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Mantovani A, Targher G. PNPLA3 variation and kidney disease. Liver Int 2024. [PMID: 38873992 DOI: 10.1111/liv.16010] [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] [Received: 04/29/2024] [Revised: 05/16/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024]
Abstract
Accumulating epidemiological evidence shows that the patatin-like phospholipase domain-containing protein-3 (PNPLA3) rs738409 G allele, which is the most robust genetic variant associated with greater susceptibility to metabolic dysfunction-associated steatotic liver disease (MASLD), is significantly associated with impaired kidney function in both adults and children, regardless of the presence of common renal risk factors, MASLD severity, and other potential confounders. Although some prospective studies have reported a significant association between the PNPLA3 rs738409 G allele and the increased risk of developing chronic kidney disease (CKD), the epidemiological evidence about a possible direct effect of the PNPLA3 rs738409 G allele on the risk of developing CKD is still limited. Experimentally, PNPLA3 is expressed in renal podocytes, pericytes, and proximal tubule cells, thus supporting the notion that the mutant PNPLA3 protein may play a role in developing renal steatosis and fibrosis. However, it cannot be ruled out that a part of the adverse effect of the PNPLA3 rs738409 G allele on kidney function may be driven by a direct impact of this genetic variant on the development and progression of MASLD. It is possible to hypothesize that identifying the PNPLA3 genotype might help identify individuals at higher risk of CKD and those at greater risk of advanced MASLD. In this narrative minireview, we summarize the current epidemiological data about the association between the PNPLA3 rs738409 G allele and the risk of CKD and abnormal albuminuria. We also briefly discuss the putative biological mechanisms underpinning this association and its potential and future clinical implications.
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Affiliation(s)
- Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy
- Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy
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2
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Semadhi MP, Muliaty D, Halimah E, Levita J. Correlation between the Cognitive Status (SIRT1) and the Metabolic Function in Geriatric Patients Using the Indonesian Version of the Montreal Cognitive Assessment (MoCA-INA). Geriatrics (Basel) 2023; 8:119. [PMID: 38132490 PMCID: PMC10742712 DOI: 10.3390/geriatrics8060119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/30/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
A growing life expectancy may result in a chronic medical condition and multimorbidity because the aging process leads to a decrease in cognitive and physiological function. These risks may affect the quality of life of geriatrics. The present study aims to determine the correlation between cognitive status (in terms of SIRT1, a nicotinamide adenine dinucleotide (NAD+)-dependent class III deacetylase) and metabolic function (in terms of the lipid profile, kidney function, and blood glucose) in geriatric patients. The differences in the parameters of metabolic function in the participants' cognitive status were determined by using the Indonesian version of the Montreal Cognitive Assessments (MoCA-Ina). The elderly participants (n = 120) were recruited at three sites in Indonesia from March to October 2022. Our study demonstrated a negative correlation between the cognitive status of geriatric patients and their metabolic function, represented by the MoCA-Ina score with a linear regression equation of y = 0.27 - 2.4 ×10-3x. Higher levels of LDL-C, cystatin C, and HbA1c were found in the Severe-Moderate Cognitive Impairment group. Determining the SIRT1 levels may be beneficial in predicting both the cognitive and metabolic status of geriatrics because this protein is among numerous metabolic sensors in the hypothalamus.
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Affiliation(s)
- Made Putra Semadhi
- Prodia National Reference Laboratory, Jakarta 10430, Indonesia;
- Doctoral Program in Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia
| | - Dewi Muliaty
- Prodia Widyahusada Tbk., Jakarta 10430, Indonesia;
| | - Eli Halimah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia;
| | - Jutti Levita
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia;
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Shete A, Wagh V, Sawant J, Shidhaye P, Sane S, Rao A, Kulkarni S, Ghate M. Antiretroviral Treatment-Induced Galectin-9 Might Impact HIV Viremia in Addition to Contributing to Inflammaging. Int J Mol Sci 2023; 24:12273. [PMID: 37569647 PMCID: PMC10418429 DOI: 10.3390/ijms241512273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Galectin-9 induces HIV reactivation and also contributes to non-AIDS events through inflammaging. Hence, it is important to assess its levels in HIV-infected individuals to determine their association with HIV viremia and other comorbidities. METHODS Plasma galectin-9 levels were estimated in viremic (n = 152) and aviremic (n = 395) individuals on first-line antiretroviral therapy (ART). They were assessed for correlation with HIV-1 viral load (VL), CD4 count, and ART duration, as well as for receiver operating characteristic curve analysis. RESULT Plasma galectin-9 levels correlated positively with VL (r = 0.507, p < 0.0001) and ART duration (r = 0.308, p = 0.002) and negatively with CD4 count (r = -0.186, p < 0.0001). Area under the curve for galectin-9/CD4 count ratio for identifying viremic individuals was 0.906. Sensitivity and specificity of the ratio at a cutoff of 14.47 were 90.13% and 70.05%, respectively, for detecting viremic individuals. Further, galectin-9 levels correlated with cystatin C (r = 0.239, p = 0.0183), IL-18 (r = 0.311, p = 0.006), and systolic blood pressure (r = 0.220, p = 0.0355). Galectin-9-induced HIV reactivation was significantly lower in individuals on long-term ART than those on short-term ART. CONCLUSION The galectin-9-to-CD4 count ratio indicated the potential of galectin-9 as a cheaper monitoring tool to detect HIV viremia. Strategies for countering the effects of galectin-9 for controlling HIV viremia and non-AIDS events are urgently warranted.
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Affiliation(s)
- Ashwini Shete
- Indian Council of Medical Research, National AIDS Research Institute (ICMR-NARI), Pune 411026, India; (V.W.); (J.S.); (P.S.); (A.R.); (S.K.); (M.G.)
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Salignon J, Faridani OR, Miliotis T, Janssens GE, Chen P, Zarrouki B, Sandberg R, Davidsson P, Riedel CG. Age prediction from human blood plasma using proteomic and small RNA data: a comparative analysis. Aging (Albany NY) 2023; 15:5240-5265. [PMID: 37341993 PMCID: PMC10333066 DOI: 10.18632/aging.204787] [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: 08/30/2022] [Accepted: 05/26/2023] [Indexed: 06/22/2023]
Abstract
Aging clocks, built from comprehensive molecular data, have emerged as promising tools in medicine, forensics, and ecological research. However, few studies have compared the suitability of different molecular data types to predict age in the same cohort and whether combining them would improve predictions. Here, we explored this at the level of proteins and small RNAs in 103 human blood plasma samples. First, we used a two-step mass spectrometry approach measuring 612 proteins to select and quantify 21 proteins that changed in abundance with age. Notably, proteins increasing with age were enriched for components of the complement system. Next, we used small RNA sequencing to select and quantify a set of 315 small RNAs that changed in abundance with age. Most of these were microRNAs (miRNAs), downregulated with age, and predicted to target genes related to growth, cancer, and senescence. Finally, we used the collected data to build age-predictive models. Among the different types of molecules, proteins yielded the most accurate model (R² = 0.59 ± 0.02), followed by miRNAs as the best-performing class of small RNAs (R² = 0.54 ± 0.02). Interestingly, the use of protein and miRNA data together improved predictions (R2 = 0.70 ± 0.01). Future work using larger sample sizes and a validation dataset will be necessary to confirm these results. Nevertheless, our study suggests that combining proteomic and miRNA data yields superior age predictions, possibly by capturing a broader range of age-related physiological changes. It will be interesting to determine if combining different molecular data types works as a general strategy to improve future aging clocks.
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Affiliation(s)
- Jérôme Salignon
- Department of Medicine, Integrated Cardio Metabolic Centre (ICMC), Karolinska Institutet, Huddinge 14157, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge 14157, Sweden
| | - Omid R. Faridani
- Department of Medicine, Integrated Cardio Metabolic Centre (ICMC), Karolinska Institutet, Huddinge 14157, Sweden
- Lowy Cancer Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia
- Garvan Institute of Medical Research, Sydney, Australia
| | - Tasso Miliotis
- Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Georges E. Janssens
- Department of Medicine, Integrated Cardio Metabolic Centre (ICMC), Karolinska Institutet, Huddinge 14157, Sweden
| | - Ping Chen
- Department of Medicine, Integrated Cardio Metabolic Centre (ICMC), Karolinska Institutet, Huddinge 14157, Sweden
| | - Bader Zarrouki
- Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Rickard Sandberg
- Department of Medicine, Integrated Cardio Metabolic Centre (ICMC), Karolinska Institutet, Huddinge 14157, Sweden
- Department of Cellular and Molecular Biology, Ludwig Institute for Cancer Research, Karolinska Institutet, Solna 17165, Sweden
| | - Pia Davidsson
- Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Christian G. Riedel
- Department of Medicine, Integrated Cardio Metabolic Centre (ICMC), Karolinska Institutet, Huddinge 14157, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge 14157, Sweden
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Ji M, Fu Y, Wan X, Du X. Age-adjusted reference values and influencing factors of cystatin C in healthy Chinese population. Int Urol Nephrol 2023; 55:1641-1644. [PMID: 36735151 DOI: 10.1007/s11255-023-03497-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Normative distribution of serum cystatin C and relationship with sex and age in healthy adult Chinese population is unknown. METHODS This is a prospective cohort study. Adult subjects (18 years of age and older) who underwent annual health examination at the Health Management Center in Sir Run Run Hospital were eligible. Subjects with major diseases, e.g., hypertension, diabetes, chronic kidney disease, obesity (body mass index ≥ 28 kg/m2) were excluded from the analysis. Multivariate logistic regression analysis was conducted to identify risk factors of elevated cystatin C (> 1.03 mg/L). Data are shown as median and 95% confidence interval (CI). RESULTS The final analysis included a total of 10,640 subjects (40 ± 12 years, 52% men). The median serum cystatin C concentration was 0.73 mg/L (95% CI 0.52-1.03 mg/L) in the overall analysis, 0.79 (95% CI 0.59-1.07 mg/L) in men, and 0.67 (95% CI 0.49-0.95 mg/L) in women. In the multivariate regression analysis, elevated cystatin C was independently associated with the male sex (odds ratio 1.94; 95% CI 1.07-3.52), older age (odds ratio 1.04 every year; 95% CI 1.02-1.06), higher body mass index (odds ratio 1.70; 95% CI 1.01-2.83), uric acid (odds ratio 1.00; 95% CI 1.00-1.01), and β2-microglobulin (odds ratio 39.35; 95% CI 22.90-67.64). CONCLUSION The median serum cystatin C concentration was 0.73 (95% CI 0.52-1.03 mg/L) in healthy adult Chinese population, 0.79 (95% CI 0.59-1.07 mg/L) in men, and 0.67 (95% CI 0.49-0.95 mg/L) in women. Elevated cystatin C was associated with the male sex, older age and higher body mass index.
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Affiliation(s)
- Ming Ji
- Department of Health Management Center, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Yongchao Fu
- Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Xinglin Wan
- Department of Health Management Center, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Xin Du
- Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, Chang Le Road 68, Nanjing, 210006, China.
