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Araya AV, Bezanilla CG, Figueroa M, Pino J, Cancino J, Mackenney B. Efectos de una rutina de ejercicios de resistencia aplicada a pacientes con enfermedad renal crónica durante la hemodiálisis. REVISTA MÉDICA CLÍNICA LAS CONDES 2023. [DOI: 10.1016/j.rmclc.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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Than WH, Chan GCK, Kwan BCH, Lai KB, Chan RCK, Teoh JYC, Ng JKC, Fung WWS, Chow KM, Cheng PMS, Law MC, Li PKT, Szeto CC. Circulating and Adipose Tissue Adiponectin Level and Outcomes in Incident Peritoneal Dialysis Patients. Kidney Med 2022; 5:100589. [PMID: 36793851 PMCID: PMC9922972 DOI: 10.1016/j.xkme.2022.100589] [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] [Indexed: 12/16/2022] Open
Abstract
Rationale & Objective Cardiovascular disease is the major cause of mortality and morbidity in peritoneal dialysis (PD) patients. Adiponectin, a key adipokine, is related to obesity and insulin resistance. We determined the clinical and prognostic value of plasma adiponectin level and its adipose tissue messenger RNA (mRNA) expression in new PD patients. Study Design Retrospective analysis of a prospective observational study. Setting & Participants 152 new PD patients from a single center; 6 adults undergoing abdominal surgeries without kidney disease served as controls. Predictors Plasma adiponectin level and its adipose tissue mRNA expression. Outcomes Body build and composition, patient and technique survival. Analytical Approach Adiponectin level and mRNA expression were grouped in quartiles for correlation analysis for body build and Cox regression for survival analysis. Results The median plasma adiponectin level was 31.98 μg/mL (IQR, 16.81-49.49 μg/mL), and adiponectin mRNA expression in adipose tissue was 1.65 times higher than in controls (IQR, 0.98-2.63). There was a modest but statistically significant correlation between plasma adiponectin and its adipose tissue mRNA expression (r = 0.40, P < 0.001). Plasma adiponectin level inversely correlated with body mass index, waist-hip ratio, mid-arm circumference, adipose tissue mass, plasma triglyceride (r = -0.39, -0.38, -0.41, -0.38, and -0.30, respectively; P < 0.001 for all), as well as serum insulin level (r = -0.24, P = 0.005). Similar correlations were present but less marked with adipose tissue adiponectin mRNA level. Neither plasma adiponectin level nor adipose tissue adiponectin mRNA level predicted patient or technique survival. Limitations Observational study, single center, single baseline measurement. Conclusions Plasma adiponectin level correlated with the degree of adiposity in new PD patients. However, neither plasma adiponectin level nor its adipose tissue mRNA expression was an independent prognostic indicator in kidney failure patients newly started on PD.
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Affiliation(s)
- Win Hlaing Than
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China,Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Gordon Chun-Kau Chan
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Bonnie Ching-Ha Kwan
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Ka-Bik Lai
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Ronald Cheong-Kin Chan
- Department of Anatomical & Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Jeromy Yuen Chun Teoh
- Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Jack Kit-Chung Ng
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Winston Wing-Shing Fung
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Kai-Ming Chow
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Phyllis Mei-Shan Cheng
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Man-Ching Law
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Philip Kam-Tao Li
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Cheuk-Chun Szeto
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China,Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China,Address for Correspondence: Cheuk-Chun Szeto, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China.
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Roumeliotis S, Georgianos PI, Roumeliotis A, Eleftheriadis T, Stamou A, Manolopoulos VG, Panagoutsos S, Liakopoulos V. Oxidized LDL Modifies the Association between Proteinuria and Deterioration of Kidney Function in Proteinuric Diabetic Kidney Disease. Life (Basel) 2021; 11:life11060504. [PMID: 34072583 PMCID: PMC8226768 DOI: 10.3390/life11060504] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022] Open
Abstract
Proteinuria is characterized by low accuracy for predicting onset and development of diabetic kidney disease (DKD) because it is not directly associated with molecular changes that promote DKD, but is a result of kidney damage. Oxidized low-density lipoprotein (ox-LDL) reflects oxidative stress and endothelial dysfunction, both underlying the development of proteinuria and loss of kidney function in DKD. We aimed to investigate whether ox-LDL modifies the association between proteinuria and progression of DKD in a cohort of 91 patients with proteinuric DKD and diabetic retinopathy, followed for 10 years. The primary endpoint was a combined kidney outcome of eGFR decline ≥30% or progression to end-stage kidney disease. After the end of the study, we considered the percentage change of eGFR over time as our secondary outcome. Proteinuria was associated with both outcomes, and ox-LDL amplified the magnitude of this link (p < 0.0001 for primary and p < 0.0001 for secondary outcome, respectively). After adjustment for duration of diabetes, history of cardiovascular disease and serum albumin, ox-LDL remained a significant effect modifier of the association between proteinuria and eGFR decline over time (p = 0.04). Our study shows that in proteinuric DKD, circulating ox-LDL levels amplified the magnitude of the association between proteinuria and progression of DKD.
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Affiliation(s)
- Stefanos Roumeliotis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.I.G.); (A.R.); (V.L.)
- Correspondence: ; Tel.: +30-231-099-4694
| | - Panagiotis I. Georgianos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.I.G.); (A.R.); (V.L.)
| | - Athanasios Roumeliotis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.I.G.); (A.R.); (V.L.)
| | - Theodoros Eleftheriadis
- Department of Nephrology, School of Medicine, University of Thessaly, 38221 Larissa, Greece;
| | - Aikaterini Stamou
- Department of Microbiology, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Vangelis G. Manolopoulos
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Stylianos Panagoutsos
- Department of Nephrology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.I.G.); (A.R.); (V.L.)
