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Abdallah HR, Thomas MM, Abuelhamd WA, Ashour AM, Youness ER, El-Hariri HM, El-Bassyouni HT. The influence of vitamin D administration on the clinical presentation, body mass index, and osteoprotegerin (OPG) level in a sample of Egyptian children with familial Mediterranean fever. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2021. [DOI: 10.1186/s43054-021-00091-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Familial Mediterranean fever (FMF) is autosomal recessive chronic disease represents by recurring attacks of polyserositis, fever, and joint pain. Vitamin D deficiency in FMF children has been recently mentioned in literature and linked to delayed physical growth. Osteoporosis in FMF patients can be linked to low levels of vitamin D, too. Osteoprotegerin (OPG) might be used as an indicator for osteoporosis. Therefore, this work aimed to investigate the impact of vitamin D administration on clinical status, BMI, and bone mineral density represented by alterations in the OPG serum levels in a group of Egyptian children with FMF. This was a prospective longitudinal study carried out on 33 children, aged 4–16 years, with FMF cases. Patients were on colchicine 0.5–2 mg/day and received vitamin D3 oral drops 2800 IU/ml; each drop contains 100 IU in a dose of 600 IU/day for 6 months. The effect of vitamin D administration was evaluated clinically, anthropometrically and by assessment of serum vitamin D and osteoprotegerin at baseline and 6 months later.
Results
Serum vitamin D levels were below the normal range before intervention and showed significant improvement (p < 0.001) 6 months after intervention. Significant increase in both BMI Z scores (p < 0.05) and OPG serum levels and improvement in the clinical status as illustrated by significant decrease in the number of cases with fever, arthritis, and abdominal pain and significant decrease in the frequency and duration of the attacks (p < 0.001).
Conclusion
Our results intensely indicate that vitamin D supplementation improved the clinical condition, BMI, and bone mineral density in children with FMF.
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Fatyga P, Pac A, Fedyk-Łukasik M, Grodzicki T, Skalska A. The relationship between malnutrition risk and inflammatory biomarkers in outpatient geriatric population. Eur Geriatr Med 2020; 11:383-391. [PMID: 32297262 PMCID: PMC7280354 DOI: 10.1007/s41999-020-00303-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/19/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Malnutrition is an underestimated, but significant problem among older persons. It is described as a consequence of genetic and environmental factors, lack of physical activity, and co-morbidities. However, a key role of a geriatrician is to further explore the multidimensional complexity of this issue. The aim of this study was to identify the relationship between nutritional status and different factors, particularly focusing on inflammatory biomarkers. METHODS Nutritional status was assessed using Mini-Nutritional-Assessment with a score below 24 (out of 30) defined as malnutrition. Different serum biomarkers of inflammation were measured, such as High-Sensitivity-C-Reactive-Protein (hsCRP), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-18(IL-18), osteoprotegerin(OPG), and Soluble-Receptor-For-TNF-alfa(sTNFRII). Medical history, mental status (Mini-Mental-State-Examination, Geriatric-Depression-Scale) and activities of daily living (using Instrumental-Activities-of-Daily-Living-Scale) were used in the evaluation. The relationship between nutritional status and the factors listed was assessed. RESULTS The mean age of 76 examined persons (40.8% female) from the outpatient clinic was 71 years. Malnutrition risk was recognized in 29%. The following factors significant in univariate regression were used in stepwise regression analysis: age, sex, mental status (MMSE, GDS), valve disease, number of diseases, IADL. Stepwise regression revealed that the risk of malnutrition was increased by the presence of valve disease, number of diseases, and female sex. Factors that increased the risk of malnutrition were: logsTNFRII (OR = 3.09; 95% CI 1.07-8.96), IL-8 (OR = 1.09; 95% CI 1.00-1.18), and OPG (OR = 1.27; 95% CI 1.02-1.57). Risk of malnutrition was negatively associated with Il-18(OR = 0.995; 95% CI 0.991-0.999). CONCLUSIONS Chronic inflammation and immunologic process are likely contributors to the complex etiopathogenesis of malnutrition in older persons.
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Affiliation(s)
- Paulina Fatyga
- Department of Toxicology and Environmental Diseases, Jagiellonian University Medical College, Kraków, Poland
- University Hospital, Kraków, Poland
| | - Agnieszka Pac
- Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Fedyk-Łukasik
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 2 Jakubowskiego Str., 30-688, Kraków, Poland
- University Hospital, Kraków, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 2 Jakubowskiego Str., 30-688, Kraków, Poland
- University Hospital, Kraków, Poland
| | - Anna Skalska
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 2 Jakubowskiego Str., 30-688, Kraków, Poland.