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Linné E, Elfström A, Åkesson A, Fisher J, Grubb A, Pettilä V, Vaara ST, Linder A, Bentzer P. Cystatin C and derived measures of renal function as risk factors for mortality and acute kidney injury in sepsis - A post-hoc analysis of the FINNAKI cohort. J Crit Care 2022; 72:154148. [PMID: 36108348 DOI: 10.1016/j.jcrc.2022.154148] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/25/2022] [Accepted: 08/26/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To assess the association between cystatin C-derived estimates of kidney function and mortality and acute kidney injury (AKI) in sepsis. MATERIALS AND METHODS Post-hoc analysis of sepsis patients in the FINNAKI-cohort (n = 802). Primary outcome was 90-day mortality. We measured plasma cystatin C and creatinine at intensive care unit (ICU) admission and estimated glomerular filtration rates (eGFRcys, eGFRcrea) and shrunken pore syndrome (SPS; defined as eGFRcys/eGFRcrea ratio < 0.7). Associations were assessed using Cox- or logistic regression. RESULTS Increased cystatin C and decreased eGFRcys were associated with mortality in unadjusted analyses and in analyses adjusted for illness severity and creatinine. Hazard ratios (HRs) in unadjusted analyses were 3.30 (95% CI; 2.12-5.13, p < 0.001) and 3.26 (95% CI; 2.12-5.02, p < 0.001) respectively. SPS was associated with mortality in an unadjusted- (HR 1.78, 95% CI; 1.33-2.37, p < 0.001) and in an adjusted analysis (HR 1.54, 95% CI; 1.07-2.22, p = 0.021). All cystatin C-derived measures were associated with mortality also after adjustment for AKI development. Cystatin C was associated with AKI in unadjusted analyses but not in analyses adjusted for creatinine. CONCLUSION Cystatin C and derived measures of kidney function at ICU admission are associated with an increased 90-day mortality. Increased AKI incidence does not fully explain this association.
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Affiliation(s)
- Erik Linné
- Department of Anesthesiology and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.
| | - Alma Elfström
- Department of Anesthesiology and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden
| | - Anna Åkesson
- Clinical Studies Sweden - Forum South, Skåne University Hospital, Lund, Sweden
| | - Jane Fisher
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Division of Infection Medicine, Lund, Sweden
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital, Lund University, Lund, Sweden
| | - Ville Pettilä
- Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Suvi T Vaara
- Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Adam Linder
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Division of Infection Medicine, Lund, Sweden
| | - Peter Bentzer
- Lund University, Helsingborg Hospital, Department of Clinical Sciences Lund, Anesthesiology and Intensive Care, Lund, Sweden
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The Most Promising Biomarkers of Allogeneic Kidney Transplant Rejection. J Immunol Res 2022; 2022:6572338. [PMID: 35669103 PMCID: PMC9167141 DOI: 10.1155/2022/6572338] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/30/2022] [Indexed: 12/13/2022] Open
Abstract
Clinical transplantology is a constantly evolving field of medicine. Kidney transplantation has become standard clinical practice, and it has a significant impact on reducing mortality and improving the quality of life of patients. Allogenic transplantation induces an immune response, which may lead to the rejection of the transplanted organ. The gold standard for evaluating rejection of the transplanted kidney by the recipient's organism is a biopsy of this organ. However, due to the high invasiveness of this procedure, alternative diagnostic methods are being sought. Therefore, the biomarkers may play an essential predictive role in transplant rejection. A review of the most promising biomarkers for early diagnosis and prognosis prediction of allogenic kidney transplant rejection summarizes novel data on neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), C-X-C motif chemokine 10 (CXCL-10), cystatin C (CysC), osteopontin (OPN), and clusterin (CLU) and analyses the dynamics of changes of the biomarkers mentioned above in kidney diseases and the mechanism of rejection of the transplanted kidney.
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Cystatin C and cystatin SN as possible soluble tumor markers in malignant uveal melanoma. Radiol Oncol 2021; 56:83-91. [PMID: 34957724 PMCID: PMC8884861 DOI: 10.2478/raon-2021-0049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/21/2021] [Indexed: 11/22/2022] Open
Abstract
Background The aim of the study was to determine the concentration of endogenous cystatin C and cystatin SN, as potential tumor biomarkers, in the serum and biological fluids of the eye in both healthy controls and patients with uveal melanoma. Patients and methods The concentration of both cystatins was determined in the intraocular fluid (IOF), tear fluid, and serum of patients with uveal melanoma and compared to baseline measurements in IOF, tears, serum, cerebral spinal fluid, saliva and urine of healthy controls. Results The concentration of cystatin C in all the biological matrices obtained from healthy controls significantly exceeded the concentration of cystatin SN and was independent of gender. Cystatin C concentrations in the tear fluid of patients with uveal melanoma (both the eye with the malignancy, as well as the contralateral, non-affected eye), were significantly greater than cystatin C concentrations in the tear fluid of healthy controls and was independent of tumor size. The concentration of cystatin SN in IOF of patients with uveal melanoma was significantly less than the corresponding concentration of cystatin SN in healthy controls. Conclusions The ratio of cystatins (CysC:CysSN) in both the serum and tear fluid, as well as the concentration of cystatin SN in IOF, would appear to strongly suggest the presence of uveal melanoma. It is further suggested that multiple diagnostic criteria be utilized if a patient is suspected of having uveal melanoma, such as determination of the cystatin C and cystatin SN concentrations in serum, tears, and IOF, ocular fundus and ultrasound imaging, and biopsy with histopathological evaluation.
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Fotheringham AK, Solon-Biet SM, Bielefeldt-Ohmann H, McCarthy DA, McMahon AC, Ruohonen K, Li I, Sullivan MA, Whiddett RO, Borg DJ, Cogger VC, Ballard WO, Turner N, Melvin RG, Raubenheimer D, Le Couteur DG, Simpson SJ, Forbes JM. Kidney disease risk factors do not explain impacts of low dietary protein on kidney function and structure. iScience 2021; 24:103308. [PMID: 34820603 PMCID: PMC8602032 DOI: 10.1016/j.isci.2021.103308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/29/2021] [Accepted: 10/15/2021] [Indexed: 02/06/2023] Open
Abstract
The kidneys balance many byproducts of the metabolism of dietary components. Previous studies examining dietary effects on kidney health are generally of short duration and manipulate a single macronutrient. Here, kidney function and structure were examined in C57BL/6J mice randomized to consume one of a spectrum of macronutrient combinations (protein [5%–60%], carbohydrate [20%–75%], and fat [20%–75%]) from weaning to late-middle age (15 months). Individual and interactive impacts of macronutrients on kidney health were modeled. Dietary protein had the greatest influence on kidney function, where chronic low protein intake decreased glomerular filtration rates and kidney mass, whereas it increased kidney immune infiltration and structural injury. Kidney outcomes did not align with cardiometabolic risk factors including glucose intolerance, overweight/obesity, dyslipidemia, and hypertension in mice with chronic low protein consumption. This study highlights that protein intake over a lifespan is an important determinant of kidney function independent of cardiometabolic changes. Chronic high macronutrient intake from any source increases kidney function (GFR) Low protein intake led to greater kidney tubular structural injury and inflammation Lower protein intake decreased kidney mass and glomerular filtration capacity Kidney outcomes did not align with longevity or cardiometabolic outcomes
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Affiliation(s)
- Amelia K Fotheringham
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane 4067, QLD, Australia
| | - Samantha M Solon-Biet
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,School of Medical Sciences, University of Sydney, Sydney 2006, NSW, Australia
| | - Helle Bielefeldt-Ohmann
- School of Veterinary Science, University of Queensland, Gatton Campus, Gatton 4343, QLD, Australia.,School of Chemistry & Molecular Biosciences, University of Queensland, Brisbane 4067, QLD, Australia
| | - Domenica A McCarthy
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia
| | - Aisling C McMahon
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,Centre for Education and Research on Aging, and Aging and Alzheimer's Institute, Concord Hospital, Sydney 2139, NSW, Australia.,ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney 2139, NSW, Australia
| | - Kari Ruohonen
- Animal Nutrition and Health, Cargill, Sandnes, Norway
| | - Isaac Li
- Faculty of Medicine, University of Queensland, Brisbane 4067, QLD, Australia
| | - Mitchell A Sullivan
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia
| | - Rani O Whiddett
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia
| | - Danielle J Borg
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane 4067, QLD, Australia
| | - Victoria C Cogger
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,Centre for Education and Research on Aging, and Aging and Alzheimer's Institute, Concord Hospital, Sydney 2139, NSW, Australia.,ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney 2139, NSW, Australia
| | - William O Ballard
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney 2052, NSW, Australia
| | - Nigel Turner
- Department of Pharmacology, School of Medical Sciences, Faculty of Medicine, University of New South Wales Sydney, NSW 2052, Australia
| | - Richard G Melvin
- Department of Biomedical Sciences, University of Minnesota Medical School, 1035 University Drive, Duluth 55812, MN, USA
| | - David Raubenheimer
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,School of Life and Environmental Sciences, University of Sydney, NSW, Australia
| | - David G Le Couteur
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,Centre for Education and Research on Aging, and Aging and Alzheimer's Institute, Concord Hospital, Sydney 2139, NSW, Australia.,ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney 2139, NSW, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,School of Life and Environmental Sciences, University of Sydney, NSW, Australia
| | - Josephine M Forbes
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane 4067, QLD, Australia.,Department of Medicine, University of Melbourne, Heidelberg, VIC 3084, Australia
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Balan P, Chong YS, Lin Q, Lim TK, Li H, Wong ML, Lopez V, He HG, Seneviratne CJ. Isobaric tags for relative and absolute quantification (iTRAQ)-based quantitative analysis of the salivary proteome during healthy pregnancy and pregnancy gingivitis. J Clin Periodontol 2021; 48:1559-1569. [PMID: 34605060 DOI: 10.1111/jcpe.13559] [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: 07/11/2021] [Accepted: 09/25/2021] [Indexed: 02/06/2023]
Abstract
AIM The present study aimed to investigate the salivary proteome profiles of pregnant women with gingivitis (PG) or without gingivitis (HP) and non-pregnant healthy controls (HC) by employing iTRAQ-based proteomics. MATERIALS AND METHODS Saliva samples were collected from 30 Chinese women comprising 10 subjects in each of the three groups (PG, HP, and HC). The samples were subjected to iTRAQ-based proteomics analysis, and ELISA was performed to validate the results. The subsequent observations were validated in a cohort of 48 subjects. RESULTS Pathways associated with neutrophil-mediated immune response and antioxidant defence mechanism were significantly higher in PG than HC. The abundance of salivary cystatins (S, SA, and SN) and antimicrobials were significantly decreased in PG and HP, while cystatin C and D were additionally decreased in PG. Cystatin C was mapped to all the major catabolic pathways and was the most re-wired protein in pregnancy gingivitis. Further validation demonstrated cystatin C to be significantly lower in PG than HC. CONCLUSIONS While the decrease in levels of salivary cystatins and antimicrobial proteins may predispose healthy pregnant women to pregnancy gingivitis, it may cause persistence of inflammation in pregnant women with gingivitis.