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Bas S, Oz K, Akkus A, Sizmaz M, Serin E, Durgun M, Karsidag S. Effect of Reduction Mammoplasty on Insulin and Lipid Metabolism in the Postoperative Third month: Compensatory Hip Enlargement. Aesthetic Plast Surg 2021; 47:536-543. [PMID: 34031735 PMCID: PMC8143058 DOI: 10.1007/s00266-021-02352-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/09/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUNDS The positive effects of reduction mammoplasty on metabolic profile have been shown in a limited number of studies. This study objective to reveal the effects of reduction mammoplasty on metabolic profile and anthropometric measurements. SUBJECTS AND METHOD The study was prospectively conducted on 42 patients who were operated between April 2019 and March 2020. Fasting plasma glucose, fasting plasma insulin, total cholesterol, triglyceride, high-density lipoprotein and low-density lipoprotein cholesterol, HgA1c, homeostasis model assessment scores, adiponectin, leptin, and resistin levels were evaluated. In addition, age, height, weight, body mass index; breast, chest, waist, hip circumference; waist-hip ratio, and bilateral breast resection tissue weights were recorded. Data and blood samples were collected one hour before the operation, 6 and 12 weeks after the operation. RESULT The patients' mean age was 43.14±10.24, and their average height was 159.42±4.96 cm. The excised bilateral dermo fatty tissue weight was 1435.85±721.16 g. At the postoperative 40th day a decrease in leptin (p = 0.001), resistin (p =0.008), glucose (p = 0.021) and insulin resistance values (p=0.013) stated. There was an increase in adiponectin (p < 0.001) and HDL (p = 0.013) levels at the postoperative 40th day. In the postoperative third month, these data returned to the previous levels that were measured before operations. However, an increase in hip circumference (p = 0.034) and a decrease in waist-hip ratio (p < 0.001) was detected in third month. Also, there was no difference in body mass index and weight compared to pre-operation. CONCLUSION After reduction mammoplasty, compensatory fat growth in the hip area, an increase in the hip circumference, and a decrease in the waist-hip ratio were observed in the postoperative third month. LEVEL OF EVIDENCE This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Soysal Bas
- Department of Plastic, Reconstructive and Aesthetic Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
| | - Kurtulus Oz
- Department of Plastic, Reconstructive and Aesthetic Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Anıl Akkus
- Department of Biochemistry, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mert Sizmaz
- Department of Plastic, Reconstructive and Aesthetic Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Erdinc Serin
- Department of Biochemistry, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Durgun
- Department of Plastic, Reconstructive and Aesthetic Surgery, Private Clinic, Izmir, Turkey
| | - Semra Karsidag
- Department of Plastic, Reconstructive and Aesthetic Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Araújo LS, da Silva MV, da Silva CA, Borges MDF, Palhares HMDC, Rocha LP, Corrêa RRM, Rodrigues Júnior V, dos Reis MA, Machado JR. Analysis of serum inflammatory mediators in type 2 diabetic patients and their influence on renal function. PLoS One 2020; 15:e0229765. [PMID: 32130282 PMCID: PMC7055870 DOI: 10.1371/journal.pone.0229765] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/14/2020] [Indexed: 02/07/2023] Open
Abstract
Aim To evaluate the serum concentrations of inflammatory mediators in patients with type 2 diabetes mellitus (T2DM) with or without renal alteration (RA) function. Methods Serum samples from 76 patients with T2DM and 24 healthy individuals were selected. Patients with T2DM were divided into two groups according to eGFR (> or < 60mL/min/1.73m2). Cytokines, chemokines and adipokines levels were evaluated using the Multiplex immunoassay and ELISA. Results TNFR1 and leptin were higher in the T2DM group with RA than in the T2DM group without RA and control group. All patients with T2DM showed increased resistin, IL-8, and MIP-1α compared to the control group. Adiponectin were higher and IL-4 decreased in the T2DM group with RA compared to the control group. eGFR positively correlated with IL-4 and negatively with TNFR1, TNFR2, and leptin in patients with T2DM. In the T2DM group with RA, eGFR was negatively correlated with TNFR1 and resistin. TNFR1 was positively correlated with resistin and leptin, as well as resistin with IL-8 and leptin. Conclusion Increased levels of TNFR1, adipokines, chemokines and decrease of IL-4 play important role in the inflammatory process developed in T2DM and decreased renal function. We also suggest that TNFR1 is a strong predictor of renal dysfunction in patients with T2DM.
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Affiliation(s)
- Liliane Silvano Araújo
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Marcos Vinícius da Silva
- Department of Microbiology, Immunology and Parasitology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Crislaine Aparecida da Silva
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Maria de Fátima Borges
- Discipline of Endocrinology and Metabolism, Health Sciences Institute of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Heloísa Marcelina da Cunha Palhares
- Discipline of Endocrinology and Metabolism, Health Sciences Institute of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Laura Penna Rocha
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Rosana Rosa Miranda Corrêa
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Virmondes Rodrigues Júnior
- Department of Microbiology, Immunology and Parasitology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Marlene Antônia dos Reis
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Juliana Reis Machado
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
- * E-mail:
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Hernández D, Alonso-Titos J, Armas-Padrón AM, Lopez V, Cabello M, Sola E, Fuentes L, Gutierrez E, Vazquez T, Jimenez T, Ruiz-Esteban P, Gonzalez-Molina M. Waiting List and Kidney Transplant Vascular Risk: An Ongoing Unmet Concern. Kidney Blood Press Res 2019; 45:1-27. [PMID: 31801144 DOI: 10.1159/000504546] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/01/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is an important independent risk factor for adverse cardiovascular events in patients waitlisted for kidney transplantation (KT). Although KT reduces cardiovascular risk, these patients still have a higher all-cause and cardiovascular mortality than the general population. This concerning situation is due to a high burden of traditional and nontraditional risk factors as well as uremia-related factors and transplant-specific factors, leading to 2 differentiated processes under the framework of CKD, atherosclerosis and arteriosclerosis. These can be initiated by insults to the vascular endothelial endothelium, leading to vascular calcification (VC) of the tunica media or the tunica intima, which may coexist. Several pathogenic mechanisms such as inflammation-related endothelial dysfunction, mineral metabolism disorders, activation of the renin-angiotensin system, reduction of nitric oxide, lipid disorders, and the fibroblast growth factor 23-klotho axis are involved in the pathogenesis of atherosclerosis and arteriosclerosis, including VC. SUMMARY This review focuses on the current understanding of atherosclerosis and arteriosclerosis, both in patients on the waiting list as well as in kidney transplant recipients, emphasizing the cardiovascular risk factors in both populations and the inflammation-related pathogenic mechanisms. Key Message: The importance of cardiovascular risk factors and the pathogenic mechanisms related to inflammation in patients waitlisted for KT and kidney transplant recipients.
