin, leptin, obesity; angiotensin II, COVID-19, obesity. Angiotensin II through its interaction with its AT1 receptor, can induce alterations in diverse systems that are related to the comorbidities observed in obesity. Therapeutic strategies to decrease the production and action of Ang II could improve the clinical conditions in individuals with obesity.
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Affiliation(s)
- Jesús Mosquera-Sulbarán
- Instituto de Investigaciones Clínicas “Dr. Américo Negrette”, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - Elena Ryder
- Instituto de Investigaciones Clínicas “Dr. Américo Negrette”, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - Adriana Pedreáñez
- Cátedra de Inmunología, Escuela de Bioanálisis, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - Renata Vargas
- Instituto de Investigaciones Clínicas “Dr. Américo Negrette”, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
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Prasad R, Jha RK, Keerti A. Chronic Kidney Disease: Its Relationship With Obesity. Cureus 2022; 14:e30535. [DOI: 10.7759/cureus.30535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 10/21/2022] [Indexed: 11/05/2022] Open
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Stasi A, Cosola C, Caggiano G, Cimmarusti MT, Palieri R, Acquaviva PM, Rana G, Gesualdo L. Obesity-Related Chronic Kidney Disease: Principal Mechanisms and New Approaches in Nutritional Management. Front Nutr 2022; 9:925619. [PMID: 35811945 PMCID: PMC9263700 DOI: 10.3389/fnut.2022.925619] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/25/2022] [Indexed: 12/12/2022] Open
Abstract
Obesity is the epidemic of our era and its incidence is supposed to increase by more than 30% by 2030. It is commonly defined as a chronic and metabolic disease with an excessive accumulation of body fat in relation to fat-free mass, both in terms of quantity and distribution at specific points on the body. The effects of obesity have an important impact on different clinical areas, particularly endocrinology, cardiology, and nephrology. Indeed, increased rates of obesity have been associated with increased risk of cardiovascular disease (CVD), cancer, type 2 diabetes (T2D), dyslipidemia, hypertension, renal diseases, and neurocognitive impairment. Obesity-related chronic kidney disease (CKD) has been ascribed to intrarenal fat accumulation along the proximal tubule, glomeruli, renal sinus, and around the kidney capsule, and to hemodynamic changes with hyperfiltration, albuminuria, and impaired glomerular filtration rate. In addition, hypertension, dyslipidemia, and diabetes, which arise as a consequence of overweight, contribute to amplifying renal dysfunction in both the native and transplanted kidney. Overall, several mechanisms are closely related to the onset and progression of CKD in the general population, including changes in renal hemodynamics, neurohumoral pathways, renal adiposity, local and systemic inflammation, dysbiosis of microbiota, insulin resistance, and fibrotic process. Unfortunately, there are no clinical practice guidelines for the management of patients with obesity-related CKD. Therefore, dietary management is based on the clinical practice guidelines for the nutritional care of adults with CKD, developed and published by the National Kidney Foundation, Kidney Disease Outcome Quality Initiative and common recommendations for the healthy population. Optimal nutritional management of these patients should follow the guidelines of the Mediterranean diet, which is known to be associated with a lower incidence of CVD and beneficial effects on chronic diseases such as diabetes, obesity, and cognitive health. Mediterranean-style diets are often unsuccessful in promoting efficient weight loss, especially in patients with altered glucose metabolism. For this purpose, this review also discusses the use of non-classical weight loss approaches in CKD, including intermittent fasting and ketogenic diet to contrast the onset and progression of obesity-related CKD.
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Yang Y, Wu Y. The association between skinfold thicknesses and estimated glomerular filtration rate in adolescents: a cross-sectional study. BMC Nephrol 2022; 23:96. [PMID: 35247978 PMCID: PMC8897831 DOI: 10.1186/s12882-022-02709-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/18/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Obesity is one of the causes of glomerular hyperfiltration. Studies on the relationship between body fat content and glomerular hyperfiltration have been limited to special children. Therefore, we aimed to evaluate the correlation between skinfold thickness, which represents body fat content, and estimated glomerular filtration rate (eGFR).
Methods
The cross-sectional study included 6655 participants (3532 boys and 3123 girls; age: 12 − 17.99 years); data was obtained from the National Health and Nutrition Examination Survey (NHANES; 2001–2010). The independent variables were subscapular skinfold thickness and triceps skinfold thickness. The dependent variable was eGFR. We used multivariate linear regression models to evaluate their associations and also performed subgroup analyses.
Results
After adjusting for age, standing height, race, family income, blood urea nitrogen and uric acid variables, multivariate regression analysis identified that triceps skinfold thickness and subscapular skinfold thickness were positively correlated with eGFR and glomerular hyperfiltration in boys. In subgroup analyses stratified by age and body mass index, triceps skinfold thickness was also associated with glomerular hyperfiltration in boys. There was a linear relationship between triceps skinfold thickness and eGFR in boys (β = 0.389, P < 0.001) and girls (β = 0.159, P = 0.0003).
Conclusions
Triceps skinfold thickness and subscapular skinfold thickness are positively correlated with eGFR and glomerular hyperfiltration in US male adolescents. In all adolescents, there is a linear relationship between triceps skinfold thickness and eGFR.
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Steele C, Nowak K. Obesity, Weight Loss, Lifestyle Interventions, and Autosomal Dominant Polycystic Kidney Disease. KIDNEY AND DIALYSIS 2022; 2:106-122. [PMID: 35350649 PMCID: PMC8959086 DOI: 10.3390/kidneydial2010013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Obesity remains a growing public health concern in industrialized countries around the world. The prevalence of obesity has also continued to rise in those with chronic kidney disease. Epidemiological data suggests those with overweight and obesity, measured by body mass index, have an increased risk for rapid kidney disease progression. Autosomal dominant polycystic kidney disease causes growth and proliferation of kidney cysts resulting in a reduction in kidney function in the majority of adults. An accumulation of adipose tissue may further exacerbate the metabolic defects that have been associated with ADPKD by affecting various cell signaling pathways. Lifestyle interventions inducing weight loss might help delay disease progression by reducing adipose tissue and systematic inflammation. Further research is needed to determine the mechanistic influence of adipose tissue on disease progression.
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Affiliation(s)
- Cortney Steele
- Division of Renal Diseases and Hypertension, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Kristen Nowak
- Division of Renal Diseases and Hypertension, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
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El-Domiaty HF, Sweed E, Kora MA, Zaki NG, Khodir SA. Activation of angiotensin-converting enzyme 2 ameliorates metabolic syndrome-induced renal damage in rats by renal TLR4 and nuclear transcription factor κB downregulation. Front Med (Lausanne) 2022; 9:904756. [PMID: 36035416 PMCID: PMC9411523 DOI: 10.3389/fmed.2022.904756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/27/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is an independent risk factor for chronic kidney disease (CKD) through many mechanisms, including activation of the renin-angiotensin system. The deleterious effects of angiotensin II (Ang II) can be counterbalanced by angiotensin-converting enzyme 2 (ACE2). Diminazene aceturate (DIZE), an anti-trypanosomal drug, can activate ACE2. OBJECTIVE This study aimed to investigate the possible reno-protective effects of DIZE in MetS rats with elucidation of related mechanisms. MATERIALS AND METHODS Thirty adult male Wistar albino rats were divided equally into control, MetS, and MetS + DIZE groups. Body weight, systolic blood pressure (SBP), and urinary albumin levels were measured. Serum levels of fasting blood glucose (FBG), insulin, uric acid, lipid profile, urea, and creatinine were measured. Homeostasis Model Assessment Index (HOMA-IR) was estimated. Subsequently, renal levels of ACE2, Ang II, malondialdehyde (MDA), reduced glutathione (GSH), and tumor necrosis factor-α (TNF-α) were measured with histopathological and immunohistochemical assessment of TLR4 and NF-κB in renal tissues. RESULTS MetS caused dyslipidemia with significant increases in body weight, SBP, FBG, serum insulin, HOMA-IR, uric acid, urea, creatinine, urinary albumin, and renal levels of Ang II, MDA, and TNF-α, whereas renal ACE2 and GSH were significantly decreased. Renal TLR4 and NF-κB immunoreactivity in MetS rats was upregulated. DIZE supplementation of MetS rats induced significant improvements in renal function parameters; this could be explained by the ability of DIZE to activate renal ACE2 and decrease renal Ang II levels with downregulation of renal TLR4 and NF-κB expression. CONCLUSION DIZE exerts a reno-protective effect in MetS, mainly by downregulating renal TLR4 and NF-κB levels.
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Affiliation(s)
- Heba F. El-Domiaty
- Department of Medical Physiology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Eman Sweed
- Department of Clinical Pharmacology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
- *Correspondence: Eman Sweed,
| | - Mona A. Kora
- Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Nader G. Zaki
- Department of Anatomy and Embryology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Suzan A. Khodir
- Department of Medical Physiology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
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13
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Bosman A, Campos-Obando N, Medina-Gomez C, Voortman T, Uitterlinden AG, Zillikens MC. Serum Phosphate, BMI, and Body Composition of Middle-Aged and Older Adults: A Cross-Sectional Association Analysis and Bidirectional Mendelian Randomization Study. J Nutr 2021; 152:276-285. [PMID: 34601595 PMCID: PMC8754515 DOI: 10.1093/jn/nxab351] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/20/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Observational studies have reported associations between serum phosphate and BMI in specific clinical settings, but the nature of this relation in the general population is unclear. OBJECTIVES The aim of this study was twofold: to investigate the association between serum phosphate and BMI and body composition, as well as to explore evidence of causality through a bidirectional one-sample Mendelian randomization (MR) in the population-based Rotterdam Study (RS). METHODS Observational associations between phosphate (mg/dL) and BMI, lean mass, and fat percentage (fat%), estimated by DXA, were analyzed using multivariable regression models in 9202 participants aged 45-100 y from 3 RS cohorts. The role of serum leptin was examined in a subgroup of 1089 participants. For MR analyses, allele scores with 6 single-nucleotide polymorphisms (SNPs) for phosphate and 905 SNPs for BMI were constructed in 7983 participants. RESULTS Phosphate was inversely associated with BMI in the total population (β: -0.89; 95% CI: -1.17, -0.62), and stronger in women (β: -1.92; 95% CI: -2.20, -1.65) than in men (β: -0.37; 95% CI: -0.68, -0.06) (P-interaction < 0.05). Adjustment for leptin did not change results in men. In women, adjustment for leptin attenuated the association, but it was not abolished (β: -0.94; 95% CI: -1.45, -0.42). Phosphate was inversely associated with fat%, but not with lean mass, in both sexes. MR analyses suggested a causal effect of BMI on serum phosphate (β: -0.01; 95% CI: -0.02, 0.00) but not vice versa. CONCLUSIONS Serum phosphate was inversely associated with BMI and fat% in a population-based study of middle-aged and older adults, with a stronger effect in women than in men. Adjusting for leptin attenuated this relation in women only. MR results suggest a causal effect of BMI on phosphate but not vice versa. An underlying sex dimorphism in phosphate homeostasis should be further explored.