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Affiliation(s)
- Preethi Balan
- Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, National Dental Center, Singapore.,Oral Health Academic Clinical Program, Duke NUS Medical School, Singapore
| | - Yap S Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University Hospital, Singapore
| | - Qingsong Lin
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
| | - Teck Kwang Lim
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
| | - Huihua Li
- Oral Health Academic Clinical Program, Duke NUS Medical School, Singapore
| | - Mun L Wong
- Discipline of Primary Dental Care and Population Oral Health, Faculty of Dentistry, National University of Singapore, Singapore
| | - Violeta Lopez
- School of Nursing, Hubei University of Medicine, Shiyan City, Hubei Province, China
| | - Hong Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chaminda Jayampath Seneviratne
- Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, National Dental Center, Singapore.,Oral Health Academic Clinical Program, Duke NUS Medical School, Singapore
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Ubaida-Mohien C, Moaddel R, Moore AZ, Kuo PL, Faghri F, Tharakan R, Tanaka T, Nalls MA, Ferrucci L. Proteomics and Epidemiological Models of Human Aging. Front Physiol 2021; 12:674013. [PMID: 34135771 PMCID: PMC8202502 DOI: 10.3389/fphys.2021.674013] [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: 02/28/2021] [Accepted: 05/03/2021] [Indexed: 12/21/2022] Open
Abstract
Human aging is associated with a decline of physical and cognitive function and high susceptibility to chronic diseases, which is influenced by genetics, epigenetics, environmental, and socio-economic status. In order to identify the factors that modulate the aging process, established measures of aging mechanisms are required, that are both robust and feasible in humans. It is also necessary to connect these measures to the phenotypes of aging and their functional consequences. In this review, we focus on how this has been addressed from an epidemiologic perspective using proteomics. The key aspects of epidemiological models of aging can be incorporated into proteomics and other omics which can provide critical detailed information on the molecular and biological processes that change with age, thus unveiling underlying mechanisms that drive multiple chronic conditions and frailty, and ideally facilitating the identification of new effective approaches for prevention and treatment.
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Affiliation(s)
- Ceereena Ubaida-Mohien
- Biomedical Research Center, National Institute on Aging, National Institute of Health, Baltimore, MD, United States
| | - Ruin Moaddel
- Biomedical Research Center, National Institute on Aging, National Institute of Health, Baltimore, MD, United States
| | - Ann Zenobia Moore
- Biomedical Research Center, National Institute on Aging, National Institute of Health, Baltimore, MD, United States
| | - Pei-Lun Kuo
- Biomedical Research Center, National Institute on Aging, National Institute of Health, Baltimore, MD, United States
| | - Faraz Faghri
- Center for Alzheimer's and Related Dementias, National Institute on Aging, Bethesda, MD, United States.,Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States.,Data Tecnica International, Glen Echo, MD, United States
| | - Ravi Tharakan
- Biomedical Research Center, National Institute on Aging, National Institute of Health, Baltimore, MD, United States
| | - Toshiko Tanaka
- Biomedical Research Center, National Institute on Aging, National Institute of Health, Baltimore, MD, United States
| | - Mike A Nalls
- Center for Alzheimer's and Related Dementias, National Institute on Aging, Bethesda, MD, United States.,Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States.,Data Tecnica International, Glen Echo, MD, United States
| | - Luigi Ferrucci
- Biomedical Research Center, National Institute on Aging, National Institute of Health, Baltimore, MD, United States
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12
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Tan XR, Huang SY, Gong S, Chen Y, Yang XJ, He QM, He SW, Liu N, Li YQ. Prognostic Value of Pretreatment Serum Cystatin C Level in Nasopharyngeal Carcinoma Patients in the Intensity-modulated Radiotherapy Era. Onco Targets Ther 2021; 14:29-37. [PMID: 33442264 PMCID: PMC7797322 DOI: 10.2147/ott.s286009] [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: 10/12/2020] [Accepted: 12/02/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose Serum cystatin C has been considered as a significant prognostic factor for various malignancies. This study aimed to evaluate the relationship between serum cystatin C level before antitumor treatment and the prognosis of nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT). Patients and Methods A cohort of 2077 NPC patients were enrolled between April 2009 and September 2012. The Kaplan–Meier curves and log rank tests were used to determine the differences of overall survival (OS) and disease-free survival (DFS). Univariate and multivariate Cox regression analyses were used to determine independent prognostic factors. Results Overall, 362/2077 (17.4%) patients had high serum cystatin C level, and they were older and more male (both P<0.001), and they had higher TNM stage (all P<0.05). Kaplan–Meier analysis revealed that patients with high serum cystatin C had worse OS (P<0.001) and DFS (P<0.001). Univariate and multivariate Cox regression analysis showed that high serum cystatin C level was an independent prognostic predictor of OS (HR: 1.56, 95%CI: 1.25–1.95) and DFS (HR: 1.38, 95%CI: 1.13–1.68). Subgroup analysis based on TNM stage revealed that advanced-stage NPC patients with high serum cystatin C had poorer OS (P<0.001) and DFS (P<0.001). Conclusion Our results revealed that high serum cystatin C level before antitumor treatment can predict clinical outcomes of NPC patients treated with IMRT, and it can guide clinicians to formulate more personalized therapy for NPC patients.
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Affiliation(s)
- Xi-Rong Tan
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China
| | - Sheng-Yan Huang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China
| | - Sha Gong
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China
| | - Yang Chen
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China
| | - Xiao-Jing Yang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China
| | - Qing-Mei He
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China
| | - Shi-Wei He
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China
| | - Na Liu
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China
| | - Ying-Qing Li
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China
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13
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Infante B, Franzin R, Madio D, Calvaruso M, Maiorano A, Sangregorio F, Netti GS, Ranieri E, Gesualdo L, Castellano G, Stallone G. Molecular Mechanisms of AKI in the Elderly: From Animal Models to Therapeutic Intervention. J Clin Med 2020; 9:jcm9082574. [PMID: 32784471 PMCID: PMC7464895 DOI: 10.3390/jcm9082574] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/21/2020] [Accepted: 08/05/2020] [Indexed: 12/17/2022] Open
Abstract
Acute kidney injury (AKI), a critical syndrome characterized by a sudden reduction of renal function, is a common disorder among elderly patients particularly in Intensive Care Unit (ICU). AKI is closely associated with both short- and long-term mortality and length of hospital stay and is considered a predictor of chronic kidney disease (CKD). Specific hemodynamic, metabolic, and molecular changes lead to increased susceptibility to injury in the aged kidney; therefore, certain causes of AKI such as the prerenal reduction in renal perfusion or vascular obstructive conditions are more common in the elderly; moreover, AKI is often multifactorial and iatrogenic. Older patients present several comorbidities (diabetes, hypertension, heart failure) and are exposed to multiple medical interventions such as the use of nephrotoxic contrasts media and medications, which can also trigger AKI. Considering the emerging relevance of this condition, prevention and treatment of AKI in the elderly should be crucial in the internist and emergency setting. This review article summarizes the incidence, the risk factors, the pathophysiology, the molecular mechanisms and the strategies of prevention and treatment of AKI in elderly patients.
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Affiliation(s)
- Barbara Infante
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy; (B.I.); (D.M.); (A.M.); (F.S.); (G.S.)
| | - Rossana Franzin
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy; (R.F.); (L.G.)
| | - Desirèe Madio
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy; (B.I.); (D.M.); (A.M.); (F.S.); (G.S.)
| | - Martina Calvaruso
- Nephrology, Dialysis and Transplantation Unit, Department of Biomedical Sciences, University of Foggia, 71122 Foggia, Italy;
| | - Annamaria Maiorano
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy; (B.I.); (D.M.); (A.M.); (F.S.); (G.S.)
| | - Fabio Sangregorio
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy; (B.I.); (D.M.); (A.M.); (F.S.); (G.S.)
| | - Giuseppe Stefano Netti
- Clinical Pathology, Department of Surgical and Medical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy; (G.S.N.); (E.R.)
| | - Elena Ranieri
- Clinical Pathology, Department of Surgical and Medical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy; (G.S.N.); (E.R.)
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy; (R.F.); (L.G.)
| | - Giuseppe Castellano
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy; (B.I.); (D.M.); (A.M.); (F.S.); (G.S.)
- Correspondence: ; Tel.: +39-088-173-2610; Fax: +39-088-173-6001
| | - Giovanni Stallone
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto Luigi 251, 71122 Foggia, Italy; (B.I.); (D.M.); (A.M.); (F.S.); (G.S.)
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14
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Kang E, Han SS, Kim J, Park SK, Chung W, Oh YK, Chae DW, Kim YS, Ahn C, Oh KH. Discrepant glomerular filtration rate trends from creatinine and cystatin C in patients with chronic kidney disease: results from the KNOW-CKD cohort. BMC Nephrol 2020; 21:280. [PMID: 32677901 PMCID: PMC7364655 DOI: 10.1186/s12882-020-01932-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/06/2020] [Indexed: 11/21/2022] Open
Abstract
Background Serum creatinine (Cr) and cystatin C (CysC) can both be used to estimate glomerular filtration rate (eGFRCr and eGFRCysC). However, certain conditions may cause discrepancies between eGFR trends from Cr and CysC, and these remain undetermined in patients with chronic kidney disease (CKD). Methods A total of 1069 patients from the Korean CKD cohort (KNOW-CKD), which enrolls pre-dialytic CKD patients, whose Cr and CysC had been followed for more than 4 years were included in the sample. We performed trajectory analysis using latent class mixed modeling and identified members of the discrepancy group when patient trends between eGFRCr and eGFRCysC differed. Multivariate logistic analyses with Firth’s penalized likelihood regression models were performed to identify conditions related to the discrepancy. Results Trajectory patterns of eGFRCr were classified into three groups: two groups with stable eGFRCr (stable with high eGFRCr and stable with low eGFRCr) and one group with decreasing eGFRCr. Trajectory analysis of eGFRCysC also showed similar patterns, comprising two groups with stable eGFRCysC and one group with decreasing eGFRCysC. Patients in the discrepancy group (decreasing eGFRCr but stable & low eGFRCysC; n = 55) were younger and had greater proteinuria values than the agreement group (stable & low eGFRCr and eGFRCysC; n = 706), differences that remained consistent irrespective of the measurement period (4 or 5 years). Conclusions In the present study, we identify conditions related to discrepant trends of eGFRCr and eGFRCysC. Clinicians should remain aware of such potential discrepancies when tracing both Cr and CysC.