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Affiliation(s)
- Domingo Hernández
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain,
| | - Juana Alonso-Titos
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
| | | | - Veronica Lopez
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
| | - Mercedes Cabello
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
| | - Eugenia Sola
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
| | - Laura Fuentes
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
| | - Elena Gutierrez
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
| | - Teresa Vazquez
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
| | - Tamara Jimenez
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
| | - Pedro Ruiz-Esteban
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
| | - Miguel Gonzalez-Molina
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain
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Munjas J, Sopić M, Bogavac-Stanojević N, Kravljača M, Miljković M, Simić-Ogrizović S, Spasojević-Kalimanovska V, Jelić-Ivanović Z. Serum Resistin, Adenylate Cyclase-Associated Protein 1 Gene Expression, and Carotid Intima-Media Thickness in Patients with End-Stage Renal Disease and Healthy Controls. Cardiorenal Med 2019; 10:51-60. [PMID: 31722350 DOI: 10.1159/000503416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 09/17/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Human resistin is a proinflammatory cytokine with significant proatherogenic effects which acts through adenylyl cyclase-associated protein 1 (CAP1). Chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients have increased cardiovascular risk and resistin levels. Previous studies indicated resistin significance as a predictor of mortality in CKD. AIMS We sought to investigate plasma resistin levels, peripheral blood mononuclear cell (PBMC) resistin mRNA, and for the first time CAP1 mRNA levels in ESRD patients and healthy controls. We also sought to investigate the relation of resistin and CAP1 to carotid intima media thickness (CIMT), CD36 gene expression, and matrix metalloproteinase 9 (MMP-9) circulating levels in ESRD patients and healthy controls. METHODS This study included 33 patients with ESRD and 27 healthy controls. Resistin and MMP-9 levels were measured by ELISA. Resistin, CAP1, and CD36 PBMC mRNA were measured by quantitative PCR. RESULTS Our study showed that ESRD patients have significantly higher levels of circulatory resistin compared to healthy controls (p < 0.001), while there was no significant difference in resistin mRNA. A significant upregulation of CAP1 and CD36 was observed in the ESRD group (p < 0.001; p < 0.001). Resistin concentration correlated with CIMT in healthy controls (r = 0.512, p = 0.036), and with MMP-9 concentration in ESRD (r = 0.353, p = 0.044) and healthy controls (r = 0.463, p = 0.026). CAP1 correlated positively with CIMT (r = 0.464, p = 0.008) in ESRD, and with CD36 in healthy controls (r = 0.447, p = 0.022) and ESRD (r = 0.824, p < 0.001). CONCLUSION The obtained data suggest that high levels of circulating resistin acting upon cells with an upregulated CAP1 gene could contribute to the increased inflammation and accelerated atherosclerosis seen in CKD patients.
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Affiliation(s)
- Jelena Munjas
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Miron Sopić
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia,
| | | | - Milica Kravljača
- Department of Nephrology, Clinical Center of Serbia, Belgrade, Serbia
| | - Milica Miljković
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | | | | | - Zorana Jelić-Ivanović
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
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Bonito B, Silva AP, Rato F, Santos N, Neves PL. Resistin as a predictor of cardiovascular hospital admissions and renal deterioration in diabetic patients with chronic kidney disease. J Diabetes Complications 2019; 33:107422. [PMID: 31484628 DOI: 10.1016/j.jdiacomp.2019.107422] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/31/2019] [Accepted: 08/17/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND High resistin levels have been associated with cardiovascular disease (CVD). Cardiovascular hospitalizations are common, especially in diabetic and renal impaired patients. The purpose of this study is to determine the role of serum resistin as a predictor of cardiovascular hospitalizations in type 2 diabetic patients with mild to moderate chronic kidney disease (CKD). METHODS We conducted a prospective, observational study. 78 diabetic patients with mild to moderate CKD and no previous CVD were included. The population was divided in two groups: G-1 with cardiovascular related admission (n = 13) and G-2 without cardiovascular related admission (n = 65). A Student's t-test was conducted to determine correlations between laboratory findings and hospitalization. We used logistic regression to assess predictors of cardiovascular events requiring hospitalization and Cox regression to identify predictors of end-stage renal disease (ESRD). RESULTS eGFR, albumin, HbA1c, phosphorous, PTH, IR, CRP, resistin and active vitamin D, were related to cardiovascular admissions. In a multivariate regression model, resistin (OR = 2.074, p = 0.047) was an independent predictor of cardiovascular hospitalization. Cox regression showed that resistin (HR = 1.931, p = 0.031) and UACr (HR = 1.151, p = 0.048) were also independent predictors of renal disease progression. CONCLUSION Resistin demonstrated to be valuable in predicting hospital admissions and progression to ESRD.