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Affiliation(s)
| | | | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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14
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Ryu H, Hong Y, Kang E, Kang M, Kim J, Oh YK, Yang SJ, Yang YJ, Park SK, Chung W, Chae DW, Sung SA, Ahn C, Oh KH. Rapid Weight Change Over Time Is a Risk Factor for Adverse Outcomes in Patients With Predialysis Chronic Kidney Disease: A Prospective Cohort Study. J Ren Nutr 2021; 31:569-578. [PMID: 33766469 DOI: 10.1053/j.jrn.2021.01.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/24/2020] [Accepted: 01/16/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Both obesity and being underweight are risk factors for adverse outcomes in chronic kidney disease (CKD) patients. However, the effects of longitudinal weight changes on patients with predialysis CKD have not yet been studied. In this study, we analyzed the effects of weight change over time on the adverse outcomes in predialysis CKD population. METHODS Longitudinal data from a multicenter prospective cohort study (KNOW-CKD) were analyzed. In a total of 2,022 patients, the percent weight change per year were calculated using regression analysis and the study subjects were classified into five categories: group 1, ≤ -5%/year; group 2, -5< to ≤ -2.5%/year; group 3, -2.5< to <2.5%/year; group 4, 2.5≤ < 5%/year; and group 5, ≥5%/year. The incidences of end-stage renal disease (ESRD) and the composite outcome of cardiovascular disease (CVD) and death were calculated in each group and compared to group 3 as reference. RESULTS During a median 4.4 years of follow-up, 414 ESRD, and 188 composite of CVD and mortality events occurred. Both weight gain and loss were independent risk factors for adverse outcomes. There was a U-shaped correlation between the degree of longitudinal weight change and ESRD (hazard ratio 3.61, 2.15, 1.86 and 3.66, for group 1, 2, 4 and 5, respectively) and composite of CVD and death (hazard ratio 2.92, 2.15, 1.73 and 2.54, respectively), when compared to the reference group 3. The U-shape correlation was most prominent in the subgroup of estimated glomerular filtration rate <45 mL/min/1.73 m2. CONCLUSION Both rapid weight gain and weight loss are associated with high risk of adverse outcomes, particularly in the advanced CKD.
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Affiliation(s)
- Hyunjin Ryu
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yeji Hong
- Rehabilitation Medical Research Center, Korea Workers' Compensation and Welfare Service Incheon Hospital, Incheon, Republic of Korea
| | - Eunjeong Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Minjung Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jayoun Kim
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Soo Jin Yang
- Department of Food and Nutrition, Seoul Women's University, Seoul, Korea
| | - Yun Jung Yang
- Department of Food and Nutrition, Seoul Women's University, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Wookyung Chung
- Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea
| | - Dong-Wan Chae
- Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Su Ah Sung
- Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul, Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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15
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Woo J, Koziol-White C, Panettieri R, Jude J. TGF-β: The missing link in obesity-associated airway diseases? CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2021; 2:100016. [PMID: 34909651 PMCID: PMC8663968 DOI: 10.1016/j.crphar.2021.100016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/15/2021] [Accepted: 01/20/2021] [Indexed: 01/19/2023] Open
Abstract
Obesity is emerging as a global public health epidemic. The co-morbidities associated with obesity significantly contribute to reduced quality of life, mortality, and global healthcare burden. Compared to other asthma comorbidities, obesity prominently engenders susceptibility to inflammatory airway diseases such as asthma and chronic obstructive pulmonary disease (COPD), contributes to greater disease severity and evokes insensitivity to current therapies. Unlike in other metabolic diseases associated with obesity, the mechanistic link between obesity and airway diseases is only poorly defined. Transforming growth factor-β (TGF-β) is a pleiotropic inflammatory cytokine belonging to a family of growth factors with pivotal roles in asthma. In this review, we summarize the role of TGF-β in major obesity-associated co-morbidities to shed light on mechanisms of the diseases. Literature evidence shows that TGF-β mechanistically links many co-morbidities with obesity through its profibrotic, remodeling, and proinflammatory functions. We posit that TGF-β plays a similar mechanistic role in obesity-associated inflammatory airway diseases such as asthma and COPD. Concerning the role of TGF-β on metabolic effects of obesity, we posit that TGF-β has a similar mechanistic role in obesity-associated inflammatory airway diseases in interplay with different comorbidities such as hypertension, metabolic diseases like type 2 diabetes, and cardiomyopathies. Future studies in TGF-β-dependent mechanisms in obesity-associated inflammatory airway diseases will advance our understanding of obesity-induced asthma and help find novel therapeutic targets for prevention and treatment.
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Affiliation(s)
- Joanna Woo
- Rutgers Institute for Translational Medicine & Science, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States,Ernest Mario School of Pharmacy, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States
| | - Cynthia Koziol-White
- Rutgers Institute for Translational Medicine & Science, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States,Robert Wood Johnson Medical School, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States
| | - Reynold Panettieri
- Rutgers Institute for Translational Medicine & Science, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States,Robert Wood Johnson Medical School, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States,Ernest Mario School of Pharmacy, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States
| | - Joseph Jude
- Rutgers Institute for Translational Medicine & Science, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States,Robert Wood Johnson Medical School, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States,Ernest Mario School of Pharmacy, The State University of New Jersey, 89 French Street, Rutgers, 160 Frelinghuysen Road, Piscataway, NJ08854, United States,Corresponding author. Rutgers Institute for Translational Medicine & Science, Rm# 4276, 89 French Street, New Brunswick, NJ08901, United States.
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16
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Increased body mass index above the upper normal limit is significantly associated with renal dysfunction among community-dwelling persons. Int Urol Nephrol 2020; 52:1533-1541. [PMID: 32462357 DOI: 10.1007/s11255-020-02501-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 05/07/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Body mass index (BMI) is a simple index of weight-to-height that is commonly used to classify people as underweight, overweight or obesity, and high BMI has been clearly linked to increased risk of illness in adults. However, few studies have examined the significance of upper normal weight as a risk factor for the development of chronic kidney disease (CKD) in the general Japanese population. METHODS We conducted a prospective cohort study designed as part of the Nomura study. We recruited a random sample of 421 men aged 67 ± 10 (mean ± standard deviation; range 24-95) years and 565 women aged 68 ± 9 (22-84) years during their annual health examination in a single community. We examined the relationship between quartiles of baseline BMI and renal dysfunction after a 3-year evaluation based on estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations modified by the Japanese coefficient. CKD was defined as having dipstick-positive proteinuria (≥ 1 +) or a low eGFR (< 60 mL/min/1.73 m2). RESULTS Of the 986 participants, a total of 134 (13.6%) participants, including 72 (17.1%) men and 62 (11.0%) women, received a new diagnosis of CKD during the study period, and 25 (9.7%), 19 (8.0%), 47 (19.0%), and 43 (17.8%) diagnoses were received in the BMI-1 (BMI, < 20.7 kg/m2), BMI-2 (BMI, 20.7 to 22.5 kg/m2), BMI-3 (BMI, 22.6 to 24.4 kg/m2), and BMI-4 (BMI ≥ 24.5 kg/m2) groups, respectively. Using BMI-2 as the reference group, the non-adjusted odds ratio (OR) (95% confidence interval) for CKD was 2.70 (1.53-4.75) for BMI-3 and 2.49 (1.40-4.42) for BMI-4, and the multivariable-adjusted OR was 2.52 (1.40-4.56) for BMI-3 and 2.30 (1.26-4.22) for BMI-4. CONCLUSIONS Increased BMI from upper normal weight is strongly associated with the development of CKD in community-dwelling persons.
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17
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Udi S, Hinden L, Ahmad M, Drori A, Iyer MR, Cinar R, Herman-Edelstein M, Tam J. Dual inhibition of cannabinoid CB 1 receptor and inducible NOS attenuates obesity-induced chronic kidney disease. Br J Pharmacol 2019; 177:110-127. [PMID: 31454063 PMCID: PMC6976880 DOI: 10.1111/bph.14849] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 12/14/2022] Open
Abstract
Background and Purpose Obesity, an important risk factor for developing chronic kidney disease (CKD), affects the kidneys by two main molecular signalling pathways: the endocannabinoid/CB1 receptor system, whose activation in obesity promotes renal inflammation, fibrosis, and injury, and the inducible NOS (iNOS), which generates ROS resulting in oxidative stress. Hence, a compound that inhibits both peripheral CB1 receptors and iNOS may serve as an effective therapeutic agent against obesity‐induced CKD. Experimental Approach Here, we describe the effect of a novel peripherally restricted, orally bioavailable dual CB1 receptor/iNOS antagonist, MRI‐1867 (3 mg·kg−1), in ameliorating obesity‐induced CKD, and compared its metabolic and renal efficacies to a stand‐alone peripheral CB1 receptor antagonist (JD5037; 3 mg·kg−1), iNOS antagonist (1400W; 10 mg·kg−1), and pair feeding. Mice with high‐fat diet‐induced obesity were treated orally with these compounds or vehicle (Veh) for 28 days. Standard diet‐fed mice treated with Veh served as controls. Key Results Enhanced expression of CB1 receptors and iNOS in renal tubules was found in human kidney patients with obesity and other CKDs. The hybrid inhibitor ameliorated obesity‐induced kidney morphological and functional changes via decreasing kidney inflammation, fibrosis, oxidative stress, and renal injury. Some of these features were independent of the improved metabolic profile mediated via inhibition of CB1 receptors. An additional interesting finding is that these beneficial effects on the kidney were partially associated with modulating renal adiponectin signalling. Conclusions and Implications Collectively, our results highlight the therapeutic relevance of blocking CB1 receptors and iNOS in ameliorating obesity‐induced CKD.