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Affiliation(s)
- Eunjeong Kang
- Department of Internal Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Seung Seok Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Jayoun Kim
- Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sue Kyung Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Wookyung Chung
- Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, South Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Dong-Wan Chae
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yong-Soo Kim
- Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
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Kudryashova KS, Burka K, Kulaga AY, Vorobyeva NS, Kennedy BK. Aging Biomarkers: From Functional Tests to Multi‐Omics Approaches. Proteomics 2020; 20:e1900408. [DOI: 10.1002/pmic.201900408] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/07/2020] [Indexed: 12/15/2022]
Affiliation(s)
| | - Ksenia Burka
- Centaura AG Bleicherweg 10 Zurich 8002 Switzerland
| | - Anton Y. Kulaga
- Centaura AG Bleicherweg 10 Zurich 8002 Switzerland
- Systems Biology of Aging GroupInstitute of Biochemistry of the Romanian Academy Splaiul Independentei 296 Bucharest 060031 Romania
| | | | - Brian K. Kennedy
- Departments of Biochemistry and Physiology Yong Loo Lin School of MedicineNational University of Singapore 8 Medical Drive, MD7, 117596 Singapore
- Singapore Institute for Clinical Sciences (SICS)Agency for Science and Technology (A*STAR)Brenner Centre for Molecular Medicine 30 Medical Drive Singapore 117609 Singapore
- Buck Institute for Research on Aging 8001 Redwood Blvd. Novato CA 94945‐1400 USA
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16
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Stephan Y, Sutin AR, Terracciano A. Subjective Age and Cystatin C Among Older Adults. J Gerontol B Psychol Sci Soc Sci 2020; 74:382-388. [PMID: 29045722 DOI: 10.1093/geronb/gbx124] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/15/2017] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Cystatin C (CysC) is a marker of kidney function that is relevant for the health and cognition of older adults. Little is known about the link between psychological factors and CysC. Therefore, the present study examined whether subjective age is related to CysC level and changes in CysC over time. METHOD Participants were 5,066 individuals drawn from the Health and Retirement Study aged from 50 to 107 years (60% women, mean age = 69.36 years, SD = 9.54). They provided data on subjective age, demographic covariates, and CysC at baseline. CysC was assessed again 4 years later. RESULTS Analysis revealed that an older subjective age was related to higher level of CysC at baseline and to an increase in CysC over 4 years, controlling for demographic factors. An older subjective age was also related to higher risk of exceeding the clinical threshold of CysC at baseline and 4 years later. Additional analysis revealed that disease burden, depressive symptoms, physical inactivity, and BMI partly mediated these associations. CONCLUSION The present study provides new evidence on the role of subjective age as a psychological factor associated with individuals' risk of kidney dysfunction, an association beyond chronological age.
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Affiliation(s)
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee
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17
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Justice JN, Ferrucci L, Newman AB, Aroda VR, Bahnson JL, Divers J, Espeland MA, Marcovina S, Pollak MN, Kritchevsky SB, Barzilai N, Kuchel GA. A framework for selection of blood-based biomarkers for geroscience-guided clinical trials: report from the TAME Biomarkers Workgroup. GeroScience 2018; 40:419-436. [PMID: 30151729 PMCID: PMC6294728 DOI: 10.1007/s11357-018-0042-y] [Citation(s) in RCA: 190] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 08/15/2018] [Indexed: 12/25/2022] Open
Abstract
Recent advances indicate that biological aging is a potentially modifiable driver of late-life function and chronic disease and have led to the development of geroscience-guided therapeutic trials such as TAME (Targeting Aging with MEtformin). TAME is a proposed randomized clinical trial using metformin to affect molecular aging pathways to slow the incidence of age-related multi-morbidity and functional decline. In trials focusing on clinical end-points (e.g., disease diagnosis or death), biomarkers help show that the intervention is affecting the underlying aging biology before sufficient clinical events have accumulated to test the study hypothesis. Since there is no standard set of biomarkers of aging for clinical trials, an expert panel was convened and comprehensive literature reviews conducted to identify 258 initial candidate biomarkers of aging and age-related disease. Next selection criteria were derived and applied to refine this set emphasizing: (1) measurement reliability and feasibility; (2) relevance to aging; (3) robust and consistent ability to predict all-cause mortality, clinical and functional outcomes; and (4) responsiveness to intervention. Application of these selection criteria to the current literature resulted in a short list of blood-based biomarkers proposed for TAME: IL-6, TNFα-receptor I or II, CRP, GDF15, insulin, IGF1, cystatin C, NT-proBNP, and hemoglobin A1c. The present report provides a conceptual framework for the selection of blood-based biomarkers for use in geroscience-guided clinical trials. This work also revealed the scarcity of well-vetted biomarkers for human studies that reflect underlying biologic aging hallmarks, and the need to leverage proposed trials for future biomarker discovery and validation.
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Affiliation(s)
- Jamie N Justice
- Internal Medicine Section on Gerontology and Geriatrics, and the Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA.
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Vanita R Aroda
- Department of Medicine, Division of Diabetes, Endocrinology, and Hypertension Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Judy L Bahnson
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Jasmin Divers
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Santica Marcovina
- Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, WA, 98109, USA
| | - Michael N Pollak
- Department of Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, H3T1E2, Canada
| | - Stephen B Kritchevsky
- Internal Medicine Section on Gerontology and Geriatrics, and the Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Nir Barzilai
- Department of Medicine, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - George A Kuchel
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT, 06030, USA
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Wang CH, Rubinsky AD, Minichiello T, Shlipak MG, Price EL. Creatinine Versus Cystatin C: Differing Estimates of Renal Function in Hospitalized Veterans Receiving Anticoagulants. J Gen Intern Med 2018; 33:1299-1306. [PMID: 29855865 PMCID: PMC6082212 DOI: 10.1007/s11606-018-4461-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 10/13/2017] [Accepted: 04/13/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current practice in anticoagulation dosing relies on kidney function estimated by serum creatinine using the Cockcroft-Gault equation. However, creatinine can be unreliable in patients with low or high muscle mass. Cystatin C provides an alternative estimation of glomerular filtration rate (eGFR) that is independent of muscle. OBJECTIVE We compared cystatin C-based eGFR (eGFRcys) with multiple creatinine-based estimates of kidney function in hospitalized patients receiving anticoagulants, to assess for discordant results that could impact medication dosing. DESIGN Retrospective chart review of hospitalized patients over 1 year who received non-vitamin K antagonist anticoagulation, and who had same-day measurements of cystatin C and creatinine. PARTICIPANTS Seventy-five inpatient veterans (median age 68) at the San Francisco VA Medical Center (SFVAMC). MAIN MEASURES We compared the median difference between eGFR by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) study equation using cystatin C (eGFRcys) and eGFRs using three creatinine-based equations: CKD-EPI (eGFREPI), Modified Diet in Renal Disease (eGFRMDRD), and Cockcroft-Gault (eGFRCG). We categorized patients into standard KDIGO kidney stages and into drug-dosing categories based on each creatinine equation and calculated proportions of patients reclassified across these categories based on cystatin C. KEY RESULTS Cystatin C predicted overall lower eGFR compared to creatinine-based equations, with a median difference of - 7.1 (IQR - 17.2, 2.6) mL/min/1.73 m2 versus eGFREPI, - 21.2 (IQR - 43.7, - 8.1) mL/min/1.73 m2 versus eGFRMDRD, and - 25.9 (IQR - 46.8, - 8.7) mL/min/1.73 m2 versus eGFRCG. Thirty-one to 52% of patients were reclassified into lower drug-dosing categories using cystatin C compared to creatinine-based estimates. CONCLUSIONS We found substantial discordance in eGFR comparing cystatin C with creatinine in this group of anticoagulated inpatients. Our sample size was limited and included few women. Further investigation is needed to confirm these findings and evaluate implications for bleeding and other clinical outcomes. NIH TRIAL REGISTRY NUMBER Not applicable.
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Affiliation(s)
- Christina Hao Wang
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Anna D Rubinsky
- Kidney Health Research Collaborative, UCSF and SFVAMC, San Francisco, CA, USA
| | - Tracy Minichiello
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Michael G Shlipak
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Kidney Health Research Collaborative, UCSF and SFVAMC, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, UCSF, San Francisco, CA, USA
| | - Erika Leemann Price
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
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19
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Schubert CR, Paulsen AJ, Nondahl DM, Dalton DS, Fischer ME, Klein BEK, Klein R, Tweed TS, Cruickshanks KJ. Association Between Cystatin C and 20-Year Cumulative Incidence of Hearing Impairment in the Epidemiology of Hearing Loss Study. JAMA Otolaryngol Head Neck Surg 2018; 144:469-474. [PMID: 29710267 PMCID: PMC6014887 DOI: 10.1001/jamaoto.2018.0041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/24/2018] [Indexed: 01/07/2023]
Abstract
Importance Hearing impairment (HI) is one of the most common conditions affecting older adults. Identification of factors associated with the development of HI may lead to ways to reduce the incidence of this condition. Objective To investigate the association between cystatin C, both as an independent biomarker and as a marker of kidney function, and the 20-year incidence of HI. Design, Setting, and Participants Data were obtained from the Epidemiology of Hearing Loss Study (EHLS), a longitudinal, population-based study in Beaver Dam, Wisconsin. Baseline examinations began in 1993 and continued through 1995, and participants were examined approximately every 5 years, with the most recent examination phase completed in 2015. The EHLS participants with serum cystatin C concentration data and without HI at the baseline examination were included in this study. Main Outcomes and Measures Participants without HI were followed up for incident HI (pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz >25 dB hearing level in either ear) for 20 years. Cystatin C was analyzed as a biomarker (concentration) and used to determine estimated glomerular filtration rate (eGFRCysC). Discrete-time Cox proportional hazards regression models were used to analyze the association between cystatin C concentration and eGFRCysC and the 20-year cumulative incidence of HI. Results There were 863 participants aged 48 to 86 years with cystatin C data and without HI at baseline. Of these, 599 (69.4%) were women. In models adjusted for age and sex, cystatin C was associated with an increased risk of developing HI (hazard ratio [HR], 1.20; 95% CI, 1.07-1.34 per 0.2-mg/L increase in cystatin C concentration), but the estimate was attenuated after further adjusting for educational level, current smoking, waist circumference, and glycated hemoglobin (HR, 1.11; 95% CI, 0.98-1.27 per 0.2-mg/L increase in cystatin C concentration). Low eGFRCysC was significantly associated with the 20-year cumulative incidence of HI in both the age- and sex-adjusted model (HR, 1.70; 95% CI, 1.16-2.48; <60 vs ≥60 mL/min/1.73 m2) and the multivariable-adjusted model (HR, 1.50; 95% CI, 1.02-2.22; <60 vs ≥60 mL/min/1.73 m2). Conclusions and Relevance Reduced kidney function as estimated using cystatin C, but not cystatin C alone, was associated with the 20-year cumulative incidence of HI, suggesting that some age-related HI may occur in conjunction with or as the result of reduced kidney function.