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Affiliation(s)
- Bruno Bonito
- Nephrology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal.
| | - Ana Paula Silva
- Nephrology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal; Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal
| | - Fátima Rato
- Clinical Pathology, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - Nélio Santos
- Clinical Pathology, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - Pedro Leão Neves
- Nephrology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal; Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal
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Acquarone E, Monacelli F, Borghi R, Nencioni A, Odetti P. Resistin: A reappraisal. Mech Ageing Dev 2019; 178:46-63. [DOI: 10.1016/j.mad.2019.01.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/28/2018] [Accepted: 01/11/2019] [Indexed: 02/07/2023]
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Hornik B, Duława J, Szewieczek J, Durmała J. Physical activity increases the resistin concentration in hemodialyzed patients without metabolic syndrome. Diabetes Metab Syndr Obes 2018; 12:43-57. [PMID: 30588054 PMCID: PMC6302825 DOI: 10.2147/dmso.s186674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Resistin (RES) concentration increases in end-stage renal disease patients. However, there have been no studies defining the role of physical activity in RES concentrations in hemodialyzed (HD) patients. This study was aimed to determine metabolic and inflammatory effects, including RES, of 4-week supervised rehabilitation program in HD patients, with or without metabolic syndrome (MS). METHODS The study was completed by 28 patients aged 56.9±13.3 years ( x ¯ ± SD ) who were HD for 50.6±73.4 months, and 30 controls aged 61.5±8.3 years with normal renal function. Both the groups were divided into two subgroups with respect to MS. Individualized supervised rehabilitation program based on physiotherapy, including exercises, was provided to each subject for 4 weeks. Baseline and post-intervention complete blood count, glycated hemoglobin (HbA1c) and levels of serum RES, leptin, adiponectin, cystatin C, erythropoietin, high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6, transforming growth factor- β1, plasminogen activator inhibitor-1 homocysteine, insulin, albumin, parathyroid hormone (PTH), and phosphorus were measured. RESULTS Compared to controls, HD patients showed higher baseline leucocytes count and higher serum concentrations of RES, leptin, cystatin C, hs-CRP, TNF-α, homocysteine, phosphorus, PTH while hemoglobin, glucose, and albumin concentrations. A positive correlation between serum albumin and RES concentrations was observed in HD patients. Post-intervention RES increase was observed in HD patients without MS (post-intervention 34.22±8.89 vs baseline 30.16±11.04 ng/mL; P=0.046) while no change was observed in patients with MS and in the control group. CONCLUSION MS modifies a RES response to the rehabilitation program in HD patients.
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Affiliation(s)
- Beata Hornik
- Department of Internal Nursing, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland,
| | - Jan Duława
- Department of Internal Medicine and Metabolic Diseases, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Szewieczek
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jacek Durmała
- Department of Rehabilitation, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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11
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Figueiredo PHS, Lima MMO, Costa HS, Martins JB, Flecha OD, Gonçalves PF, Alves FL, Rodrigues VGB, Maciel EHB, Mendonça VA, Lacerda ACR, Vieira ÉLM, Teixeira AL, de Paula F, Balthazar CH. Effects of the inspiratory muscle training and aerobic training on respiratory and functional parameters, inflammatory biomarkers, redox status and quality of life in hemodialysis patients: A randomized clinical trial. PLoS One 2018; 13:e0200727. [PMID: 30048473 PMCID: PMC6061993 DOI: 10.1371/journal.pone.0200727] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/23/2018] [Indexed: 01/19/2023] Open
Abstract
Objective Evaluate and compare the isolated and combined effects of Inspiratory Muscle Training (IMT) and Aerobic Training (AT) on respiratory and functional parameters, inflamatory biomarkers, redox status and health-related quality of life (HRQoL) in hemodialysis patients. Methods A randomised controlled trial with factorial allocation and intention-to-treat analysis was performed in hemodialysis patients. Volunteers were randomly assigned to performe 8-weeks of IMT at 50% of maximal inspiratory pressure (MIP), low intensity AT or combined training (CT). Before the interventions, all the volunteers went 8-weeks through a control period (without training). Measures are taken at baseline, 8-week (after control period) and 16-week (after the interventions). Primary outcomes were functional capacity (incremental shuttle walk test), MIP and lower limbs strength (Sit-to-Stand test of 30 seconds). Plasma levels of interleukin-6 (IL-6), soluble tumor necrosis factor receptor 1 (sTNFR1) and 2 (sTNFR2), adiponectin, resistin and leptin, redox status parameters and HRQoL (KDQOL-SF questionnaire) were the scondary outcomes. Data analyses were performed by two-way repeated measurements ANOVA. Results 37 hemodialysis patients aged 48.2 years old (IC95% 43.2–54.7) were randomized. Increase of MIP, functional capacity, lower limbs strength and resistin levels, and reduction of sTNFR2 levels in 16-week, compared to baseline and 8-week, were observed in all the groups (p<0.001). IMT improved functional capacity, MIP and lower limbs strength in 96.7m (IC95% 5.6–189.9), 34.5cmH2O (IC95% 22.4–46.7) and 2.2repetitions (IC95% 1.1–3.2) respectively. Increase in resistin leves and reduction in sTNFR2 leves after IMT was 0.8ng/dL (IC95% 0.5–1.1) and 0.8ng/dL (IC95% 0.3–1.3), respectively, without between-group differences. Compared to baseline and 8-week, adiponectin levels (p<0.001) and fatigue domain of the HRQoL (p<0.05) increased in 16-week only in CT. Conclusion IMT, AT and CT improved functional parameters and modulated inflammatory biomarkers, in addition, IMT provoked a similar response to low intensity AT in hemodialysis patients. Trial registration Registro Brasileiro de Ensaios clínicos RBR-4hv9rs.
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Affiliation(s)
- Pedro Henrique Scheidt Figueiredo
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- * E-mail:
| | - Márcia Maria Oliveira Lima
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Henrique Silveira Costa
- Medical School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Jeanne Brenda Martins
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Olga Dumont Flecha
- Dentistry School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Patrícia Furtado Gonçalves
- Dentistry School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Frederico Lopes Alves
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina Hospital, Diamantina, Minas Gerais, Brazil
- Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Vanessa Gomes Brandão Rodrigues
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina Hospital, Diamantina, Minas Gerais, Brazil
- Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Emílio Henrique Barroso Maciel
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina Hospital, Diamantina, Minas Gerais, Brazil
- Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Vanessa Amaral Mendonça
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | | | - Antônio Lúcio Teixeira
- Medical School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Fabrício de Paula
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina Hospital, Diamantina, Minas Gerais, Brazil
| | - Cláudio Heitor Balthazar
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
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12
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Vahdat S. The complex effects of adipokines in the patients with kidney disease. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:60. [PMID: 30181742 PMCID: PMC6091131 DOI: 10.4103/jrms.jrms_1115_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/12/2018] [Accepted: 04/29/2018] [Indexed: 12/27/2022]
Abstract
Kidney diseases are categorized as the highest prevalent ones with worldwide noticeable incidence. They cause accelerated cardiovascular diseases and noticeable mortalities. Adipose tissue and its messengers, adipokines, are reported to have the highest relationship with end-stage renal diseases or chronic kidney diseases. Over recent years, with shifting of scientists’ mindset from a simple overview of adipose tissue as a fat store to the complex paradigm of this issue as a multipotential secretory organ, the importance of studies on this tissue has emerged.