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Affiliation(s)
- Shiran Udi
- Obesity and Metabolism Laboratory, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Liad Hinden
- Obesity and Metabolism Laboratory, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Majdoleen Ahmad
- Obesity and Metabolism Laboratory, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adi Drori
- Obesity and Metabolism Laboratory, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Malliga R Iyer
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Resat Cinar
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Michal Herman-Edelstein
- Department of Nephrology & Hypertension, Rabin Medical Center, Petah Tikva, Israel.,Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Joseph Tam
- Obesity and Metabolism Laboratory, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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18
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Zhao X, Kratzke AK, Ballout F, Kimura RE, Jandeska SE. Retrospective cohort study of individuals born with low birthweight: implications for screening practices. Clin Kidney J 2019; 14:167-173. [PMID: 33564415 PMCID: PMC7857780 DOI: 10.1093/ckj/sfz130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 08/27/2019] [Indexed: 11/13/2022] Open
Abstract
Background Previous studies have established an association between low birthweight (LBW) and future kidney disease, but few have explored the progression of kidney dysfunction through the pediatric years leading up through adolescence and young adulthood. Methods To better understand the temporal effects of birthweight on kidney disease progression, we conducted a retrospective cohort study comparing the glomerular filtration rate (GFR) between LBW (<2500 grams) and normal birthweight (NBW) infants who were admitted to the neonatal intensive care unit (NICU) at our institution from 1992 to 2006. Results Age at follow-up ranged 1–26 years old. GFR was found to be significantly lower in participants born with LBW than those born with NBW, with a mean difference of 5.5 mL/min/1.73m2 (P < 0.01). These differences were found in the adolescent and young adult age group over 9 years of age, specifically in the extremely low birthweight group (ELBW) whose birthweight was less than 1000 grams. Conclusions We recommend screening for CKD in ELBW individuals starting at the age of 9 years old, regardless of their previous medical history.
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Affiliation(s)
- Xixi Zhao
- Department of Internal Medicine and Pediatrics, Rush University Medical Center, Chicago, IL, USA
| | - Andrea K Kratzke
- Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - Fatima Ballout
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Robert E Kimura
- Department of Neonatal-Perinatal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Sara E Jandeska
- Department of Pediatric Nephrology, Rush University Medical Center, Chicago, IL, USA
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19
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Marchelek-Myśliwiec M, Dziedziejko V, Nowosiad-Magda M, Dołęgowska K, Dołęgowska B, Pawlik A, Safranow K, Wiśniewska M, Stępniewska J, Domański M, Ciechanowski K. Chronic Kidney Disease Is Associated with Increased Plasma Levels of Fibroblast Growth Factors 19 and 21. Kidney Blood Press Res 2019; 44:1207-1218. [PMID: 31614355 DOI: 10.1159/000502647] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 08/10/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is the result of a reduced number of nephrons, in which adipose tissue and its metabolites play a significant role. Fibroblast growth factors, FGF19 and FGF21, are involved in lipid and carbohydrate metabolism. The aim of the study was to examine the concentrations of FGF19 and FGF21 in patients with CKD, as well as the correlation between FGF19 and FGF21 and selected biochemical parameters. MATERIALS AND METHODS The study included 178 subjects: 52 patients with CKD in stages 2-4, without haemodialysis (CKD), 47 haemodialysed patients with CKD (HD), 56 patients with CKD after a renal transplantation (Tx) and 23 healthy subjects as the control group (C). RESULTS The highest FGF19 serum concentrations were observed in CKD patients and the lowest were observed in the Tx group. Patients in the CKD group had significantly higher serum FGF21 concentrations. There were negative correlations between FGF19 and glomerular filtration rate (GFR), as well as high-density lipoprotein cholesterol levels in patients after kidney transplantation. Negative correlations were also found between serum FGF21 concentrations and GFR in patients after Tx, while positive correlations were observed between FGF21 concentrations and lean body mass in the CKD group, body mass index and total cholesterol in the HD group. CONCLUSIONS Our results suggest that increased concentrations of FGF19 and FGF21 in patients with CKD may be associated with the metabolism of lipids and carbohydrates. Our results also indicate that haemodialysis and transplantation results in the reduction of FGF19 and FGF21 concentrations in patients with CKD.
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Affiliation(s)
- Małgorzata Marchelek-Myśliwiec
- Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Monika Nowosiad-Magda
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna Dołęgowska
- Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Barbara Dołęgowska
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland,
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Magda Wiśniewska
- Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Joanna Stępniewska
- Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Maciej Domański
- Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Kazimierz Ciechanowski
- Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
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20
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Martínez R, Kapravelou G, López-Chaves C, Cáceres E, Coll-Risco I, Sánchez-González C, Llopis J, Arrebola F, Galisteo M, Aranda P, López-Jurado M, Porres JM. Aerobic interval exercise improves renal functionality and affects mineral metabolism in obese Zucker rats. Am J Physiol Renal Physiol 2019; 316:F90-F100. [PMID: 30303711 DOI: 10.1152/ajprenal.00356.2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Obesity, metabolic syndrome, and renal injury are considered risk factors for type 2 diabetes, as well as kidney disease. Functional and structural changes in the kidney as consequence of obesity and metabolic syndrome may lead to impaired mineral metabolism in what is known as chronic kidney disease-mineral and bone disorder. Lifestyle interventions such as physical activity are good strategies to manage these pathologies and therefore, prevent the loss of kidney functionality and related complications in mineral metabolism. In this study, we have used 40 male Zucker rats that were randomly allocated into four different experimental groups, two of them (an obese and a lean one) performed an aerobic interval training protocol, and the other two groups were sedentary. At the end of the experimental period (8 wk), urine, plasma, and femur were collected for biochemical and mineral composition analysis, whereas the kidney was processed for histological studies. The obese rats exhibited albuminuria, glomerulosclerosis, and hypertrophy in glomeruli and renal tubule in some areas, together with alterations in mineral content of plasma but not of femur. The training protocol prevented the generation of albuminuria and glomerulosclerosis, showing a significant action on plasma and bone mineral levels. Therefore, the specific training protocol used in this study was able to prevent the development of diabetic nephropathy and affected the metabolism of certain minerals.
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Affiliation(s)
- Rosario Martínez
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
| | - Garyfallia Kapravelou
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
| | - Carlos López-Chaves
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
| | - Elena Cáceres
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
| | - Irene Coll-Risco
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
| | - Cristina Sánchez-González
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
| | - Juan Llopis
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
| | - Francisco Arrebola
- Department of Histology, Institute of Neurosciences, Centre for Biomedical Research, Universidad de Granada , Granada , Spain
| | - Milagros Galisteo
- Department of Pharmacology, School of Pharmacy, Universidad de Granada, Campus Universitario de Cartuja, Granada , Spain
| | - Pilar Aranda
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
| | - María López-Jurado
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
| | - Jesus M Porres
- Department of Physiology, Institute of Nutrition and Food Technology, Centre for Biomedical Research, Centre for Research in Sport and Health, Universidad de Granada , Granada , Spain
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Lipid Metabolism Disorder and Renal Fibrosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1165:525-541. [PMID: 31399983 DOI: 10.1007/978-981-13-8871-2_26] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Since the lipid nephrotoxicity hypothesis was proposed in 1982, increasing evidence has supported the hypothesis that lipid abnormalities contributed to the progression of glomerulosclerosis. In this chapter, we will discuss the general promises of the original hypothesis, focusing especially on the role of lipids and metabolic inflammation accompanying CKD in renal fibrosis and potential new strategies of prevention.
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22
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Garcia IJP, Cézar JS, Lemos BS, Silva LN, Ribeiro RIMDA, Santana CC, Grillo LAM, Pinto FCH, Buzelle SL, Cortes VF, Santos HDL, Santos MESMD, Barbosa LA. Effects of high fat diet on kidney lipid content and the Na,K-ATPase activity. BRAZ J PHARM SCI 2018. [DOI: 10.1590/s2175-97902018000117165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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23
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Yun JS, Park YM, Han K, Cha SA, Ahn YB, Ko SH. Association between BMI and risk of severe hypoglycaemia in type 2 diabetes. DIABETES & METABOLISM 2018; 45:19-25. [PMID: 29678506 DOI: 10.1016/j.diabet.2018.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 03/14/2018] [Accepted: 03/24/2018] [Indexed: 01/09/2023]
Abstract
AIM This study aimed to assess the association between body mass index (BMI) and the development of severe hypoglycaemia in patients with type 2 diabetes (T2D), using nationwide data for the entire South Korean population. METHODS The association between BMI and severe hypoglycaemia was retrospectively examined from claims and National Health examination data registered between 2002 and 2015. A total of 1,366,692 subjects assigned clinical codes for T2D and prescribed antihypoglycaemic agents were included. The primary outcome was an episode of severe hypoglycaemia after the baseline health examination. RESULTS A total of 37,682 subjects (2.7%) experienced a new severe hypoglycaemic event during the follow-up period (mean: 8.6 years). An inverse J-shaped association was observed between BMI and severe hypoglycaemic events. The association between low BMI and high risk of severe hypoglycaemia was similar in subjects who had never smoked, did not consume alcohol, did not use insulin and had no major comorbidities, after adjusting for multiple confounding variables. This association was also found to be intensified in men, young people aged 30-49 years, those with major comorbidities and insulin users. CONCLUSION BMI and severe hypoglycaemia were found to be inversely associated. Thus, those who fall into the category of having low BMI and high risk of severe hypoglycaemia should be warned about the risk of having a hypoglycaemic event and be properly informed about hypoglycaemia to minimize the risk of fatal hypoglycaemia-related outcomes.