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Affiliation(s)
- Carla R. Schubert
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Adam J. Paulsen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - David M. Nondahl
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Dayna S. Dalton
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Mary E. Fischer
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Barbara E. K. Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Ted S. Tweed
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Karen J. Cruickshanks
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
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Serum cystatin C is an independent biomarker associated with the renal resistive index in patients with chronic kidney disease. PLoS One 2018. [PMID: 29513723 PMCID: PMC5841772 DOI: 10.1371/journal.pone.0193695] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Cystatin C is a cysteine protease inhibitor that is produced by nearly all human cells. The serum level of cystatin C is a stronger predictor of the renal outcome and the risk of cardiovascular events than the creatinine level. The resistive index (RI) on renal Doppler ultrasonography is a good indicator of vascular resistance as well as the renal outcomes in patients with chronic kidney disease (CKD). However, it is unclear whether serum cystatin C is associated with signs of vascular dysfunction, such as the renal RI. We measured the serum cystatin C levels in 101 CKD patients and investigated the relationships between cystatin C and markers of vascular dysfunction, including the renal RI, ankle-brachial pulse wave velocity (baPWV), intima-media thickness (IMT), and cardiac function. The renal RI was significantly correlated with the serum cystatin C level (p < 0.0001, r = 0.6920). The serum cystatin C level was found to be a significant determinant of the renal RI (p < 0.0001), but not the baPWV, in a multivariate regression analysis. The multivariate odds ratio of the serum cystatin C level for a renal RI of more than 0.66 was statistically significant (2.92, p = 0.0106). The area under the receiver-operating characteristic curve comparing the sensitivity and specificity of cystatin C for predicting an RI of more than 0.66 was 0.882 (cutoff value: 2.04 mg/L). In conclusion, the serum cystatin C level is an independent biomarker associated with the renal RI in patients with CKD.
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Kidney function and use of nonsteroidal anti-inflammatory drugs among elderly people: a cross-sectional study on potential hazards for an at risk population. Int J Clin Pharm 2018; 40:870-877. [PMID: 29460083 PMCID: PMC6132969 DOI: 10.1007/s11096-018-0598-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 01/20/2018] [Indexed: 01/01/2023]
Abstract
Background Renal elimination normally decreases with age. Nonsteroidal antiinflammatory drugs (NSAIDs) carry a risk of additional kidney damage. Objective The aims of this study were to assess the prevalence of NSAIDs in the elderly (aged ≥ 65) population in Sweden, explore reasons for any possible differences in the level of use and assess their kidney functions. Setting Data were obtained from the cohort study Good Aging in Skåne, Sweden. Patients aged 65 or more were included. Methods Medication lists were collected as well as variables such as cognition and education levels. Glomerular filtration rate was estimated from creatinine and cystatin C. Descriptive statistics and multiple linear regression analysis were used. MAIN OUTCOME MEASURE NSAID use among the general elderly population. Results A total of 1798 patients were included. Approximately six percent (n = 105) of the people in the study group were using NSAIDs and of those 82 (78%) bought NSAIDs over the counter (OTC). 42% of those buying NSAIDs OTC showed an estimated glomerular filtration rate below 60 ml/min/1.73 m2. Education level did not affect the use of nonsteroidal anti-inflammatory drugs, nor did age. NSAIDs were more commonly used than other recommended analgesics. Conclusion Many people are unaware of the risks associated with the use of NSAIDs. The findings imply that the frailest elderly use NSAIDs to the same extent as the younger elderly do. It is important that information about safety of these drugs be communicated to both patients and healthcare professionals.
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Canney M, Sexton DJ, O'Leary N, Healy M, Kenny RA, Little MA, O'Seaghdha CM. Examining the utility of cystatin C as a confirmatory test of chronic kidney disease across the age range in middle-aged and older community-dwelling adults. J Epidemiol Community Health 2018; 72:287-293. [PMID: 29332011 DOI: 10.1136/jech-2017-209864] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 12/11/2017] [Accepted: 01/02/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cystatin C has been proposed as a confirmatory test of chronic kidney disease (CKD). This is most applicable to older individuals with CKD, the majority of whom have a creatinine-based estimated glomerular filtration rate (eGFR) of 45-59 mL/min/1.73 m2 (CKD stage 3a). We sought to examine the utility of cystatin C as a confirmatory test of CKD across the age range in the general population of older adults. METHODS Cross-sectional analysis of 5386 participants from The Irish Longitudinal Study on Ageing, a cluster-sampled national cohort of community-dwelling adults aged ≥50 years. Cystatin C and creatinine were measured simultaneously using standardised assays. Using generalised additive models, we modelled the distributions of creatinine and cystatin C per year of age from four distributional parameters: location, dispersion, skewness, kurtosis. Among participants with CKD stage 3a, we estimated the predicted probability of cystatin C eGFR <60 mL/min/1.73 m2 ('confirmed CKD') as a function of age. RESULTS Median age was 62 years, 53% were female and median cystatin C eGFR was 80 mL/min/1.73 m2. We observed progressive variability in cystatin C with increasing age. Compared with creatinine, cystatin C levels rose sharply beyond the age of 65. Among participants with CKD stage 3a (n=463), the predicted probability of 'confirmed CKD' increased steadily with age, from 15% at age 50 to 80% at age 80. CONCLUSIONS The clinical utility of cystatin C may be maximised in middle-aged individuals, in whom the distribution of cystatin C is less variable than older adults, and the pretest probability of confirming CKD is lower.
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Affiliation(s)
- Mark Canney
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Trinity Health Kidney Centre, Tallaght Hospital, Dublin, Ireland
| | - Donal J Sexton
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Trinity Health Kidney Centre, Tallaght Hospital, Dublin, Ireland
| | - Neil O'Leary
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Martin Healy
- Department of Biochemistry, St. James' Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Mark A Little
- Trinity Health Kidney Centre, Tallaght Hospital, Dublin, Ireland
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Jenny NS, Olson NC, Allison MA, Rifkin DE, Daniels LB, de Boer IH, Wassel CL, Tracy RP. Biomarkers of Key Biological Pathways in CVD. Glob Heart 2018; 11:327-336.e3. [PMID: 27741979 DOI: 10.1016/j.gheart.2016.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/19/2016] [Accepted: 07/21/2016] [Indexed: 01/30/2023] Open
Abstract
This review provides background on the laboratory design for MESA (Multi-Ethnic Study of Atherosclerosis) as well as the approach used in MESA to select biomarkers for measurement. The research related to the multitude of circulating and urinary biomarkers of inflammation and other novel and emerging biological pathways in MESA is summarized by domain, or pathway, represented by the biomarker. The contributions of MESA biomarkers to our knowledge of these key pathways in the development and progression of atherosclerosis, cardiovascular disease, diabetes, kidney disease, and pulmonary disease are highlighted, as are the contributions of MESA to recommendations for clinical use of several of these biomarkers. In addition, contributions of MESA to multicohort genomics consortia and current collaborations in transomics and metabolomics are noted.
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Affiliation(s)
- Nancy Swords Jenny
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA.
| | - Nels C Olson
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Matthew A Allison
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, USA
| | - Dena E Rifkin
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, USA
| | - Lori B Daniels
- Department of Medicine, Division of Cardiovascular Medicine, University of California, San Diego, CA, USA
| | - Ian H de Boer
- Kidney Research Institute, University of Washington, Seattle, WA, USA
| | - Christina L Wassel
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Russell P Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA; Department of Biochemistry, University of Vermont College of Medicine, Burlington, VT, USA
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Higher Cystatin C Levels Are Associated With Neurocognitive Impairment in Older HIV+ Adults. J Acquir Immune Defic Syndr 2017; 74:243-249. [PMID: 27861242 DOI: 10.1097/qai.0000000000001235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The study aims to determine whether cystatin C is associated with HIV disease and HIV-associated neurocognitive impairment (NCI). METHODS Participants included 124 (HIV+ n = 77; HIV- n = 47) older adults (age ≥ 50 years) examined at the University of California, San Diego HIV Neurobehavioral Research Program. Cystatin C, a biomarker of kidney functioning that has been linked to poor health outcomes, was measured in blood. Participants completed a comprehensive neurocognitive assessment that was used to define both global and domain NCI. RESULTS The HIV+ group had significantly higher cystatin C concentrations than the HIV- group (d = 0.79 P < 0.001). Among HIV+ participants, those with NCI had higher cystatin C concentrations than those without NCI (d = 0.42, P = 0.055), particularly among participants taking tenofovir (d = 0.78, P = 0.004). A receiver-operator characteristic curve identified that cystatin C levels ≥0.75 mg/L were associated with NCI in the HIV+ group. Using this binary variable and including relevant covariates, multivariate modeling confirmed that NCI was associated with higher cystatin C levels (OR = 3.0; P = 0.03). CONCLUSIONS Our results confirm that HIV+ older adults have higher cystatin C than HIV- older adults and further identify that cystatin C may be associated with NCI in this population, particularly if they use tenofovir. This blood biomarker may be a useful clinical tool to identify older HIV+ persons at greater risk for cognitive decline.
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Newman AB, Sanders JL, Kizer JR, Boudreau RM, Odden MC, Zeki Al Hazzouri A, Arnold AM. Trajectories of function and biomarkers with age: the CHS All Stars Study. Int J Epidemiol 2016; 45:1135-1145. [PMID: 27272182 DOI: 10.1093/ije/dyw092] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Multimorbidity is a major driver of physical and cognitive impairment, but rates of decline are also related to ageing. We sought to determine trajectories of decline in a large cohort by disease status, and examined their correspondence with biomarkers of ageing processes including growth hormone, sex steroid, inflammation, visceral adiposity and kidney function pathways. METHODS We have followed the 5888 participants in the Cardiovascular Health Study (CHS) for healthy ageing and longevity since 1989-90. Gait speed, grip strength, modified mini-mental status examination (3MSE) and the digit symbol substitution test (DSST) were assessed annually to 1998-99 and again in 2005-06. Insulin-like growth hormone (IGF-1), dehydroepiandrosterone sulphate (DHEAS), interleukin-6 (IL-6), adiponectin and cystatin-C were assessed 3-5 times from stored samples. Health status was updated annually and dichotomized as healthy vs not healthy. Trajectories for each function measure and biomarker were estimated using generalized estimating equations as a function of age and health status using standardized values. RESULTS Trajectories of functional decline showed strong age acceleration late in life in healthy older men and women as well as in chronically ill older adults. Adiponectin, IL-6 and cystatin-C tracked with functional decline in all domains; cystatin-C was consistently associated with functional declines independent of other biomarkers. DHEAS was independently associated with grip strength and IL-6 with grip strength and gait speed trajectories. CONCLUSIONS Functional decline in late life appears to mark a fundamental ageing process in that it occurred and was accelerated in late life regardless of health status. Cystatin C was most consistently associated with these functional declines.