- University Hospital, Kraków, Poland.
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Khadir A, Kavalakatt S, Madhu D, Tiss A. Fetuin-a expression profile in mouse and human adipose tissue. Lipids Health Dis 2020; 19:38. [PMID: 32164711 PMCID: PMC7068996 DOI: 10.1186/s12944-020-01225-7] [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: 05/05/2019] [Accepted: 03/09/2020] [Indexed: 02/06/2023] Open
Abstract
Fetuin-A (Fet-A) was one of the first hepatokines to be reportedly linked to metabolic diseases. Fet-A was also suggested to be an adipokine, but its expression in the adipose tissue remains debatable. Here we compared the expression of Fet-A between human and mice adipose tissue biopsies as well as among human subcutaneous tissue and visceral adipose tissue primary cells, and mouse 3 T3-L1 cells at various stages of differentiation. Fet-A was expressed in mice biopsies and cells but not in human biopsies and cells, except in visceral adipose tissue primary cells following differentiation. Although the marginal expression of Fet-A in human visceral adipose tissue, a major contribution of Fet-A expression in human adipose tissue to systemic Fet-A levels is discounted, but it could indicate specific local Fet-A action in the visceral adipose tissue.
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Affiliation(s)
- Abdelkrim Khadir
- Genetics and Bioinformatics department, Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Sina Kavalakatt
- Biochemistry and Molecular Biology department, Research Division, Dasman Diabetes Institute, P.O. Box1180, 15462, Dasman, Kuwait
| | - Dhanya Madhu
- Biochemistry and Molecular Biology department, Research Division, Dasman Diabetes Institute, P.O. Box1180, 15462, Dasman, Kuwait
| | - Ali Tiss
- Biochemistry and Molecular Biology department, Research Division, Dasman Diabetes Institute, P.O. Box1180, 15462, Dasman, Kuwait.
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Khadir A, Kavalakatt S, Madhu D, Hammad M, Devarajan S, Tuomilehto J, Tiss A. Fetuin-A levels are increased in the adipose tissue of diabetic obese humans but not in circulation. Lipids Health Dis 2018; 17:291. [PMID: 30579336 PMCID: PMC6303986 DOI: 10.1186/s12944-018-0919-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/19/2018] [Indexed: 12/18/2022] Open
Abstract
Background The hepatokine fetuin-A is linked to obesity and type 2 diabetes, but its presence and expression in adipose tissue remain unclear. In this study, we aimed to assess the circulating levels of fetuin-A and its expression in subcutaneous adipose tissue (SAT) from diabetic and non-diabetic obese subjects and their modulation by exercise. Methods SAT and blood were obtained from adults obese (diabetic, n=118 and non-diabetic, n=166) before and after a 3-month exercise program (diabetic, n=40 and non-diabetic, n=36, respectively). Plasma fetuin-A was assayed using ELISA. The presence and expression of fetuin-A in SAT, peripheral blood mononuclear cells (PBMCs) and cell lines (3T3-L1, THP-1, HepG2, RAW 264.7) were analysed using confocal microscopy, immunoblotting and qRT-PCR. Results Plasma fetuin-A level did not significantly differ between diabetic and non-diabetic obese subjects. However, when the non-diabetic group was divided into metabolically healthy and unhealthy phenotypes, significantly higher fetuin-A level was observed in the unhealthy sub-group. Circulating fetuin-A was mainly associated with glycaemic markers. In SAT, fetuin-A protein level was significantly higher in the diabetic obese subjects but its mRNA was not detected. Similarly, fetuin-A protein was detected in PBMCs, but its mRNA was not. In line with this, the use of various cell lines and culture media indicated that the presence of fetuin-A in SAT and PBMCs was due to its uptake from circulation rather than its endogenous expression. Finally, physical exercise decreased fetuin-A levels in both plasma and SAT in both groups. Conclusions Fetuin-A levels increased in association with diabetes in SAT but not in circulation in the obese subjects. Moreover, physical exercise decreased fetuin-A level. Fetuin-A potentially acts as a hepatokine taken up by other tissues, such as adipose tissue. Electronic supplementary material The online version of this article (10.1186/s12944-018-0919-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Sina Kavalakatt
- Research Division, Dasman Diabetes Institute, Al Kuwayt, Kuwait
| | - Dhanya Madhu
- Research Division, Dasman Diabetes Institute, Al Kuwayt, Kuwait
| | - Maha Hammad
- Research Division, Dasman Diabetes Institute, Al Kuwayt, Kuwait
| | | | | | - Ali Tiss
- Research Division, Dasman Diabetes Institute, Al Kuwayt, Kuwait. .,Functional Proteomics & Metabolomics Unit, Dasman Diabetes Institute, P.O. Box 1180, 15462, Dasman, Kuwait.