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Affiliation(s)
- J-S Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Y-M Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - K Han
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S-A Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Y-B Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - S-H Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
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Ma YH. Renal dysfunction in patients with nonalcoholic fatty liver disease and risk factors. Shijie Huaren Xiaohua Zazhi 2018; 26:667-672. [DOI: 10.11569/wcjd.v26.i11.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the renal function in patients with nonalcoholic fatty liver disease (NAFLD) and to identify the risk factors for renal dysfunction.
METHODS A total of 856 volunteers who underwent health examination were initially enrolled in this study to identify those with NAFLD. The biochemical indexes of patients with NAFLD and healthy volunteers were statistically analyzed, and the renal function with estimated glomerular filtration rate was calculated. In addition, the risk factors for renal damage were identified.
RESULTS A total of 253 patients with NAFLD were identified, and the remaining 603 cases were used as a control group. There was no significant difference in serum BUN between the two groups (t = 1.678, P = 0.062), while other biochemical indexes differed significantly (P < 0.05). The prevalence of renal function impairment was higher in individuals with NAFLD compared to those without (28.8% vs 17.5%, P < 0.0001). Logistic regression analysis showed that NAFLD was associated with renal function impairment, even after adjustment for demographics and components of metabolic syndrome (OR = 2.85, 95%CI: 1.93-4.21, P = 0.000).
CONCLUSION The biochemical indexes of NAFLD patients are significantly abnormal, and renal function impairment is associated with NAFLD. Patients with NAFLD should be regularly assessed for renal function to avoid progressing into chronic kidney disease and increasing the medical burden.
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Affiliation(s)
- Yan-Hong Ma
- Department of Infectious Diseases, Binhai Hospital of Tianjin Medical University General Hospital, Tianjin 300480, China
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Liu Y, Tan RS, Zhou DY, Xiao X, Ran JM, Qin DP, Zhong XS, Hu JG, Liu Y, Zheng YY. The effects of protein intake on albuminuria in different estimated glomerular filtration rate: A population-based study. Eur J Intern Med 2018; 48:80-88. [PMID: 29122437 DOI: 10.1016/j.ejim.2017.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/22/2017] [Accepted: 10/30/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) is a serious condition associated with early mortality, decreased quality of life, and increased health-care expenditures. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) collected from 1999 to 2012 were used. Subjects were divided into 4 estimated glomerular filtration rate (eGFR) categories: stage 1: eGFR≥90mL/min/1.73m2, stage 2: eGFR 60-89, stage 3: eGFR 30-59, and stage 4/5: eGFR<30, and 3 age strata (<45y, 45-64, 65+). Associations between protein intake and albuminuria were determined. RESULTS A total of 45,259 subjects were included. Despite decreasing protein intake, there was a significant increase in the prevalence of albuminuria with decreasing levels of eGFR. Multivariable analysis showed that albuminuria was associated with daily protein intake in patients ≥65years old with stage 1 disease, and that diabetes was associated with albuminuria in patients ≥65years old with stage 2 and 3 diseases. Overall, albuminuria in patients with stage 1 disease was associated with hours of sitting per day and blood glucose level. CONCLUSION Albuminuria was associated with daily protein intake in patients of 45-64years old with stage 1 CKD disease, and was associated with hours of sitting per day and blood glucose level. These data further support the importance of lifestyle changes in the management of CKD, especially in patients with early-stage disease.
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Affiliation(s)
- Yan Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China; Guangzhou Institute of Disease-Oriented Nutritional Research, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China.
| | - Rong-Shao Tan
- Guangzhou Institute of Disease-Oriented Nutritional Research, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
| | - Dao-Yuan Zhou
- Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China; Guangzhou Institute of Disease-Oriented Nutritional Research, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
| | - Xiao Xiao
- Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
| | - Jian-Min Ran
- Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China; Guangzhou Institute of Disease-Oriented Nutritional Research, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
| | - Dan-Ping Qin
- Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
| | - Xiao-Shi Zhong
- Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
| | - Jian-Guang Hu
- Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
| | - Yun Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China; Guangzhou Institute of Disease-Oriented Nutritional Research, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
| | - Yuan-Yuan Zheng
- Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
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Low, rather than High, Body Mass Index Is a Risk Factor for Acute Kidney Injury in Multiethnic Asian Patients: A Retrospective Observational Study. Int J Nephrol 2018; 2018:3284612. [PMID: 29552359 PMCID: PMC5818948 DOI: 10.1155/2018/3284612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 10/08/2017] [Accepted: 11/20/2017] [Indexed: 12/20/2022] Open
Abstract
Background Acute kidney injury (AKI) is common in hospitalised patients. The relationship between body mass index (BMI) and the risk of having AKI for patients in the acute hospital setting is not known, particularly in the Asian population. Methods This was a retrospective, single-centre, observational study conducted in Singapore, a multiethnic population. All patients aged ≥21 years and hospitalised from January to December 2013 were recruited. Results A total of 12,555 patients were eligible for the analysis. A BMI of <18.5 kg/m2 was independently associated with the development of AKI in hospitalised patients (odds ratio (OR): 1.23 [95% confidence interval [CI]: 1.04–1.44, P = 0.01]) but not for overweight and obesity. Subgroup analysis further revealed that underweight patients aged ≥75 and repeated hospitalisation posed a higher risk of AKI (OR: 1.25 [CI: 1.01–1.56], P = 0.04; OR: 1.23 [CI: 1.04–1.44], P = 0.01, resp.). Analyses by interactions between different age groups and BMI using continuous or categorised variables did not affect the overall probability of developing AKI. Conclusions Underweight Asian patients are susceptible to AKI in acute hospital settings. Identification of this novel risk factor for AKI allows us to optimise patient care by prevention, early detection, and timely intervention.
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Joyce T, Chirino YI, Natalia MT, Jose PC. Renal damage in the metabolic syndrome (MetSx): Disorders implicated. Eur J Pharmacol 2018; 818:554-568. [DOI: 10.1016/j.ejphar.2017.11.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 02/08/2023]
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Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists with Chronic Kidney Disease: A Meta-Analysis. Dig Dis Sci 2017; 62:2821-2827. [PMID: 28836158 DOI: 10.1007/s10620-017-4725-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/16/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND/AIMS The aim of this meta-analysis was to assess the risks of chronic kidney disease (CKD) and/or end-stage kidney disease (ESRD) in patients who are taking proton-pump inhibitors (PPIs) and/or H2 receptor antagonists (H2RAs). METHODS Comprehensive literature review was conducted utilizing MEDLINE and EMBASE databases through April 2017 to identify all studies that investigated the risks of CKD or ESRD in patients taking PPIs/H2RAs versus those without PPIs/H2RAs. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird. The protocol for this study is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42017067252). RESULTS Five studies with 536,902 participants were patients were identified and included in the data analysis. When compared with non-PPIs users, the pooled risk ratio (RR) of CKD or ESRD in patients with PPI use was 1.33 (95% CI 1.18-1.51). Pre-specified subgroup analysis (stratified by CKD or ESRD status) demonstrated pooled RRs of 1.22 (95% CI 1.14-1.30) for association between PPI use and CKD and 1.88 (95% CI 1.71-2.06) for association between PPI use and ESRD, respectively. However, there was no association between the use of H2RAs and CKD with a pooled RR of 1.02 (95% CI 0.83-1.25). When compared with the use of H2RAs, the pooled RR of CKD in patients with PPI use was 1.29 (95% CI 1.22-1.36). CONCLUSIONS Our study demonstrates statistically significant 1.3-fold increased risks of CKD and ESRD in patients using PPIs, but not in patients using H2RAs.
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He J, Yuan G, Cheng F, Zhang J, Guo X. Mast Cell and M1 Macrophage Infiltration and Local Pro-Inflammatory Factors Were Attenuated with Incretin-Based Therapies in Obesity-Related Glomerulopathy. Metab Syndr Relat Disord 2017; 15:344-353. [PMID: 28737448 PMCID: PMC5576269 DOI: 10.1089/met.2017.0057] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: The global increase of obesity parallels the obesity-related glomerulopathy (ORG) epidemic. Dipeptidyl peptidase 4 inhibitors and glucagon-like peptide-1 receptor agonists were well recognized to attenuate renal injury independent of glucose control in diabetic nephropathy. There are limited studies focusing on their effects on ORG. We explored the effects of incretin-based therapies on early ORG and the inflammatory responses involved mainly concentrated on mast cell (MC) and macrophage (M) infiltration and local pro-inflammatory factors. Methods: ORG rat models were induced by high-fat diet and then divided into ORG vehicle, vildagliptin (3 mg/kg/day, qd) and liraglutide (200 μg/kg, bid) treated groups. After 8 weeks of treatments, albuminuria, glomerular histology, renal inflammatory cell infiltration, and pro-inflammatory factors were analyzed. Results: Early ORG model was demonstrated by albuminuria, glomerulomegaly, foot process fusion, and mesangial and endothelial mild proliferation. Incretin-based therapies limited body weight gain and improved insulin sensitivity. ORG was alleviated, manifested by decreased average glomerular area, attenuated mesangial and endothelial cell proliferation, and revived cell-to-cell propagation of podocytes, which contributed to reduced albuminuria. Compared with ORG vehicle, MC and M1 macrophage (pro-inflammatory) infiltration and M1/M2 ratio were significantly decreased; M2 macrophage (anti-inflammatory) was not significantly increased after incretin-based treatments. Tumor necrosis factor-α (TNF-α) and IL-6 in renal cortex were significantly downregulated, while transforming growth factor-β1 (TGF-β1) remained unchanged. Conclusions: Incretin-based treatments could alleviate high-fat diet-induced ORG partly through the systemic insulin sensitivity improvement and the attenuated local inflammation, mainly by the decrease of MC and M1 macrophage infiltration and reduction of TNF-α and IL-6.