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Affiliation(s)
- Anne B Newman
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jason L Sanders
- Harvard Affiliated Emergency Medicine Residency, Massachusetts General Hospital, and Brigham and Women's Hospital Department of Emergency Medicine, Boston, MA, USA
| | - Jorge R Kizer
- Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, Bronx, NY, USA
| | - Robert M Boudreau
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michelle C Odden
- Department of Epidemiology, Oregon State University, Corvallis, OR, USA
| | | | - Alice M Arnold
- Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA, USA
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Heianza Y, Hara S, Saito K, Tsuji H, Tanaka S, Kodama S, Kobayashi T, Arase Y, Sone H. Assessment of kidney dysfunction with cystatin C- and creatinine-based estimated glomerular filtration rate and predicting type 2 diabetes: Toranomon Hospital Health Management Center Study 21. Diabetes Res Clin Pract 2016; 113:60-8. [PMID: 26972964 DOI: 10.1016/j.diabres.2016.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/17/2016] [Accepted: 01/22/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Whether early stages of kidney dysfunction assessed by the estimated glomerular filtration rate from cystatin C measurements (eGFRCysC) rather than from creatinine measurements (eGFRCr) would more precisely reflect the risk of developing type 2 diabetes (T2D) has not been clarified. We compared the risk of developing T2D associated with renal dysfunction indicated by eGFRCysC or eGFRCr measurements. METHODS Studied were 2131 Japanese individuals without diabetes. Hazard ratios (HRs) for the development of T2D over 3-5 y were calculated across categories of eGFRCysC and eGFRCr, respectively. RESULTS Reduced levels of eGFRCysC were associated with a step-wise increase in the cumulative incidence rate of T2D (p=0.007). In comparison with the eGFRCysC >85th percentile group (≥ 117.4 ml/min/1.73 m(2)), the lowest group, which was the eGFRCysC <15th percentile group (<86.2 ml/min/1.73 m(2)), had an adjusted HR of 2.30 (95% CI 1.13, 4.68) for T2D. Compared with the eGFRCr >85th percentile group, the lowest eGFRCr group (<15th percentile) had an HR of 1.19 (0.63, 2.24) for T2D. However, individuals with eGFRCr <60 ml/min/1.73 m(2) had a significantly increased risk of T2D. Clustering of both low eGFRCysC and low eGFRCr further elevated the HR for T2D compared with the presence of either. CONCLUSIONS Although eGFRCr in ranges indicating chronic kidney disease reflected an elevated risk of developing diabetes, earlier stages of kidney dysfunction indicated by reduced eGFRCysC, which could not be captured by reduced eGFRCr, would be a marker for an elevated risk of developing T2D.
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Affiliation(s)
- Yoriko Heianza
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Shigeko Hara
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Kazumi Saito
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Hiroshi Tsuji
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Shiro Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Satoru Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Tetsuro Kobayashi
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Yasuji Arase
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan.
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Huang R, Gu J, Cao Q, Ma J, Gu W, Fan Z. The association between serum cystatin C and carotid intima–media thickness in metabolic syndrome patients with normal estimated glomerular filtration rate. Clin Chim Acta 2015; 448:170-3. [DOI: 10.1016/j.cca.2015.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/03/2015] [Accepted: 07/06/2015] [Indexed: 12/09/2022]
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Zhang Y, Zhu Y, Wu Y, Wang G, Xie X, Ke R, Li S, Liu L, Fen W, Li F, Li F, Li M. Serum cystatin C as a potential biomarker for the evaluation COPD. Int J Clin Exp Med 2014; 7:5484-5490. [PMID: 25664059 PMCID: PMC4307506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 11/25/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Imbalance between protease-antiprotease plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Cystatin C in circulating blood is a cysteine protease inhibitor and contributes to elastolysis and tissue destruction. OBJECTIVES The aims of the present study were to investigate whether cystatin C was a promising biomarker for the evaluation and follow-up of patients with COPD. METHODS Serum cystatin C level was determined in groups of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (n = 93), stable COPD (SCOPD) (n = 299) and healthy controls (n = 151). The influences of smoking on the level of serum cystatin C and the correlation of cystatin C with lung functional parameters were further analyzed. RESULTS Serum cystatin C level was significantly higher in COPD patients than that of healthy controls. Smoking increased serum cystatin C level in patients with SCOPD but not in AECOPD and control. In SCOPD group, serum cystatin C level was positively correlated with RV%TLC and negatively correlations with FEV1% predicted, FEV1%FVC, MMEF75/25% predicted, MVV% predicted and DLco% predicted. In multiple line analysis, FEV1% predicted and age were found to be independent predictors of serum cystatin C levels, but not smoking statue, sex and BMI. CONCLUSIONS COPD had a higher level of serum cystatin C, smoking only increased cystatin C level in SCOPD. Serum cystatin C level was negatively correlated with FEV1% predicted. These results suggest that cystatin C might be a potential biomarker for lung tissue destruction and severity of COPD.
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Affiliation(s)
- Yonghong Zhang
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Yanting Zhu
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Yuanyuan Wu
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Guizuo Wang
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Xinming Xie
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Rui Ke
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Shaojun Li
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Lu Liu
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Wei Fen
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Fengjuan Li
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Fangxia Li
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
| | - Manxiang Li
- Department of Respiratory Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University Xi'an 710004, Shanxi, People's Republic of China
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Werner KB, Elmståhl S, Christensson A, Pihlsgård M. Male sex and vascular risk factors affect cystatin C-derived renal function in older people without diabetes or overt vascular disease. Age Ageing 2014; 43:411-7. [PMID: 24321840 PMCID: PMC4001172 DOI: 10.1093/ageing/aft191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background/objectives: to explore the effect of ageing on renal function with cystatin C as the marker of glomerular filtration rate (GFR) in the general population without vascular disease or diabetes. Design: a cross-sectional analysis of a healthy subset from the Good Aging in Skåne-cohort study representative of the Swedish general population. Subjects: 1252 participants without vascular disease and diabetes (43.9% men) of whom 203 were over 80 years old were included from the original cohort of 2931. Methods: plasma cystatin C and plasma creatinine were used as markers for GFR. Estimated GFR (eGFR) was calculated with three chronic kidney disease epidemiology collaboration (CKD-EPI) formulas involving cystatin C, creatinine or both. Results: the median for plasma cystatin C was 0.93 mg/l (60–69 years old), 1.04 (70–79 years old) and 1.24 (80+ years old). The difference in mg/l between the 5th and 95th percentile was 0.46, 0.62 and 0.90 for these age groups. Male sex increased the age effect on plasma cystatin C levels with 0.004 mg/l/year (P = 0.03), adjusted for vascular risk factors. Smoking, lower HDL and higher diastolic blood pressure were associated with higher cystatin C levels. 54.7% (CKD-EPI creatinine) to 73.9% (CKD-EPI cystatin C) of the 80+ had an eGFR < 60 ml/min/1.73 m2. Conclusion: non-diabetics without overt vascular disease exhibit an age related but heterogeneous decline in renal function. The ageing effect is more pronounced in men. At least half of healthy 80+ years old could be expected to have at least CKD Stage 3 with eGFR < 60 ml/min/1.73 m2.
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Affiliation(s)
- Karin Birgitta Werner
- Department of Health Sciences, Lund University, Geriatriska kliniken Jan Waldenströmgata 35, Malmö 205 02, Sweden
- Department of Geriatrics, Skåne University Hospital, Jan Waldenströmsgata 35, Malmö 205 02, Sweden
- Address correspondence to: K. B. Werner.
| | - Sölve Elmståhl
- Department of Health Sciences, Lund University, Geriatriska kliniken Jan Waldenströmgata 35, Malmö 205 02, Sweden
- Department of Geriatrics, Skåne University Hospital, Jan Waldenströmsgata 35, Malmö 205 02, Sweden
| | - Anders Christensson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Nephrology and Transplantation, Skåne University Hospital, Malmö, Sweden
| | - Mats Pihlsgård
- Department of Health Sciences, Lund University, Geriatriska kliniken Jan Waldenströmgata 35, Malmö 205 02, Sweden
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Zhang WG, Bai XJ, Sun XF, Cai GY, Bai XY, Zhu SY, Zhang M, Chen XM. Construction of an integral formula of biological age for a healthy Chinese population using principle component analysis. J Nutr Health Aging 2014; 18:137-42. [PMID: 24522464 DOI: 10.1007/s12603-013-0345-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Whereas chronological age (CA) cannot distinguish functional differences among individuals of the same age, the biological age (BA) may be used to reflect the functional state of the body. The purpose of this study was to construct an integral formula of the BA, by using principle component analysis (PCA). METHODS The vital organ function of 505 healthy individuals of Han origin (age 35-91 years) was examined. A total of 114 indicators of cardiovascular, pulmonary, and brain functions, and clinical, inflammatory, genetic, psychological, and life habit factors were assessed as candidate indicators of aging. Candidate indicators were submitted with CA to correlation and redundancy analyses. The PCA method was used to build an integral formula of the BA for the population. RESULTS Seven biomarkers were selected in accordance with a certain load standard. These biomarkers included the trail making test (TMT), pulse pressure (PP), mitral valve annulus ventricular septum of the peak velocity of early filling (MVES), minimum carotid artery intimal-medial thickness (IMTmin), maximum internal diameter of the carotid artery (Dmax), maximal midexpiratory flow rate 75/25 (MMEF75/25), and Cystatin C (CysC). The formula for the BA was: BA = 0.0685 (TMT) + 0.267 (PP) - 1.375 (MVES) + 22.443 (IMTmin) + 2.962 (Dmax) - 2.332 (MMEF75/25) + 16.104 (CysC) + 0.137 (CA) + 0.492. CONCLUSION Several genetic and lifestyle indicators were considered as candidate markers of aging. However, ultimately, only markers reflecting the function of the vital organs were included in the BA formula. This study represents a useful attempt to employ multiple indicators to build a comprehensive BA evaluation formula of aging populations.
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Affiliation(s)
- W-G Zhang
- Xiang-Mei Chen, Department of Nephrology, Kidney Institute of Chinese PLA, Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases, Beijing, 100853, People's Republic of China, , Phone: 86-010-66937463, Fax: 86-010-68130297
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Salgado JV, França AK, Cabral NA, Lages J, Ribeiro VS, Santos AM, Salgado BJ. Cystatin C, kidney function, and cardiovascular risk factors in primary hypertension. Rev Assoc Med Bras (1992) 2013; 59:21-7. [PMID: 23440138 DOI: 10.1590/s0104-42302013000100007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 07/10/2012] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To investigate the clinical usefulness of serum cystatin C (Scys) and cystatin C-based equations for the screening of chronic kidney disease in primary hypertensive patients, and correlate these markers with risk factors for cardiovascular disease. METHODS A cross-sectional study was performed in 199 middle-aged adults at a basic health unit. Kidney function assessment included measurements of serum creatinine (Scr) and Scys levels, 24-hour microalbuminuria (MA), as well as glomerular filtration rate (GFR) through Larsson and Modification of Diet in Renal Disease (MDRD) study equations. Bland- Altman plot analysis was used to calculate the agreement between equations. RESULTS High levels of Scys were found in 22% of the patients, even with normal values of GFR estimated by MDRD study equation. Systolic blood pressure and MA correlated better with Scys than Scr, but there was no correlation between Scys and diastolic blood pressure. Gender, age > 60 years, MA, and uric acid were significantly associated with high Scys levels. After multivariate analysis, only age > 60 yrs (RR = 6.4; p < 0.001) and male gender (RR = 3.0; p = 0.006) remained associated with high Scys levels. CONCLUSION Cystatin C can be used as a screening marker both for detecting mild declines of renal function and for preventing the risk of cardiovascular events in hypertensive subjects with presumably normal renal function.