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Affiliation(s)
- Sahar Vahdat
- Isfahan Kidney Diseases Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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13
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Piotti G, Gandolfini I, Palmisano A, Maggiore U. Metabolic risk profile in kidney transplant candidates and recipients. Nephrol Dial Transplant 2018; 34:388-400. [DOI: 10.1093/ndt/gfy151] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/01/2018] [Indexed: 12/30/2022] Open
Affiliation(s)
- Giovanni Piotti
- Department of Nephrology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Ilaria Gandolfini
- Department of Nephrology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Alessandra Palmisano
- Department of Nephrology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Umberto Maggiore
- Department of Nephrology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
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14
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Antunovic T, Stefanovic A, Gligorovic Barhanovic N, Miljkovic M, Radunovic D, Ivanisevic J, Prelevic V, Bulatovic N, Ratkovic M, Stojanov M. Prooxidant-antioxidant balance, hsTnI and hsCRP: mortality prediction in haemodialysis patients, two-year follow-up. Ren Fail 2018; 39:491-499. [PMID: 28494192 PMCID: PMC6014488 DOI: 10.1080/0886022x.2017.1323645] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Oxidative stress and inflammation are highly intertwined pathophysiological processes. We analyzed the markers of these processes and high-sensitive troponin I (hsTnI) for mortality prediction in patients on haemodialysis. This study enrolled a total of 62 patients on regular haemodialysis. The patients were monitored for two years, and the observed outcomes were all-cause and cardiovascular mortality. Blood samples were taken before one dialysis session for analysis of the baseline concentrations of prooxidant–antioxidant balance (PAB), total antioxidant status (TAS), total oxidative status (TOS), hsTnI, hsCRP and resistin. The overall all-cause mortality was 37.1% and CVD mortality 16.1%. By univariate and multivariate logistic regression, our findings suggest that good predictors of all-cause mortality include hsCRP and PAB (p < .05) and of CVD mortality hsCRP (p < .05) and hsTnI (p < .001). To evaluate the relationship between the combined parameter measurements and all-cause/CVD mortality risk, patients were divided into three groups according to their PAB, hsCRP and hsTnI concentrations. The cutoffs for hsCRP and hsTnI and the median for PAB were used. Kaplan–Meier survival curves pointed out that the highest mortality risk of all-cause mortality was in the group with hsCRP levels above the cutoff and PAB levels above the median (p < .001). The highest risk of CVD mortality was found in the group with hsCRP and hsTnI levels above the cutoff levels (p = .001). Our data suggest that hsCRP and PAB are very good predictors of all-cause mortality. For CVD complications and mortality prediction in HD patients, the most sensitive parameters appear to be hsTnI and hsCRP.
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Affiliation(s)
- Tanja Antunovic
- a Centre for Clinical-Laboratory Diagnostics , Clinical Centre of Montenegro , Podgorica , Montenegro
| | - Aleksandra Stefanovic
- b Department of Medical Biochemistry , University of Belgrade , Faculty of Pharmacy , Belgrade , Serbia
| | | | - Milica Miljkovic
- b Department of Medical Biochemistry , University of Belgrade , Faculty of Pharmacy , Belgrade , Serbia
| | - Danilo Radunovic
- c Clinic for Urology and Nephrology , Clinical Centre of Montenegro , Podgorica , Montenegro
| | - Jasmina Ivanisevic
- b Department of Medical Biochemistry , University of Belgrade , Faculty of Pharmacy , Belgrade , Serbia
| | - Vladimir Prelevic
- c Clinic for Urology and Nephrology , Clinical Centre of Montenegro , Podgorica , Montenegro
| | - Nebojsa Bulatovic
- d Clinic for Cardiac Diseases , Clinical Centre of Montenegro , Podgorica , Montenegro
| | - Marina Ratkovic
- c Clinic for Urology and Nephrology , Clinical Centre of Montenegro , Podgorica , Montenegro.,e Faculty of Medicine , University of Montenegro , Podgorica , Montenegro
| | - Marina Stojanov
- b Department of Medical Biochemistry , University of Belgrade , Faculty of Pharmacy , Belgrade , Serbia
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15
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Menzaghi C, Trischitta V. The Adiponectin Paradox for All-Cause and Cardiovascular Mortality. Diabetes 2018; 67:12-22. [PMID: 29263167 PMCID: PMC6181068 DOI: 10.2337/dbi17-0016] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/03/2017] [Indexed: 12/13/2022]
Abstract
Basic science studies have shown beneficial effects of adiponectin on glucose homeostasis, chronic low-grade inflammation, apoptosis, oxidative stress, and atherosclerotic processes, so this molecule usually has been considered a salutary adipokine. It was therefore quite unexpected that large prospective human studies suggested that adiponectin is simply a marker of glucose homeostasis, with no direct favorable effect on the risk of type 2 diabetes and cardiovascular disease. But even more unforeseen were data addressing the role of adiponectin on the risk of death. In fact, a positive, rather than the expected negative, relationship was reported between adiponectin and mortality rate across many clinical conditions, comprising diabetes. The biology underlying this paradox is unknown. Several explanations have been proposed, including adiponectin resistance and the confounding role of natriuretic peptides. In addition, preliminary genetic evidence speaks in favor of a direct role of adiponectin in increasing the risk of death. However, none of these hypotheses are based on robust data, so further efforts are needed to unravel the elusive role of adiponectin on cardiometabolic health and, most important, its paradoxical association with mortality rate.