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Affiliation(s)
- Jiao He
- Department of Endocrinology, Peking University First Hospital , Beijing, People's Republic of China
| | - Geheng Yuan
- Department of Endocrinology, Peking University First Hospital , Beijing, People's Republic of China
| | - Fangxiao Cheng
- Department of Endocrinology, Peking University First Hospital , Beijing, People's Republic of China
| | - Junqing Zhang
- Department of Endocrinology, Peking University First Hospital , Beijing, People's Republic of China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital , Beijing, People's Republic of China
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Mahmoodnia L, Beigrezaei S. Chronic kidney disease and obesity; a mini-review to the current knowledge. J Nephropharmacol 2017. [DOI: 10.15171/npj.2017.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Atanassova K, Masin-Spasovska J, Spasovski G, Paskalev E. Is there any Gender Difference in the Association between Obesity, Chronic Kidney Disease and Anemia. BANTAO JOURNAL 2016. [DOI: 10.1515/bj-2015-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction. Nowadays, obesity has emerged as one of the most independent risk factors for chronic kidney disease (CKD) in both economically developed and undeveloped countries. The number of patients requiring dialysis as a consequence of obesity-related renal diseases, such as diabetes mellitus and hypertension, is increasing worldwide. Moreover, obesity has been shown to favorize the risk of cardiovascular diseases (CVD) with premature death due to CKD and/or end-stage renal disease (ESRD). The aim of the study was to investigate the association between obesity [e.g. body mass index (BMI)], kidney function [e.g. glomerular filtration rate (GFR)] and renal anemia in CKD patients.
Methods. Retrospectively, data from the register of 315 pre-dialysis patients with different stages of CKD not on erythropoiesis stimulation agents (ESAs) during the period between 1 Jan 2013-30 June 2013 were used to assess the association between the degree of CKD impairment with the degree of obesity and anemia. The stage and/or progression of CKD was calculated by GFR, while the degree of obesity by the body mass index (BMI). CKD was defined as a glomerular filtration rate (GFR) <60 mL/min per 1.73 m2. Data analysis was performed by means of the simple Microsoft excel program.
Results. Within the study population of 315 CKD patients, 123 were males with mean age of 63.4±1.33 years and 192 females of 57.3±1.2 years. The GFR reduced with the increased BMI in both genders, and majority of patients (n=243) were in CKD stage 3, with a mean GFR of 44.5 ml/min/1.73 m2. The BMI values in female patients with first and second degree of obesity negatively correlated with GFR (r=−0.46, p<0.05). Only female patients with second degree of obesity (BMI of 35-39.9 kg/m2) had a positive correlation between the decreased renal function and reduced Hb levels.
Conclusions. Our study provided an unconditional evidence not only for the presence of an association between the degree of obesity (BMI) and the degree of renal function impairment (GFR), but also an association between the higher BMI and the higher degree of kidney anemia seen in women with second degree of obesity. Further larger scale trials and interventional studies are required to see the effect of body weight reduction on renal function and especially anemia.
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Affiliation(s)
| | - Jelka Masin-Spasovska
- Department of Nephrology, Medical Faculty Skopje, Macedonia (the former Yugoslav Republic of)
| | - Goce Spasovski
- Department of Nephrology, Medical Faculty Skopje, Macedonia (the former Yugoslav Republic of)
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Briffa JF, Grinfeld E, Jenkin KA, Mathai ML, Poronnik P, McAinch AJ, Hryciw DH. Diet induced obesity in rats reduces NHE3 and Na(+) /K(+) -ATPase expression in the kidney. Clin Exp Pharmacol Physiol 2016; 42:1118-26. [PMID: 26173747 DOI: 10.1111/1440-1681.12452] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/25/2015] [Accepted: 07/01/2015] [Indexed: 01/25/2023]
Abstract
The consumption of a high fat diet (HFD) is associated with proteinuria and altered sodium handling and excretion, which can lead to kidney disease. In the proximal tubule, the Na(+) /H(+) Exchanger 3 (NHE3) is responsible for normal protein reabsorption and the reabsorption of approximately 70% of the renal sodium load. It is the Na(+) /K(+) -ATPase that provides the driving force for the reabsorption of sodium and its exit across the basolateral membrane. This study investigates the effects that consumption of a HFD for 12 weeks has on NHE3 and Na(+) /K(+) -ATPase expression in the kidney. Western blot analysis identified a significant reduction in NHE3 and its modulator, phosphorylated protein kinase B, in renal lysate from obese rats. In the obese rats, a reduction in NHE3 expression in the proximal tubule may impact on the acidification of endosomes which are responsible for albumin uptake, suggesting a key role for the exchanger in protein endocytosis in obesity. Western blot analysis identified a reduction in Na(+) /K(+) -ATPase which could also potentially impact on albumin uptake and sodium reabsorption. This study demonstrates that consumption of a HFD for 12 weeks reduces renal NHE3 and Na(+) /K(+) -ATPase expression, an effect that may contribute to the albuminuria associated with obesity. Furthermore the reduction in these transporters is not likely to contribute to the reduced sodium excretion in obesity. These data highlight a potential link between NHE3 and Na(+) /K(+) -ATPase in the pathophysiological changes in renal protein handling observed in obesity.
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Affiliation(s)
- J F Briffa
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia.,Department of Physiology, The University of Melbourne, Parkville, Victoria, Australia
| | - E Grinfeld
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia
| | - K A Jenkin
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia
| | - M L Mathai
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia
| | - P Poronnik
- Department of Physiology, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - A J McAinch
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia
| | - D H Hryciw
- Department of Physiology, The University of Melbourne, Parkville, Victoria, Australia
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Reena, Kaur T, Kaur A, Singh M, Buttar HS, Pathak D, Singh AP. Mast cell stabilizers obviate high fat diet-induced renal dysfunction in rats. Eur J Pharmacol 2016; 777:96-103. [DOI: 10.1016/j.ejphar.2016.02.066] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 02/26/2016] [Accepted: 02/29/2016] [Indexed: 01/03/2023]
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Sohel BM, Rumana N, Ohsawa M, Turin TC, Kelly MA, Al Mamun M. Renal function trajectory over time and adverse clinical outcomes. Clin Exp Nephrol 2016; 20:379-93. [PMID: 26728745 DOI: 10.1007/s10157-015-1213-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 12/07/2015] [Indexed: 12/13/2022]
Abstract
The growing burden of chronic kidney disease (CKD), with its associated morbidity and mortality, is recognized as a major public health problem globally and causing substantial load on health care systems. The current framework for the definition and staging of CKD, based on eGFR levels or presence of kidney damage, is useful for clinical classification of patients, but identifies a huge number of people as having CKD which is too many to target for intervention. The ability to identify a subset of patients, at high risk for adverse outcomes, would be useful to inform clinical management. The current staging system applies static definitions of kidney function that fail to capture the dynamic nature of the kidney disease over time. Now-a-days, it is possible to capture multiple measurements of different laboratory test results for an individual including eGFR values. A new possibility for identifying individuals at higher risk of adverse outcomes is being explored through assessment and consideration of the rate of change in kidney function over time, and this approach will be feasible in the current context of digitalization of health record keeping system. On the basis of the existing evidence, this paper summarizes important findings that support the concept of dynamic changes in kidney function over time, and discusses how the magnitude of these changes affect the future adverse outcomes of kidney disease, particularly the End Stage Renal Disease (ESRD), CVD and mortality.
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Affiliation(s)
| | - Nahid Rumana
- Foothills Medical Centre, University of Calgary, Calgary, AB, Canada
| | - Masaki Ohsawa
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Iwate, Japan
| | | | - Martina Ann Kelly
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Mohammad Al Mamun
- Department of Public Health, General Directorate of Health Affairs in Tabuk Region, Ministry of Health, Tabuk, Kingdom of Saudi Arabia.
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Cheungpasitporn W, Thongprayoon C, O'Corragain OA, Edmonds PJ, Kittanamongkolchai W, Erickson SB. Associations of sugar-sweetened and artificially sweetened soda with chronic kidney disease: a systematic review and meta-analysis. Nephrology (Carlton) 2015; 19:791-7. [PMID: 25251417 DOI: 10.1111/nep.12343] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND/OBJECTIVES The risk of chronic kidney disease (CKD) in patients who regularly drink soda is controversial. The objective of this meta-analysis was to evaluate the associations between consumption of sugar-sweetened and artificially sweetened soda and CKD. METHODS A literature search was performed using MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from inception until 30 June 2014. Studies that reported odds ratios or hazard ratios comparing the risk of CKD in patients consuming significant amounts of either sugar-sweetened or artificially sweetened soda versus those who did not consume soda were included. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using a random-effects, generic inverse variance method. RESULTS Five studies were included in our analysis of the association between consumption of sugar-sweetened soda and CKD. The pooled RR of CKD in patients consuming sugar-sweetened soda was 1.58 (95% CI 1.00-2.49). Four studies were selected to assess the association between consumption of artificially sweetened soda and CKD. The pooled RR of CKD in patients consuming artificially sweetened soda was 1.33 (95% CI 0.82-2.15). CONCLUSIONS Our study demonstrates statistically significant increased risks of CKD in patients consuming sugar-sweetened soda, but not in patients consuming artificially sweetened soda. This finding suggests that sugar-sweetened soda consumption is associated with CKD and may impact clinical management and primary prevention of CKD in high-risk patients.