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Affiliation(s)
- João Victor Salgado
- Kidney Disease Prevention Centre, Universidade Federal do Maranhão, São Luís, MA, Brazil.
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Yamashita H, Nishino T, Obata Y, Nakazato M, Inoue K, Furusu A, Takamura N, Maeda T, Ozono Y, Kohno S. Association between cystatin C and arteriosclerosis in the absence of chronic kidney disease. J Atheroscler Thromb 2013; 20:548-56. [PMID: 23574755 DOI: 10.5551/jat.13193] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
AIM Chronic kidney disease (CKD) is a known risk factor for cardiovascular disease (CVD). Cystatin C was recently reported to be an endogenous surrogate of kidney function, and a high level of cystatin C is reported to be a strong predictor of CVD; however, the association between cystatin C and arteriosclerosis in a non-CKD population is unclear. This study aimed to clarify the association between cystatin C and arteriosclerosis in a non-CKD population. METHODS Of the 637 Japanese adults (264 men, 373 women) enrolled, we analyzed 446 participants with an estimated glomerular filtration rate (eGFR) >60 mL/min and no proteinuria (177 men, 269 women) without a history of CVD. Kidney function was evaluated according to serum cystatin C levels and eGFR. Arteriosclerosis was evaluated on the basis of the cardio-ankle vascular index (CAVI) and carotid intima-media thickness (CIMT). RESULTS The mean age of our subjects was 67.0±10.0 years. No variables showed any significant differences according to gender. The results of multiple linear regression analysis showed a significant correlation between serum cystatin C and CAVI only in women, but not CIMT. CONCLUSION We observed a significant correlation between cystatin C and CAVI, which is a marker of early-stage arteriosclerosis, in women in a non-CKD population with no proteinuria and eGFR>60 mL/min.
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Affiliation(s)
- Hiroshi Yamashita
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan
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Lassus J, Harjola VP. Cystatin C: a step forward in assessing kidney function and cardiovascular risk. Heart Fail Rev 2013; 17:251-61. [PMID: 21431356 DOI: 10.1007/s10741-011-9242-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The cardiorenal syndrome is a clinical manifestation of the bidirectional interaction between the heart and kidneys. Evaluating renal function is an essential part of the assessment of every cardiac patient. It has become clear that serum creatinine is not an accurate enough marker of glomerular filtration rate (GFR) and should not be used to evaluate kidney dysfunction. Creatinine-based estimates of GFR are preferred, but require renal function to be stable and are not suitable when changes in kidney function occur. Cystatin C (CysC) has been the target of much interest in the search for an alternative measure of GFR. As an endogenous biomarker, CysC possesses many of the properties required of a good marker of renal function. Compared with that of creatinine, plasma concentrations of CysC are less influenced by factors other than GFR. Consequently, CysC correlates with true GFR more accurately than creatinine. Equations for estimating GFR from CysC values have also been developed, which makes values easier to interpret and facilitates the clinical use of this new marker. The use of CysC in acute kidney injury has also shown promising results. CysC has been studied as a risk marker for prognosis in cardiovascular disease. This effect is attributed to the strong impact of renal dysfunction on progressive cardiovascular disease and impaired survival. Higher levels of CysC have consistently been predictive of incident or recurrent cardiovascular events and adverse outcomes. CysC is a predictor of the development of heart failure and increased levels of CysC have an independent association with higher mortality in both chronic and acute heart failure. In conclusion, CysC appears to be an interesting marker of renal function and is useful for risk stratification in heart failure.
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Affiliation(s)
- Johan Lassus
- Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
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Odden MC, Tager IB, Gansevoort RT, Bakker SJL, Fried LF, Newman AB, Katz R, Satterfield S, Harris TB, Sarnak MJ, Siscovick D, Shlipak MG. Hypertension and low HDL cholesterol were associated with reduced kidney function across the age spectrum: a collaborative study. Ann Epidemiol 2013; 23:106-11. [PMID: 23313266 PMCID: PMC3570601 DOI: 10.1016/j.annepidem.2012.12.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 12/06/2012] [Accepted: 12/06/2012] [Indexed: 01/01/2023]
Abstract
PURPOSE To determine if the associations among established risk factors and reduced kidney function vary by age. METHODS We pooled cross-sectional data from 14,788 nondiabetics aged 40 to 100 years in 4 studies: Cardiovascular Health Study, Health, Aging, and Body Composition Study, Multi-Ethnic Study of Atherosclerosis, and Prevention of Renal and Vascular End-Stage Disease cohort. RESULTS Hypertension and low high-density lipoprotein (HDL) cholesterol were associated with reduced cystatin C-based estimated glomerular filtration rate (eGFR) across the age spectrum. In adjusted analyses, hypertension was associated with a 2.3 (95% confidence interval [CI], 0.1, 4.4), 5.1 (95% CI, 4.1, 6.1), and 6.9 (95% CI, 3.0, 10.4) mL/min/1.73 m(2) lower eGFR in participants 40 to 59, 60 to 79, and at least 80 years, respectively (P for interaction < .001). The association of low HDL cholesterol with reduced kidney function was also greater in the older age groups: 4.9 (95% CI, 3.5, 6.3), 7.1 (95% CI, 6.0, 8.3), 8.9 (95% CI, 5.4, 11.9) mL/min/1.73 m(2) (P for interaction < .001). Smoking and obesity were associated with reduced kidney function in participants under 80 years. All estimates of the potential population impact of the risk factors were modest. CONCLUSIONS Hypertension, obesity, smoking, and low HDL cholesterol are modestly associated with reduced kidney function in nondiabetics. The associations of hypertension and HDL cholesterol with reduced kidney function seem to be stronger in older adults.
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Affiliation(s)
- Michelle C Odden
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
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Donneurs à critères élargis: jusqu’où ? MEDECINE INTENSIVE REANIMATION 2013. [DOI: 10.1007/s13546-012-0626-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lopez OL, Becker JT, Kuller LH. Patterns of compensation and vulnerability in normal subjects at risk of Alzheimer's disease. J Alzheimers Dis 2013; 33 Suppl 1:S427-38. [PMID: 22669014 PMCID: PMC3951098 DOI: 10.3233/jad-2012-129015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Alzheimer's disease (AD) is the most frequent form of dementia in elderly individuals and its incidence and prevalence increases with age. This risk of AD is increased in the presence of genetic and demographic factors including apolipoprotein E 4 allele, lower education, and family history of AD. There are medical risk modifiers including systemic hypertension, diabetes mellitus, cardiovascular disease, and cerebrovascular disease that increase the vulnerability for AD. By contrast, there are lifestyle risk modifiers that reduce the effects of AD risk factors include diet and physical and cognitive activity. Our research has consistently shown that it is the interactions among these risk factors with the pathobiological cascade of AD that determine the likelihood of a clinical expression of AD-either as dementia or mild cognitive impairment. However, the association between "vulnerability" and "protective" factors varies with age, since the effects of these factors on the risk for AD may differ in younger (age < 80) versus older (age > 80) individuals. The understanding of the dynamic of these factors at different age periods will be essential for the implementation of primary prevention treatments for AD.
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Affiliation(s)
- Oscar L Lopez
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15215, USA.
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Zamora E, Lupón J, de Antonio M, Vila J, Galán A, Gastelurrutia P, Urrutia A, Bayes-Genis A. Limited value of cystatin-C over estimated glomerular filtration rate for heart failure risk stratification. PLoS One 2012; 7:e51234. [PMID: 23240006 PMCID: PMC3519756 DOI: 10.1371/journal.pone.0051234] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 10/30/2012] [Indexed: 01/02/2023] Open
Abstract
Background To compare the prognostic value of estimated glomerular filtration rate, cystatin-C, an alternative renal biomarker, and their combination, in an outpatient population with heart failure.Estimated glomerular filtration rate is routinely used to assess renal function in heart failure patients. We recently demonstrated that the Cockroft-Gault formula is the best among the most commonly used estimated glomerular filtration rate formulas for predicting heart failure prognosis. Methodology/Principal Findings A total of 879 consecutive patients (72% men, age 70.4 years [P25–75 60.5–77.2]) were studied. The etiology of heart failure was mainly ischemic heart disease (52.7%). The left ventricular ejection fraction was 34% (P25–75 26–43%). Most patients were New York Heart Association class II (65.8%) or III (25.9%). During a median follow-up of 3.46 years (P25–75 1.85–5.05), 312 deaths were recorded. In an adjusted model, estimated glomerular filtration rate and cystatin-C showed similar prognostic value according to the area under the curve (0.763 and 0.765, respectively). In Cox regression, the multivariable analysis hazard ratios were 0.99 (95% CI: 0.98–1, P = 0.006) and 1.14 (95% CI: 1.02–1.28, P = 0.02) for estimated glomerular filtration rate and cystatin-C, respectively. Reclassification, assessed by the integration discrimination improvement and the net reclassification improvement indices, was poorer with cystatin-C (−0.5 [−1.0;−0.1], P = 0.024 and −4.9 [−8.8;−1.0], P = 0.013, respectively). The value of cystatin-C over estimated glomerular filtration rate for risk-stratification only emerged in patients with moderate renal dysfunction (eGFR 30–60 ml/min/1.73 m2, chi-square 12.9, P<0.001). Conclusions/Significance Taken together, the results indicate that estimated glomerular filtration rate and cystatin-C have similar long-term predictive values in a real-life ambulatory heart failure population. Cystatin-C seems to offer improved prognostication in heart failure patients with moderate renal dysfunction.