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Affiliation(s)
- Claudia Menzaghi
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, Sapienza University of Rome, Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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16
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Wakino S, Minakuchi H, Miya K, Takamatsu N, Tada H, Tani E, Inamoto H, Minakuchi J, Kawashima S, Itoh H. Aldosterone and Insulin Resistance: Vicious Combination in Patients on Maintenance Hemodialysis. Ther Apher Dial 2017; 22:142-151. [PMID: 29271574 DOI: 10.1111/1744-9987.12632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/20/2017] [Accepted: 08/28/2017] [Indexed: 12/14/2022]
Abstract
Recently, we demonstrated that plasma aldosterone contributed to insulin resistance in chronic kidney disease. The aim of this study is the clinical impact of this relationship in hemodialysis patients. In a cross section study using a total of 128 hemodialysis patients, multiple regression analysis revealed that plasma aldosterone levels were independently associated with HOMA-IR, insulin resistance index. This association was found to be more stringent in diabetic patients than in non-diabetic patients. Aldosterone levels were associated with cardiac hypertrophy and carotid artery stenosis. HOMA-IR was associated with cardiac hypertrophy. The patients whose aldosterone and HOMA-IR were above the top tertile of each parameter in this cohort showed more severe cardiac hypertrophy and lower contractile function as compared with the patients whose aldosterone levels and HOMA-IR are below the lowest tertile of each parameter. In conclusion, in hemodialysis patients, aldosterone levels and insulin resistance are closely interrelated and the constellation of the two is related to severe cardiovascular tissue damages.
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Affiliation(s)
- Shu Wakino
- Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Hitoshi Minakuchi
- Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Keiko Miya
- Department of Internal Medicine, Kawashima Hospital, Tokushima, Japan
| | | | - Hiroaki Tada
- Department of Laboratory Medicine, Kawashima Hospital, Tokushima, Japan
| | - Erina Tani
- Department of Laboratory Medicine, Kawashima Hospital, Tokushima, Japan
| | | | - Jun Minakuchi
- Department of Internal Medicine, Kawashima Hospital, Tokushima, Japan
| | - Shu Kawashima
- Department of Internal Medicine, Kawashima Hospital, Tokushima, Japan
| | - Hiroshi Itoh
- Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
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17
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Vascular Damage and Kidney Transplant Outcomes: An Unfriendly and Harmful Link. Am J Med Sci 2017; 354:7-16. [DOI: 10.1016/j.amjms.2017.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 12/20/2016] [Accepted: 01/09/2017] [Indexed: 12/31/2022]
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18
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Liu W, Jiang L, Chen J, Gao C, Zhou J, Zhou J, Bai Y, Chu H, Fan W, Wang L, Sun Z, Li X, Yang J. Association of adipokines with blood pressure, arterial elasticity and cardiac markers in dialysis patients: cross-sectional analysis of baseline data from a cohort study. Nutr Metab (Lond) 2017; 14:34. [PMID: 28491119 PMCID: PMC5424399 DOI: 10.1186/s12986-017-0185-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 04/28/2017] [Indexed: 11/30/2022] Open
Abstract
Background Adipokines are a set of cytokines secreted by white adipose tissue that have been suggested to be involved in the development of cardiovascular diseases. We aimed to evaluate the cross-sectional associations of a panel of representative adipokines with cardiovascular measures in a cohort of hemodialysis patients. Methods We measured plasma adiponectin, resistin, plasminogen activator inhibitor-1 (PAI-1), leptin, monocyte chemotactic protein 1 (MCP-1) and adipsin levels in 366 dialysis patients and 60 healthy controls. The associations of these adipokines with systolic blood pressure (assessed by ambulatory blood pressure monitoring), pulse wave velocity (PWV) and cardiac markers (BNP, NT-proBNP, Troponin I, Troponin T) in these patients were determined by general linear models with stepwise adjustment for covariates. Results In unadjusted comparison with controls, dialysis patients showed increased adiponectin, resistin, MCP-1 and adipsin levels, decreased PAI-1 concentrations (all p <0.001) and similar leptin levels (p = 0.82). On adjustment for body mass index and diabetes, however, the PAI-1 level was comparable between group (p = 0.06), whereas leptin levels became significantly higher in the patients(p <0.001). Higher adiponectin, lower PAI-1 and leptin levels were associated with higher systolic blood pressure, even after extensive adjustment (all p ≤ 0.01). Adiponectin was also consistently and inversely associated with PWV in fully adjusted models (p = 0.003). Resistin, PAI-1, leptin and adipsin showed negative associations with one or more circulating cardiac markers (all p ≤ 0.02). Conclusions We found significant associations between adipokines and cardiovascular measures. Our data suggest the possible involvement of adipokines in cardiovascular modulation in dialysis patients. Electronic supplementary material The online version of this article (doi:10.1186/s12986-017-0185-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wenjin Liu
- Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, 262# North Zhongshan Road, Nanjing, 210003 China
| | - Lei Jiang
- Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, 262# North Zhongshan Road, Nanjing, 210003 China
| | - Jianping Chen
- Department of Statistics Analysis, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Chaoqing Gao
- Department of Hemodialysis, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Jianmei Zhou
- Department of Hemodialysis, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Jiajun Zhou
- Department of Hemodialysis, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Youwei Bai
- Department of Nephrology, Luan People's Hospital, Luan, China
| | - Hong Chu
- Department of Nephrology, Affiliated Yixing People's Hospital, Jiangsu University, Yixing, China
| | - Wei Fan
- Department of Nephrology, Affiliated Yixing People's Hospital, Jiangsu University, Yixing, China
| | - Liang Wang
- Department of Nephrology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, China
| | - Zhuxing Sun
- Department of Nephrology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, China
| | - Xiurong Li
- Department of Blood Purification, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Junwei Yang
- Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, 262# North Zhongshan Road, Nanjing, 210003 China
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Inflammatory Cytokines as Uremic Toxins: "Ni Son Todos Los Que Estan, Ni Estan Todos Los Que Son". Toxins (Basel) 2017; 9:toxins9040114. [PMID: 28333114 PMCID: PMC5408188 DOI: 10.3390/toxins9040114] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 01/03/2023] Open
Abstract
Chronic kidney disease is among the fastest growing causes of death worldwide. An increased risk of all-cause and cardiovascular death is thought to depend on the accumulation of uremic toxins when glomerular filtration rate falls. In addition, the circulating levels of several markers of inflammation predict mortality in patients with chronic kidney disease. Indeed, a number of cytokines are listed in databases of uremic toxins and uremic retention solutes. They include inflammatory cytokines (IL-1β, IL-18, IL-6, TNFα), chemokines (IL-8), and adipokines (adiponectin, leptin and resistin), as well as anti-inflammatory cytokines (IL-10). We now critically review the cytokines that may be considered uremic toxins. We discuss the rationale to consider them uremic toxins (mechanisms underlying the increased serum levels and evidence supporting their contribution to CKD manifestations), identify gaps in knowledge, discuss potential therapeutic implications to be tested in clinical trials in order to make this knowledge useful for the practicing physician, and identify additional cytokines, cytokine receptors and chemokines that may fulfill the criteria to be considered uremic toxins, such as sIL-6R, sTNFR1, sTNFR2, IL-2, CXCL12, CX3CL1 and others. In addition, we suggest that IL-10, leptin, adiponectin and resistin should not be considered uremic toxins toxins based on insufficient or contradictory evidence of an association with adverse outcomes in humans or preclinical data not consistent with a causal association.