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Russo D, Morrone LF, Errichiello C, De Gregorio MG, Imbriaco M, Battaglia Y, Russo L, Andreucci M, Di Iorio BR. Impact of BMI on cardiovascular events, renal function, and coronary artery calcification. Blood Purif 2014; 38:1-6. [PMID: 25196674 DOI: 10.1159/000362862] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS High BMI increases the risk of cardiovascular events (CVEs) in the general population. Conflicting results have been reported on the role of BMI on CVEs and on decline of renal function in patients with chronic kidney disease not on dialysis (CKD). This study evaluates the impact of BMI on CVEs, dialysis initiation, and coronary artery calcification (CAC) in CKD patients. METHODS CKD patients were divided in normal-BMI and high-BMI patients. CVEs, initiation of dialysis, and extent and progression of CAC were assessed. Univariate and multivariable analysis were performed (adjustment variables: age, diabetes, hypertension, gender, CKD stage, serum concentration of hemoglobin, parathyroid hormone, calcium, phosphorus, albumin, C-reactive protein, LDL-cholesterol, total calcium score, 24-hour proteinuria). Patients were followed to the first event (CVE, dialysis) or for 2 years. RESULTS 471 patients were evaluated. A CVE occurred in 13.5 and 21.3% (p < 0.05) of normal-BMI and high-BMI patients, respectively. High BMI did not increase the risk for CVEs in univariate (HR: 1.86; 95% CI: 0.97-3.54; p = 0.06) or multivariable analysis (HR: 1.36; 95% CI: 0.57-3.14; p = 0.50). High BMI did not increase the risk for initiation of dialysis in univariate (HR: 0.96; 95% CI: 0.58-1.60; p = 0.9) or multivariable analysis (HR: 1.77; 95% CI: 0.82-3.81; p = 0.14). Adding the interaction term (between BMI and glomerular filtration rate) to other variables, the risk of dialysis initiation significantly increased (HR: 3.06; 95% CI: 1.31-7.18; p = 0.01) in high-BMI patients. High BMI was not a predictor of CAC extent or progression. CONCLUSIONS High BMI was not a predictor of CVEs. High BMI increased the risk for dialysis initiation, but high BMI was not associated to CAC extent and progression. The presence of confounders may underestimate the impact of high BMI on dialysis initiation.
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Affiliation(s)
- Domenico Russo
- Department of Nephrology, University of Naples 'Federico II', Naples, Italy
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Chandra A, Biersmith M, Tolouian R. Obesity and kidney protection. J Nephropathol 2014; 3:91-7. [PMID: 25093156 PMCID: PMC4119329 DOI: 10.12860/jnp.2014.18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 05/11/2014] [Accepted: 06/07/2014] [Indexed: 12/24/2022] Open
Abstract
CONTEXT Obesity, both directly and indirectly, increases the risk for a variety of disease conditions including diabetes, hypertension, liver disease, and certain cancers, which in turn, decreases the overall lifespan in both men and women. Though the cardiovascular risks of obesity are widely acknowledged, less often identified is the relationship between obesity and renal function. EVIDENCE ACQUISITIONS Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO and Web of Science has been searched. RESULTS The concept of the "Metabolic Syndrome" helps us to understand this close link between obesity, diabetes, hypertension, and renal dysfunction. An elevated body mass index has shown to be one of the major determinants of glomerular hyperfiltration that lead to the development of chronic kidney disease. Interestingly, weight loss can lead to attenuation of hyperfiltration in severely obese patients suggesting a possible therapeutic option to combat obesity-related hyperfiltration. CONCLUSIONS Various treatment strategies had been suggested to decrease impact of obesity on kidneys. These are blood pressure controling, inhibition of the renin-angiotensinaldosterone axis, improving glycemic control, improving dyslipidemia, improving protein uriaand lifestyle modifications. Regardless of the numerous pharmacotherapies, the focus should be on the root cause: obesity.
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Affiliation(s)
- Aravind Chandra
- Division of Nephrology and Hypertension, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Michael Biersmith
- Division of Nephrology and Hypertension, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Ramin Tolouian
- Division of Nephrology and Hypertension, Eastern Virginia Medical School, Norfolk, VA, USA
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Lim S, Kim KM, Kim MJ, Woo SJ, Choi SH, Park KS, Jang HC, Meigs JB, Wexler DJ. The association of maximum body weight on the development of type 2 diabetes and microvascular complications: MAXWEL study. PLoS One 2013; 8:e80525. [PMID: 24324607 PMCID: PMC3851456 DOI: 10.1371/journal.pone.0080525] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/14/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Obesity precedes the development of type 2 diabetes (T2D). However, the relationship between the magnitude and rate of weight gain to T2D development and complications, especially in non-White populations, has received less attention. METHODS AND FINDINGS We determined the association of rate and magnitude of weight gain to age at T2D diagnosis (Age(T2D)), HbA1c at T2D diagnosis (HbA1c(T2D)), microalbuminuria, and diabetic retinopathy after adjusting for sex, BMI at age 20 years, lifestyles, family history of T2D and/or blood pressure and lipids in 2164 Korean subjects aged ≥30 years and newly diagnosed with diabetes. Body weight at age 20 years (Wt(20y)) was obtained by recall or from participants' medical, school, or military records. Participants recalled their maximum weight (Wt(max)) prior to T2D diagnosis and age at maximum weight (Age(max_wt)). The rate of weight gain (Rate(max_wt)) was calculated from magnitude of weight gain (ΔWt = Wt(max)-Wt(20y)) divided by ΔTime (Age(max_wt) -20 years). The mean Age(max_wt) and Age(T2D) were 41.5±10.9 years and 50.1±10.5 years, respectively. The Wt(20y) and Wt(max) were 59.9±10.5 kg and 72.9±11.4 kg, respectively. The Rate(max_wt) was 0.56±0.50 kg/year. After adjusting for risk factors, greater ΔWt and higher Rate(max_wt) were significantly associated with earlier Age(T2D), higher HbA1c(T2D) after additional adjusting for Age(T2D), and microalbuminuria after further adjusting for HbA1c(T2D) and lipid profiles. Greater ΔWt and higher Rate(max_wt) were also significantly associated with diabetic retinopathy. CONCLUSIONS This finding supports public health recommendations to reduce the risk of T2D and its complications by preventing weight gain from early adulthood.
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Affiliation(s)
- Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Korea
- Division of General Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Kyoung Min Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Joo Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Korea
- * E-mail:
| | - James B. Meigs
- Division of General Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Deborah J. Wexler
- Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States of America
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
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Moreira TR, Bassani T, de Souza G, Manfro RC, Gonçalves LFS. Obesity in kidney transplant recipients: association with decline in glomerular filtration rate. Ren Fail 2013; 35:1199-203. [DOI: 10.3109/0886022x.2013.819735] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nasrallah MP, Ziyadeh FN. Overview of the physiology and pathophysiology of leptin with special emphasis on its role in the kidney. Semin Nephrol 2013; 33:54-65. [PMID: 23374894 DOI: 10.1016/j.semnephrol.2012.12.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The adipocyte product leptin is a pleiotropic adipokine and hormone, with a role extending beyond appetite suppression and increased energy expenditure. This review summarizes the biology of the leptin system and the roles of its different receptors in a multitude of cellular functions in different organs, with special emphasis on the kidney. Leptin's physiological functions as well as deleterious effects in states of leptin deficiency or hyperleptinemia are emphasized. Chronic hyperleptinemia can increase blood pressure through the sympathetic nervous system and renal salt retention. The concept of selective leptin resistance in obesity is emerging, whereby leptin's effect on appetite and energy expenditure is blunted, with a concomitant increase in leptin's other effects as a result of the accompanying hyperleptinemia. The divergence in response likely is explained by different receptors and post-receptor activating mechanisms. Chronic kidney disease is a known cause of hyperleptinemia. There is an emerging view that the effect of hyperleptinemia on the kidney can contribute to the development and/or progression of chronic kidney disease in selective resistance states such as in obesity or type 2 diabetes mellitus. The mechanisms of renal injury are likely the result of exaggerated and undesirable hemodynamic influences as well as profibrotic effects.
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Affiliation(s)
- Mona P Nasrallah
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
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Arora P, Vasa P, Brenner D, Iglar K, McFarlane P, Morrison H, Badawi A. Prevalence estimates of chronic kidney disease in Canada: results of a nationally representative survey. CMAJ 2013; 185:E417-23. [PMID: 23649413 PMCID: PMC3680588 DOI: 10.1503/cmaj.120833] [Citation(s) in RCA: 230] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Chronic kidney disease is an important risk factor for death and cardiovascular-related morbidity, but estimates to date of its prevalence in Canada have generally been extrapolated from the prevalence of end-stage renal disease. We used direct measures of kidney function collected from a nationally representative survey population to estimate the prevalence of chronic kidney disease among Canadian adults. METHODS We examined data for 3689 adult participants of cycle 1 of the Canadian Health Measures Survey (2007-2009) for the presence of chronic kidney disease. We also calculated the age-standardized prevalence of cardiovascular risk factors by chronic kidney disease group. We cross-tabulated the estimated glomerular filtration rate (eGFR) with albuminuria status. RESULTS The prevalence of chronic kidney disease during the period 2007-2009 was 12.5%, representing about 3 million Canadian adults. The estimated prevalence of stage 3-5 disease was 3.1% (0.73 million adults) and albuminuria 10.3% (2.4 million adults). The prevalence of diabetes, hypertension and hypertriglyceridemia were all significantly higher among adults with chronic kidney disease than among those without it. The prevalence of albuminuria was high, even among those whose eGFR was 90 mL/min per 1.73 m(2) or greater (10.1%) and those without diabetes or hypertension (9.3%). Awareness of kidney dysfunction among adults with stage 3-5 chronic kidney disease was low (12.0%). INTERPRETATION The prevalence of kidney dysfunction was substantial in the survey population, including individuals without hypertension or diabetes, conditions most likely to prompt screening for kidney dysfunction. These findings highlight the potential for missed opportunities for early intervention and secondary prevention of chronic kidney disease.