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Affiliation(s)
- Elisabet Zamora
- Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Josep Lupón
- Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Marta de Antonio
- Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Joan Vila
- Inflammatory and Cardiovascular Disease Programme, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
- CIBER Epidemiology and Public Health, Barcelona, Spain
| | - Amparo Galán
- Biochemistry Service, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Paloma Gastelurrutia
- Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Agustín Urrutia
- Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Antoni Bayes-Genis
- Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
- * E-mail:
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Poortmans JR, Gulbis B, De Bruyn E, Baudry S, Carpentier A. Limitations of serum values to estimate glomerular filtration rate during exercise. Br J Sports Med 2012; 47:1166-70. [DOI: 10.1136/bjsports-2012-090976] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Salgado JV, Salgado BJ, Neves FA. Cystatin C may better reflect the effect of obesity on renal function. Obesity (Silver Spring) 2012; 20:1136. [PMID: 22627976 DOI: 10.1038/oby.2011.366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Baird GS, Nelson SK, Keeney TR, Stewart A, Williams S, Kraemer S, Peskind ER, Montine TJ. Age-dependent changes in the cerebrospinal fluid proteome by slow off-rate modified aptamer array. THE AMERICAN JOURNAL OF PATHOLOGY 2012; 180:446-56. [PMID: 22122984 PMCID: PMC3349859 DOI: 10.1016/j.ajpath.2011.10.024] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 10/06/2011] [Accepted: 10/13/2011] [Indexed: 10/15/2022]
Abstract
An important precondition for the successful development of diagnostic assays of cerebrospinal fluid (CSF) biomarkers of age-related neurodegenerative diseases is an understanding of the dynamic nature of the CSF proteome during the normal aging process. In this study, a novel proteomic technology was used to quantify hundreds of proteins simultaneously in the CSF from 90 cognitively normal adults 21 to 85 years of age. SomaLogic's highly multiplexed proteomic platform can measure more than 800 proteins simultaneously from small volumes of biological fluids using novel slow off-rate modified aptamer (SOMAmer) protein affinity reagents with sensitivity, specificity, and dynamic ranges that meet or exceed those of enzyme-linked immunosorbent assays. In the first application of this technology to CSF, we detected 248 proteins that possessed signals greater than twofold over background. Several novel correlations between detected protein concentrations and age were discovered that indicate that both inflammation and response to injury in the central nervous system may increase with age. Applying this powerful proteomic approach to CSF provides potential new insight into the aging of the human central nervous system that may have utility in discovering new disease-related changes in the CSF proteome.
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Affiliation(s)
- Geoffrey S Baird
- Department of Laboratory Medicine, University of Washington, Harborview Medical Center, Box 359743, 325 9th Avenue, Seattle, WA 98105, USA.
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Serum cystatin C as a predictor for cardiovascular events in end-stage renal disease patients at the initiation of dialysis. Clin Exp Nephrol 2012; 16:456-63. [PMID: 22278599 DOI: 10.1007/s10157-011-0583-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 12/26/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND There has been no study to investigate whether cystatin C could predict cardiovascular events in incident dialysis patients. We aimed to delineate the role of serum cystatin C and cystatin C-based estimated glomerular filtration rate (eGFR(cysC)) for prediction of cardiovascular events. METHODS This study included 66 end-stage renal disease patients who survived for >3 months after the start of dialysis, and serum cystain C levels were measured at the point of dialysis initiation. RESULTS Serum cystatin C was correlated with blood urea nitrogen (r = 0.537, p < 0.001), serum creatinine (r = 0.480, p < 0.001) and smoking (r = 0.284, p = 0.021). Cystatin C was inversely correlated with age (r = -0.316, p = 0.01) and eGFR(Cr) by modification of diet in renal disease (r = -0.533, p < 0.001). Kaplan-Meier analysis for cardiovascular events revealed that patients in the group with lower cystatin C levels (<4.14 mg/L) had a better event-free survival rate than patients in the group with higher cystatin C levels (≥4.14 mg/L) (p = 0.039). In univariate analysis, cystatin C (hazard ratio (HR) 2.62, p = 0.011) and eGFR(cysC) (HR 0.64, p = 0.004) were significant factors for the prediction of cardiovascular events. After multivariate adjustment, serum cystatin C and eGFR(cysC) were independent determinants of cardiovascular events (HR 3.952, p = 0.001 and HR 0.640, p = 0.004, respectively). CONCLUSION Serum cystatin C might be an independent marker of cardiovascular events in incident dialysis patients. Furthermore, eGFR(cysC) based on measured serum cystatin C could have a new role in predicting cardiovascular events beyond the estimation of true GFR.
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Hannemann A, Friedrich N, Dittmann K, Spielhagen C, Wallaschofski H, Völzke H, Rettig R, Endlich K, Lendeckel U, Stracke S, Nauck M. Age- and sex-specific reference limits for creatinine, cystatin C and the estimated glomerular filtration rate. Clin Chem Lab Med 2011; 50:919-26. [PMID: 22080819 DOI: 10.1515/cclm.2011.788] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 10/21/2011] [Indexed: 11/15/2022]
Abstract
BACKGROUND Early detection of patients with chronic kidney disease is of great importance. This study developed reference limits for serum creatinine and serum cystatin C concentrations and for the estimated glomerular filtration rate (eGFR) in healthy subjects from the general population aged 25-65 years. METHODS This study defined a reference population including 985 subjects from the first follow-up of the Study of Health in Pomerania. Serum creatinine was measured with a modified kinetic Jaffé method. Serum cystatin C was measured with a nephelometric assay. The eGFR was calculated from serum creatinine according to the Cockcroft-Gault (eGFR(CG)) and the Modification of Diet in Renal Disease (eGFR(MDRD)) equation, respectively, as well as from serum cystatin C according to the formula by Larsson (eGFR(Larsson)). Non-parametric quantile regression was used to estimate the reference limits. For serum creatinine and serum cystatin C the 95th percentile and for eGFR(CG), eGFR(MDRD) and eGFR(Larsson) the 5th percentile were selected as reference limits. All data was weighted to reflect the age- and sex-structure of the German population in 2008. RESULTS The reference limits for serum creatinine (men: 1.11-1.23 mg/dL; women: 0.93-1.00 mg/dL) and serum cystatin C levels (men: 0.92-1.04 mg/L; women: 0.84-1.02 mg/L) increased with advancing age. The reference limits for eGFR decreased with increasing age (eGFR(CG) men: 106.0-64.7 mL/min, women 84.4-57.9 mL/min; eGFR(MDRD) men: 82.5-62.2 mL/min/1.73 m², women 75.0-58.2 mL/min/1.73 m²; eGFR(Larsson) men: 85.5-72.9 mL/min, women 94.5-75.7 mL/min). CONCLUSIONS This study presents age- and sex-specific reference limits for five measures of renal function based on quantile regression models.
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Affiliation(s)
- Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.
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Roderick PJ. Chronic kidney disease in older people: a cause for concern? Nephrol Dial Transplant 2011; 26:3083-6. [PMID: 21917730 DOI: 10.1093/ndt/gfr515] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
The aging process affects all organs, including the kidneys. As part of this process, progressive scarring and a measurable decline in renal function occur in most people over time. The improved understanding of the processes that can lead to and/or hasten scarring and loss of renal function over time parallels advances in our understanding of the aging process. Clinical factors, including hypertension, diabetes mellitus, obesity, abnormal lipid levels and vitamin D deficiency, have been associated with increasing renal sclerosis with age. In addition, tissue factors such as angiotensin II, advanced glycation end products, oxidative stress and Klotho are associated with renal aging. These associations and possible interventions, including the control of blood pressure, blood sugar, weight, diet and calorie restriction might make renal aging more preventable than inevitable.
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Davenport A, Cholongitas E, Xirouchakis E, Burroughs AK. Pitfalls in assessing renal function in patients with cirrhosis--potential inequity for access to treatment of hepatorenal failure and liver transplantation. Nephrol Dial Transplant 2011; 26:2735-42. [PMID: 21690201 DOI: 10.1093/ndt/gfr354] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Serum creatinine is universally used to assess renal function in clinical practice. Creatinine and changes in serum creatinine are used to define acute kidney injury and hepatorenal syndrome (HRS) in patients with progressive liver disease. In addition, creatinine is a key variable in the calculation used to determine priority for liver transplantation in many countries. As there is no universal standardized creatinine assay, there is variation in creatinine determinations between laboratory assays, compounded by assay interference due to chromogens, including bilirubin. This leads to patients with the same actual renal function potentially being offered different treatment options, in terms of access to therapy for HRS and priority waiting time for liver transplantation. Alternative methods for assessing renal function either also tend to overestimate renal function or are too time consuming and expensive to provide practical alternatives for standard clinical practice. Standardization of creatinine assays with readily available reference standards would help minimize interlaboratory variation; of the current creatinine assays, enzymatic creatinine appears more accurate, but even this is inaccurate at high bilirubin concentrations. Further work is required to determine whether interpatient variation can be reduced by correcting creatinine and cystatin measurements for muscle mass.
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Targońska-Stepniak B, Majdan M. Cystatin C concentration is correlated with disease activity in rheumatoid arthritis patients. Scand J Rheumatol 2011; 40:341-6. [PMID: 21619490 DOI: 10.3109/03009742.2011.571219] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Rheumatoid arthritis (RA) is a systemic, inflammatory disease. Renal involvement worsens the course of RA and increases mortality. It is suggested that chronic inflammatory processes may contribute to renal impairment. The aim of this study was to investigate the impact of chronic inflammation and RA activity on glomerular filtration rate (GFR). METHODS The study population consisted of 140 RA patients. High disease activity was observed in 42 patients (30%), and long-term RA (duration ≥ 10 years) in 64 (45.7%). Measures of renal function included: serum cystatin C, serum creatinine (SCr), and creatinine-based estimated GFR (eGFR) calculated by Cockcroft and Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulas. RESULTS The mean (SD) cystatin C concentration was 0.77 (0.2) mg/L, SCr 0.71 (0.23) mg/dL, eGFR(CG) 110.5 (37.8) mL/min/1.73 m², and eGFR(MDRD) 109.5 (34.5) mL/min/1.73 m². Cystatin C levels correlated positively with creatinine, and negatively with eGFR(CG) and eGFR(MDRD). Cystatin C concentration was significantly higher in patients with high disease activity, long-term RA, and hypertension, and in males. Patients currently being treated with biologics had non-significantly lower cystatin C levels than those treated with conventional modifying drugs. Cystatin C levels were significantly associated with markers of clinical, functional disease activity, and markers of inflammation. By contrast, there were no such correlations with other parameters of renal function. CONCLUSIONS In patients with RA, cystatin C may be not only an indicator of GFR but also a marker of intensity of chronic inflammatory processes.
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Affiliation(s)
- B Targońska-Stepniak
- Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Lublin, Poland.
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Evangelopoulos AA, Vallianou NG, Bountziouka VP, Giotopoulou AN, Bonou MS, Barbetseas J, Avgerinos PC, Panagiotakos DB. The impact of demographic characteristics and lifestyle in the distribution of cystatin C values in a healthy greek adult population. Cardiol Res Pract 2010; 2011:163281. [PMID: 20976124 PMCID: PMC2957100 DOI: 10.4061/2011/163281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 10/03/2010] [Indexed: 11/20/2022] Open
Abstract
Background. The aim of the present study was to examine sources of variation for serum cystatin C in a healthy Greek population. Methods. Cystatin C together with basic clinical chemistry tests was measured in a total of 490 adults (46 ± 16 yrs, 40% males) who underwent an annual health check. Demographic, anthropometric, and lifestyle characteristics were recorded. Results. Higher values of cystatin C were observed among males (P = .04), participants aged over 65 years (P < .001), current smokers (P = .001) and overweight/obese participants (P = .03). On the contrary, alcohol consumption and physical activity seemed to have no influence on cystatin C levels (P = .61; P = .95, resp.). Conclusions. In interpreting serum cystatin C values in a healthy adult population, age, gender, Body Mass Index, and cigarette smoking need to be considered, and determination of reference ranges among distinct subpopulations seem to be prudent.
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