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Serum resistin is causally related to mortality risk in patients with type 2 diabetes: preliminary evidences from genetic data. Sci Rep 2017; 7:61. [PMID: 28246403 PMCID: PMC5427821 DOI: 10.1038/s41598-017-00138-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/09/2017] [Indexed: 02/07/2023] Open
Abstract
Resistin has been firmly associated with all-cause mortality. We investigated, whether, in patients with type 2 diabetes (T2D), this association is sustained by a cause-effect relationship. A genotype risk score (GRS), created by summing the number of resistin increasing alleles of two genome-wide association studies (GWAS)-derived single nucleotide polymorphisms (SNPs), serum resistin measurements and all-cause death records were obtained in 1,479 (403 events/12,454 person-years), patients with T2D from three cohorts, Gargano Heart Study-prospective design (n = 350), Gargano Mortality Study (n = 698) and Foggia Mortality Study (n = 431), from Italy. GRS was strongly associated with serum resistin in a non-linear fashion (overall p = 3.5 * 10-7) with effect size modest for GRS = 1 and 2 and much higher for GRS >3, with respect to GRS = 0. A significant non-linear association was observed also between GRS and all-cause mortality (overall p = 3.3 * 10-2), with a low effect size for GRS = 1 and 2, and nearly doubled for GRS ≥ 3, with respect to GRS = 0. Based on the above-reported associations, each genetic equivalent SD increase in log-resistin levels showed a causal hazard ratio of all-cause mortality equal to 2.17 (95%CI: 1.22-3.87), thus providing evidence for a causal role of resistin in shaping the risk of mortality in diabetic patients.
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Nagy K, Nagaraju SP, Rhee CM, Mathe Z, Molnar MZ. Adipocytokines in renal transplant recipients. Clin Kidney J 2016; 9:359-73. [PMID: 27274819 PMCID: PMC4886901 DOI: 10.1093/ckj/sfv156] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 12/18/2015] [Indexed: 02/07/2023] Open
Abstract
In the last two decades, perceptions about the role of body fat have changed. Adipocytes modulate endocrine and immune homeostasis by synthesizing hundreds of hormones, known as adipocytokines. Many studies have been investigating the influences and effects of these adipocytokines and suggest that they are modulated by the nutritional and immunologic milieu. Kidney transplant recipients (KTRs) are a unique and relevant population in which the function of adipocytokines can be examined, given their altered nutritional and immune status and subsequent dysregulation of adipocytokine metabolism. In this review, we summarize the recent findings about four specific adipocytokines and their respective roles in KTRs. We decided to evaluate the most widely described adipocytokines, including leptin, adiponectin, visfatin and resistin. Increasing evidence suggests that these adipocytokines may lead to cardiovascular events and metabolic changes in the general population and may also increase mortality and graft loss rate in KTRs. In addition, we present findings on the interrelationship between serum adipocytokine levels and nutritional and immunologic status, and mechanisms by which adipocytokines modulate morbidity and outcomes in KTRs.
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Affiliation(s)
- Kristof Nagy
- Department of Transplantation and Surgery , Semmelweis University , Budapest , Hungary
| | | | - Connie M Rhee
- Harold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension , University of California Irvine , Orange, CA , USA
| | - Zoltan Mathe
- Department of Transplantation and Surgery , Semmelweis University , Budapest , Hungary
| | - Miklos Z Molnar
- Division of Nephrology, Department of Medicine , University of Tennessee Health Science Center , Memphis, TN , USA
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Nagy K, Ujszaszi A, Czira ME, Remport A, Kovesdy CP, Mathe Z, Rhee CM, Mucsi I, Molnar MZ. Association between serum resistin level and outcomes in kidney transplant recipients. Transpl Int 2016; 29:352-61. [PMID: 26639524 DOI: 10.1111/tri.12728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/28/2015] [Accepted: 11/25/2015] [Indexed: 01/08/2023]
Abstract
Resistin is an adipocytokine that is associated with inflammation, coronary artery disease, and other types of cardiovascular disease among patients with normal kidney function. However, little is known about the association of resistin with outcomes in kidney transplant recipients. We collected socio-demographic and clinical parameters, medical and transplant history, and laboratory data from 988 prevalent kidney transplant recipients enrolled in the Malnutrition-Inflammation in Transplant-Hungary Study (MINIT-HU study). Serum resistin levels were measured at baseline. Associations between serum resistin level and death with a functioning graft over a 6-year follow-up period were examined in unadjusted and adjusted models. The mean±SD age of the study population was 51 ± 13 years, among whom 57% were men and 21% were diabetics. Median serum resistin concentrations were significantly higher in patients who died with a functioning graft as compared to those who did not die during the follow-up period (median [IQR]: 22[15-26] vs. 19[14-22] ng/ml, respectively; P < 0.001). Higher serum resistin level was associated with higher mortality risk in both unadjusted and fully adjusted models: HRs (95% CI): 1.33(1.16-1.54) and 1.21(1.01-1.46), respectively. In prevalent kidney transplant recipients, serum resistin was an independent predictor of death with a functioning graft.