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Affiliation(s)
- Paul Arora
- From the Division of Science and Technology, Laboratory for Foodborne Zoonoses (Arora, Badawi), Public Health Agency of Canada, Toronto, Ont.; the Division of Epidemiology (Arora, Brenner), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; the Department of Family and Community Medicine (Vasa), University of Toronto, Toronto, Ont.; the Departments of Family and Community Medicine (Vasa, Iglar) and Medicine (McFarlane), St. Michael’s Hospital, Toronto, Ont.; and the Science Integration Division, Social Determinants and Science Integration Directorate, Health Promotion and Chronic Disease Prevention Branch (Morrison), Public Health Agency of Canada, Ottawa, Ont
| | - Priya Vasa
- From the Division of Science and Technology, Laboratory for Foodborne Zoonoses (Arora, Badawi), Public Health Agency of Canada, Toronto, Ont.; the Division of Epidemiology (Arora, Brenner), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; the Department of Family and Community Medicine (Vasa), University of Toronto, Toronto, Ont.; the Departments of Family and Community Medicine (Vasa, Iglar) and Medicine (McFarlane), St. Michael’s Hospital, Toronto, Ont.; and the Science Integration Division, Social Determinants and Science Integration Directorate, Health Promotion and Chronic Disease Prevention Branch (Morrison), Public Health Agency of Canada, Ottawa, Ont
| | - Darren Brenner
- From the Division of Science and Technology, Laboratory for Foodborne Zoonoses (Arora, Badawi), Public Health Agency of Canada, Toronto, Ont.; the Division of Epidemiology (Arora, Brenner), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; the Department of Family and Community Medicine (Vasa), University of Toronto, Toronto, Ont.; the Departments of Family and Community Medicine (Vasa, Iglar) and Medicine (McFarlane), St. Michael’s Hospital, Toronto, Ont.; and the Science Integration Division, Social Determinants and Science Integration Directorate, Health Promotion and Chronic Disease Prevention Branch (Morrison), Public Health Agency of Canada, Ottawa, Ont
| | - Karl Iglar
- From the Division of Science and Technology, Laboratory for Foodborne Zoonoses (Arora, Badawi), Public Health Agency of Canada, Toronto, Ont.; the Division of Epidemiology (Arora, Brenner), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; the Department of Family and Community Medicine (Vasa), University of Toronto, Toronto, Ont.; the Departments of Family and Community Medicine (Vasa, Iglar) and Medicine (McFarlane), St. Michael’s Hospital, Toronto, Ont.; and the Science Integration Division, Social Determinants and Science Integration Directorate, Health Promotion and Chronic Disease Prevention Branch (Morrison), Public Health Agency of Canada, Ottawa, Ont
| | - Phil McFarlane
- From the Division of Science and Technology, Laboratory for Foodborne Zoonoses (Arora, Badawi), Public Health Agency of Canada, Toronto, Ont.; the Division of Epidemiology (Arora, Brenner), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; the Department of Family and Community Medicine (Vasa), University of Toronto, Toronto, Ont.; the Departments of Family and Community Medicine (Vasa, Iglar) and Medicine (McFarlane), St. Michael’s Hospital, Toronto, Ont.; and the Science Integration Division, Social Determinants and Science Integration Directorate, Health Promotion and Chronic Disease Prevention Branch (Morrison), Public Health Agency of Canada, Ottawa, Ont
| | - Howard Morrison
- From the Division of Science and Technology, Laboratory for Foodborne Zoonoses (Arora, Badawi), Public Health Agency of Canada, Toronto, Ont.; the Division of Epidemiology (Arora, Brenner), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; the Department of Family and Community Medicine (Vasa), University of Toronto, Toronto, Ont.; the Departments of Family and Community Medicine (Vasa, Iglar) and Medicine (McFarlane), St. Michael’s Hospital, Toronto, Ont.; and the Science Integration Division, Social Determinants and Science Integration Directorate, Health Promotion and Chronic Disease Prevention Branch (Morrison), Public Health Agency of Canada, Ottawa, Ont
| | - Alaa Badawi
- From the Division of Science and Technology, Laboratory for Foodborne Zoonoses (Arora, Badawi), Public Health Agency of Canada, Toronto, Ont.; the Division of Epidemiology (Arora, Brenner), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; the Department of Family and Community Medicine (Vasa), University of Toronto, Toronto, Ont.; the Departments of Family and Community Medicine (Vasa, Iglar) and Medicine (McFarlane), St. Michael’s Hospital, Toronto, Ont.; and the Science Integration Division, Social Determinants and Science Integration Directorate, Health Promotion and Chronic Disease Prevention Branch (Morrison), Public Health Agency of Canada, Ottawa, Ont
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Abstract
Thanks to remarkable advances in neonatal intensive care, infants who once had little chance for survival can now enter adulthood. Yet the consequences of premature birth or low birth weight (LBW) on nephrogenesis, final nephron number, and long-term kidney function are unclear. This review focuses on the theory, experimental evidence, and observational data that suggest an increased risk of chronic kidney disease (CKD) for infants born prematurely. Many premature and LBW infants begin life with an incomplete complement of immature nephrons. They are then exposed to a variety of external stressors that can hinder ongoing kidney development or cause additional nephron loss such as hemodynamic alterations, nephrotoxic medications, infections, and suboptimal nutrition. Acute kidney injury, in particular, may be a significant risk factor for the development of CKD. According to Brenner's hypothesis, patients with decreased nephron number develop hyperfiltration that results in sodium retention, hypertension, nephron loss, and CKD due to secondary focal segmental glomerulosclerosis. Because the risk of CKD in premature and LBW infants has not been accurately determined, there are no evidence-based recommendations for screening or management. Yet with the first generation of infants from the surfactant era only now reaching adulthood, it is possible that there is already an unrecognized epidemic of CKD. We suggest individualized, risk-based assessments of premature and LBW infants due to the increased risk of CKD and call for additional research into the long-term risk for CKD these infants face.
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Affiliation(s)
- J Bryan Carmody
- Department of Pediatrics, University of Virginia, Charlottesville, VA 22908, USA
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Fang F, Liu GC, Kim C, Yassa R, Zhou J, Scholey JW. Adiponectin attenuates angiotensin II-induced oxidative stress in renal tubular cells through AMPK and cAMP-Epac signal transduction pathways. Am J Physiol Renal Physiol 2013; 304:F1366-74. [PMID: 23535586 DOI: 10.1152/ajprenal.00137.2012] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Obesity is a risk factor for chronic kidney disease (CKD) progression. Circulating levels of adiponectin, an adipokine, decrease with obesity and play a protective role in the cardiovascular system. We hypothesized that adiponectin might also protect the kidney. Because activation of the renin-angiotensin system (RAS) is a contributor to CKD progression, we tested our hypothesis by studying the interactions between adiponectin and angiotensin II (ANG II) in renal tubular cells. Primary human renal proximal tubule cells expressed both adiponectin receptor 1 and 2 (adipoR1 and R2). ANG II-induced NADPH oxidase activation and oxidative stress were attenuated by adiponectin and dependent on adipoR1. Activation of AMPK with 5-aminoimidazole-4-carboxamide-1-β-d-ribofuranoside (AICAR) mimicked, while inhibition of AMPK with compound C abrogated, the effect of adiponectin on ANG II-induced activation of NADPH oxidase. Similarly, the effect of adiponectin was recapitulated by the stable cAMP analogs 4-chlorophenylthio (pCPT)-cAMP and dibutyryl (db)-cAMP and blocked by the adenylate cyclase inhibitor SQ22536. Adiponectin did not activate PKA in renal tubular cells, and the specific PKA inhibitor myristoylated PKI (14-22) amide failed to block the inhibitory effect of adiponectin on ANG II-induced NADPH oxidase activation. In contrast, the specific Epac activator 8-(4-chlorophenylthio)-2'-O-methyl (8-CPT-2-O-Me)-cAMP blocked ANG II-induced activation of NADPH oxidase, an effect that was reversed by coincubation with the AMPK inhibitor compound C. Finally, adiponectin attenuated ANG II-induced NF-κB activation and fibronectin protein expression. These in vitro findings support the hypothesis that adiponectin may attenuate the deleterious effects of ANG II in the kidney and play a protective role in CKD.
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Affiliation(s)
- Fei Fang
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
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Karalius VP, Shoham DA. Dietary sugar and artificial sweetener intake and chronic kidney disease: a review. Adv Chronic Kidney Dis 2013; 20:157-64. [PMID: 23439375 DOI: 10.1053/j.ackd.2012.12.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 12/01/2012] [Accepted: 12/10/2012] [Indexed: 01/21/2023]
Abstract
Sugar consumption, especially in the form of fructose, has been hypothesized to cause kidney disease. This review provides an overview of the epidemiologic evidence that sugar consumption increases CKD risk. Research supports a causal role of sugar in several kidney disease risk factors, including increasing serum uric acid levels, diabetes, and obesity. Sugar may also harm the kidney via other mechanisms. There is no evidence that sucrose is any safer for the kidney than high fructose corn syrup (HFCS) because both are similar in composition. To date, 5 epidemiologic studies have directly evaluated the relationship between sugar consumption (in the form of sugar-sweetened beverages) and CKD. Although most studies suggest that the risk of CKD is elevated among consumers of sugar-sweetened beverages, only 2 studies report statistically significant associations. Three studies have also examined diet soda consumption, with two reporting positive and significant associations. Confounding by unmeasured lifestyle factors may play a role in the positive results whereas poor measurement of sugar and artificial sweetener intake could explain null results. Nevertheless, the hypothesis that sugar causes kidney disease remains plausible, and alternative research designs may be needed.
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45
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Silva MIB, Vale BS, Lemos CCS, Torres MRSG, Bregman R. Body adiposity index assess body fat with high accuracy in nondialyzed chronic kidney disease patients. Obesity (Silver Spring) 2013; 21:546-52. [PMID: 23592662 DOI: 10.1002/oby.20261] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 05/25/2012] [Indexed: 02/04/2023]
Abstract
OBJECTIVE High body fat (BF) is an alarming condition that also affects nondialyzed chronic kidney disease (CKD) patients. Distinct methods are used to evaluate BF; however, in CKD population it remains unclear which one is more reliable showing high accuracy. Dual-energy X-ray absorptiometry (DXA), used as reference method to estimate adiposity, is expensive and time consuming to be applied in clinical settings. Recently, a new body adiposity index (BAI), that estimates BF from easily accessible measures, was validated in the general population. The aim of this study was to evaluate which simple and practical method, routinely used to estimate BF, shows the highest accuracy compared with DXA, in nondialyzed CKD patients. DESIGN AND METHODS In this cross-sectional study BF was estimated by DXA, bioelectrical impedance analysis (BIA), anthropometry (ANTHRO), and BAI. Serum leptin levels were determined. RESULTS Studied patients (n = 134) were 55% males, 54% overweight/obese, and 64.9 ± 12.5 years old, with estimated glomerular filtration rate (eGFR) = 29.0 ± 12.7 ml/min. The correlation coefficient was higher between DXA vs. ANTHRO (r = 0.76) and BAI (r = 0.61) than with BIA (r = 0.57), after adjusting for gender, age, and eGFR (P < 0.0001). Therefore, the Lin's concordance correlation coefficient and Bland-Altman plots were performed to measure the accuracy (C_b) between DXA with both ANTHRO and BAI. A higher accuracy (C_b = 0.82) and lower mean difference (-3.4%) was observed for BAI than for ANTHRO (C_b = 0.61; -8.4%). Leptin levels correlated (P < 0.0001) with DXA (r = 0.56) and BAI (r = 0.59). CONCLUSIONS These findings suggest that BAI estimates BF with high accuracy in nondialyzed CKD patients and may be helpful in the treatment of this population with increased BF.
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Affiliation(s)
- Maria Inês B Silva
- Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.
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Palatini P, Dorigatti F, Saladini F, Benetti E, Mos L, Mazzer A, Zanata G, Garavelli G, Casiglia E. Factors associated with glomerular hyperfiltration in the early stage of hypertension. Am J Hypertens 2012; 25:1011-6. [PMID: 22673015 DOI: 10.1038/ajh.2012.73] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Glomerular hyperfiltration predicts development of nephropathy in hypertension but the factors responsible for increased glomerular filtration rate (GFR) are not well known. Aim of this study was to examine which clinical variables influence GFR in the early stage of hypertension. METHODS Participants were 1,106 young-to-middle-age hypertensive adults with creatinine clearance >60 ml/min/1.73 m(2). Clinic and ambulatory blood pressures (BPs) were measured and the difference between clinic and 24-h systolic BP was defined as the white-coat effect (WCE). In 606 participants, 24-h urinary epinephrine and norepinephrine were also measured. Glomerular hyperfiltration, defined as a GFR ≥150 ml/min/1.73 m(2), was present in 201 subjects. RESULTS Patients' mean age was 33.1 ± 8.5 years and office BP was 146 ± 10.5/94 ± 5.0 mm Hg. In multivariable linear regression, significant predictors of GFR were younger age (P < 0.0001), male gender (P < 0.0001), 24-h systolic BP (P = 0.0001), body mass (P < 0.0001), WCE (P = 0.02), log-epinephrine (P = 0.01), and coffee use (P < 0.01). In a logistic model, independent predictors of glomerular hyperfiltration were obesity (odds ratio, 95% confidence interval = 6.1, 3.8-9.8), male gender (2.9, 1.8-4.9), age <33 years (2.1, 1.5-3.1), ambulatory hypertension (2.0, 1.4-3.0), WCE >15 mm Hg (1.6, 1.1-2.3), heavy coffee use (2.0, 1.1-3.8), and epinephrine >25 mcg/24 h (1.9, 1.2-3.1). CONCLUSIONS The novel finding of this study is that hyper-reactivity to stress, as determined by urinary epinephrine level and WCE, and coffee use contribute to determining glomerular hyperfiltration in the early stage of hypertension. Our data may help to identify a subset of patients with glomerular hyperfiltration, who may be at increased risk of chronic kidney disease and may benefit from antihypertensive treatment.
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Grethen E, Hill KM, Jones R, Cacucci BM, Gupta CE, Acton A, Considine RV, Peacock M. Serum leptin, parathyroid hormone, 1,25-dihydroxyvitamin D, fibroblast growth factor 23, bone alkaline phosphatase, and sclerostin relationships in obesity. J Clin Endocrinol Metab 2012; 97:1655-62. [PMID: 22362819 PMCID: PMC3339883 DOI: 10.1210/jc.2011-2280] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Obesity is associated with hyperparathyroidism and increased bone mass and turnover, but their pathogeneses are unclear. AIMS Our aim was to determine in obesity interrelationships among serum levels of leptin, the mineral-regulating hormones, bone turnover markers, and sclerostin. METHODS This case-control study was performed in 20 women having bariatric surgery and 20 control women matched for race and age. Anthropometrics and fasting serum biochemistries were measured in controls and in bariatric patients the morning of surgery. RESULTS Body mass index (48.9 vs. 25.4 kg/m(2)), weight (128.6 vs. 71.9 kg), serum leptin (74.6 vs. 25.2 ng/ml), PTH (44.5 vs. 28.8 pg/ml), fibroblast growth factor 23 (FGF23) (42.4 vs. 25.9 pg/ml), and bone alkaline phosphatase (BAP) (25.8 vs. 17.5 U/liter) were higher, but height (162.3 vs. 167.7 cm) and 1,25-dihydroxyvitamin D (1,25D) (39.2 vs. 48.7 pg/ml) were lower in bariatric surgery patients than controls. There was no difference in serum sclerostin, amino-terminal collagen cross-links, 25-hydroxyvitamin D (25D), calcium, phosphate, and creatinine between groups. In the combined sample, leptin was positively related to PTH, FGF23, and BAP but not to 1,25D or sclerostin. Multiple regression analysis demonstrated that PTH was predicted by leptin and Ca (R(2) = 0.39); 1,25D by 25D, FGF23, and phosphate (R(2) = 0.43); FGF23 by leptin and 1,25D (R(2) = 0.27); BAP by leptin, PTH, and Ca (R(2) = 0.39); and sclerostin by leptin and PTH (R(2) = 0.20). CONCLUSIONS Women having bariatric surgery had higher leptin, PTH, FGF23, and BAP and lower 1,25D than controls. Leptin predicted the serum levels of PTH, 1,25D, and FGF23, the mineral-regulating hormones, and BAP, a bone formation marker, in women with body mass index ranging from 13.9-65.8 kg/m(2). The results suggest that leptin has an endocrine or paracrine effect on PTH and FGF23 production and that PTH may be one of the signals in obesity that leads to increased bone mass.
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Affiliation(s)
- Elizabeth Grethen
- Division of Endocrinology and Metabolism, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
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Palatini P. Glomerular hyperfiltration: a marker of early renal damage in pre-diabetes and pre-hypertension. Nephrol Dial Transplant 2012; 27:1708-14. [DOI: 10.1093/ndt/gfs037] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Senevirathna L, Abeysekera T, Nanayakkara S, Chandrajith R, Ratnatunga N, Harada KH, Hitomi T, Komiya T, Muso E, Koizumi A. Risk factors associated with disease progression and mortality in chronic kidney disease of uncertain etiology: a cohort study in Medawachchiya, Sri Lanka. Environ Health Prev Med 2011; 17:191-8. [PMID: 21881957 DOI: 10.1007/s12199-011-0237-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 08/08/2011] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The alarming rise in the prevalence of chronic kidney disease of uncertain etiology (CKDu) among the low socioeconomic farming community in the North Central Province of Sri Lanka has been recognized as an emerging public health issue in the country. METHODS This study sought to determine the possible factors associated with the progression and mortality of CKDu. The study utilized a single-center cohort registered in 2003 and followed up until 2009 in a regional clinic in the endemic region, and used a Cox proportional hazards model. RESULTS We repeatedly found an association between disease progression and hypertension. Men were at higher risk of CKDu than women. A significant proportion of the patients in this cohort were underweight, which emphasized the need for future studies on the nutritional status of these patients. CONCLUSIONS Compared with findings in western countries and other regions of Asia, we identified hypertension as a major risk factor for progression of CKDu in this cohort.
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Affiliation(s)
- Lalantha Senevirathna
- Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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Hayashi N, Matsushima M, Yamamoto T, Sasaki H, Takahashi H, Egawa S. The impact of hypertriglyceridemia on prostate cancer development in patients aged ≥60 years. BJU Int 2011; 109:515-9. [PMID: 21812901 DOI: 10.1111/j.1464-410x.2011.10358.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE • To investigate the relationship between serum triglyceride (TG) levels and the incidence and characteristics of prostate cancer detected on biopsy. PATIENTS AND METHODS • We evaluated data from consecutive patients who underwent prostatic biopsy. Data analysed included age, total serum prostate-specific antigen (PSA) level, prostatic volume, body mass index (BMI), TG levels, and cholesterol-lowering medications. RESULTS • We analysed data from 905 patients, including 528 (58.3%) with positive biopsy findings. • Using 150 mg/dL as the threshold point of TG levels, multivariate analysis yielded an adjusted odds ratio (OR) reflecting the association of higher TG levels with prostate cancer diagnosis of 1.66 (95% confidence interval (CI) 1.21-2.29, P = 0.002). • Pearson correlation coefficient analysis including age, PSA level, prostatic volume, BMI and TG, showed TG level significantly correlated with BMI (r = 0.185, P < 0.001). • In the analysis by age intervals (≤59, 60-69, and ≥70 years), the association between high TG levels and positive biopsy findings was enhanced in the age groups 60-69 and ≥70 years (OR 2.10, 95% CI 1.31-3.37, P = 0.002 and OR 1.91, 95% CI 1.03-3.53, P = 0.039, respectively), but not in the group aged ≤59 years. • In patients aged ≥60 years, high TG levels were statistically significantly associated with a Gleason score of ≥8. CONCLUSIONS • High TG levels correlated well with a higher incidence of prostate cancer, especially in patients aged ≥60 years. • High TG levels were also associated with a Gleason score of ≥8 in this age group. • Our results suggest that elderly patients with high TG levels may be more vulnerable to the development of prostate cancer with an aggressive biology.
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Affiliation(s)
- Norihiro Hayashi
- Department of Urology, Division of Clinical Research and Development, Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
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