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Affiliation(s)
- Kristof Nagy
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Akos Ujszaszi
- Institute of Pathophysiology, Semmelweis University, Budapest, Hungary
| | - Maria E Czira
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Adam Remport
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Csaba P Kovesdy
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.,Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, TN, USA
| | - Zoltan Mathe
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Connie M Rhee
- Division of Nephrology and Hypertension, University of California Irvine Medical Center, Orange, CA, USA
| | - Istvan Mucsi
- Division of Nephrology and Multiorgan Transplant Program, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Miklos Z Molnar
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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Fontana A, Spadaro S, Copetti M, Spoto B, Salvemini L, Pizzini P, Frittitta L, Mallamaci F, Pellegrini F, Trischitta V, Menzaghi C. Association between resistin levels and all-cause and cardiovascular mortality: a new study and a systematic review and meta-analysis. PLoS One 2015; 10:e0120419. [PMID: 25793385 PMCID: PMC4368155 DOI: 10.1371/journal.pone.0120419] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 01/21/2015] [Indexed: 11/21/2022] Open
Abstract
Context Studies concerning the association between circulating resistin and mortality risk have reported, so far, conflicting results. Objective To investigate the association between resistin and both all-cause and cardiovascular (CV) mortality risk by 1) analyzing data from the Gargano Heart Study (GHS) prospective design (n=359 patients; 81 and 58 all-cause and CV deaths, respectively); 2) performing meta-analyses of all published studies addressing the above mentioned associations. Data Source and Study Selection MEDLINE and Web of Science search of studies reporting hazard ratios (HR) of circulating resistin for all-cause or CV mortality. Data Extraction Performed independently by two investigators, using a standardized data extraction sheet. Data Synthesis In GHS, adjusted HRs per one standard deviation (SD) increment in resistin concentration were 1.28 (95% CI: 1.07-1.54) and 1.32 (95% CI: 1.06-1.64) for all-cause and CV mortality, respectively. The meta-analyses included 7 studies (n=4016; 961 events) for all-cause mortality and 6 studies (n=4,187: 412 events) for CV mortality. Pooled HRs per one SD increment in resistin levels were 1.21 (95% CI: 1.03-1.42, Q-test p for heterogeneity<0.001) and 1.05 (95% CI: 1.01-1.10, Q-test p for heterogeneity=0.199) for all-cause and CV mortality, respectively. At meta-regression analyses, study mean age explained 9.9% of all-cause mortality studies heterogeneity. After adjusting for age, HR for all-cause mortality was 1.24 (95% CI: 1.06-1.45). Conclusions Our results provide evidence for an association between circulating resistin and mortality risk among high-risk patients as are those with diabetes and coronary artery disease.
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Affiliation(s)
- Andrea Fontana
- Unit of Biostatistics, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Sara Spadaro
- Endocrine Unit, Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
- Scuola Superiore di Catania, University of Catania, Catania, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Belinda Spoto
- CNR-IBIM and Nephrology, Dialysis and Transplantation Unit of Reggio Calabria, Reggio Calabria, Italy
| | - Lucia Salvemini
- Research Unit of Diabetes and Endocrine Diseases, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Patrizia Pizzini
- CNR-IBIM and Nephrology, Dialysis and Transplantation Unit of Reggio Calabria, Reggio Calabria, Italy
| | - Lucia Frittitta
- Endocrine Unit, Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Francesca Mallamaci
- CNR-IBIM and Nephrology, Dialysis and Transplantation Unit of Reggio Calabria, Reggio Calabria, Italy
| | - Fabio Pellegrini
- Unit of Biostatistics, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Diseases, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- * E-mail: (VT); (CM)
| | - Claudia Menzaghi
- Research Unit of Diabetes and Endocrine Diseases, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
- * E-mail: (VT); (CM)
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Abstract
Obesity in combination with diabetes and hypertension likely is contributing to the increasing incidence of chronic kidney disease (CKD) in the 21st century worldwide and requires novel insights and strategies for treatment. There is an increasing recognition that the kidney has an important role in the complex inter-organ communication that occurs with the development of inflammation and fibrosis with obesity. Inhibition of the adiponectin-AMPK pathway has now become established as a critical pathway regulating both inflammation and pro-fibrotic pathways for both obesity-related kidney disease and diabetic kidney disease. AMPK regulates NFκB activation and is a potent regulator of NADPH oxidases. Nox4 in particular has emerged as a key contribtor to the early inflammation of diabetic kidney disease. AMPK also regulates several transcription factors that contribute to stimulation of the transforming growth factor-beta (TGF-β) system. Another key aspect of AMPK regulation is its control of mammalian target of rapamycin (mTOR) and mitochondrial biogenesis. Inhibition of PGC-1α, the transcriptional co-activator of mitochondrial biogenesis is being recognized as a key pathway that is inhibited in diabetic kidney disease and may be linked to inhibition of mitochondrial function. Translation of this concept is emerging via the field of urine metabolomics, as several metabolites linked to mitochondria are consistently downregulated in human diabetic kidney disease. Further studies to explore the role of AMPK and related energy-sensing pathways will likely lead to a more comprehensive understanding of why the kidney is affected early on and in a progressive manner with obesity and diabetes.
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Affiliation(s)
- Sarah Leyking
- Division of Nephrology and Hypertension, Department of Internal Medicine IV, Saarland University, Homburg, Germany
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