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Zha Y, Qian Q. Protein Nutrition and Malnutrition in CKD and ESRD. Nutrients 2017; 9:nu9030208. [PMID: 28264439 PMCID: PMC5372871 DOI: 10.3390/nu9030208] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/23/2017] [Indexed: 01/28/2023] Open
Abstract
Elevated protein catabolism and protein malnutrition are common in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The underlying etiology includes, but is not limited to, metabolic acidosis intestinal dysbiosis; systemic inflammation with activation of complements, endothelin-1 and renin-angiotensin-aldosterone (RAAS) axis; anabolic hormone resistance; energy expenditure elevation; and uremic toxin accumulation. All of these derangements can further worsen kidney function, leading to poor patient outcomes. Many of these CKD-related derangements can be prevented and substantially reversed, representing an area of great potential to improve CKD and ESRD care. This review integrates known information and recent advances in the area of protein nutrition and malnutrition in CKD and ESRD. Management recommendations are summarized. Thorough understanding the pathogenesis and etiology of protein malnutrition in CKD and ESRD patients will undoubtedly facilitate the design and development of more effective strategies to optimize protein nutrition and improve outcomes.
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Affiliation(s)
- Yan Zha
- Department of Nephrology, Guizhou Provincial People's Hospital, Guizhou 550002, China.
| | - Qi Qian
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
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Cordeiro AC, Amparo FC, Oliveira MAC, Amodeo C, Smanio P, Pinto IMF, Lindholm B, Stenvinkel P, Carrero JJ. Epicardial fat accumulation, cardiometabolic profile and cardiovascular events in patients with stages 3-5 chronic kidney disease. J Intern Med 2015; 278:77-87. [PMID: 25556720 DOI: 10.1111/joim.12344] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND It has been hypothesized that epicardial adipose tissue (EAT) exerts pathogenic effects on cardiac structures. We analysed the associations between EAT and both cardiovascular (CV) disease risk factors and CV events in patients with chronic kidney disease (CKD). PATIENTS AND METHODS We included 277 nondialysed patients [median age 61, interquartile range (IQR) 53-68 years; 63% men] with stages 3-5 CKD in this cross-sectional evaluation. EAT and abdominal visceral adipose tissue (VAT) were assessed by computed tomography. Patients were followed for median 32 (IQR 20-39) months, and the composite of fatal and nonfatal CV events was recorded. RESULTS With increasing EAT quartiles, patients were older, had higher glomerular filtration rate, body mass index, waist, VAT and coronary calcification, higher levels of haemoglobin, triglycerides, albumin, C-reactive protein and leptin and higher prevalence of left ventricular hypertrophy and myocardial ischaemia; total and high-density lipoprotein cholesterol, 25-hydroxy-vitamin D and 1, 25-dihydroxy-vitamin D progressively decreased. Associations between EAT and cardiac alterations were not independent of VAT. During follow-up, 58 CV events occurred. A 1-SD higher EAT volume was associated with an increased risk of CV events in crude [hazard ratio (HR) 1.41, 95% confidence interval (CI) (1.12-1.78) and adjusted (HR 1.55, 95% CI 1.21-1.99) Cox models. However, adding EAT to a standard CV disease risk prediction model did not result in a clinically relevant improvement in prediction. CONCLUSION Epicardial adipose tissue accumulation in patients with CKD increases the risk of CV events independent of general adiposity. This is consistent with the notion of a local pathogenic effect of EAT on the heart or heart vessels, or both. However, EAT adds negligible explanatory power to standard CV disease risk factors.
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Affiliation(s)
- A C Cordeiro
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - F C Amparo
- Department of Nutrition, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - M A C Oliveira
- Department of Nuclear Medicine, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - C Amodeo
- Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - P Smanio
- Department of Nuclear Medicine, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - I M F Pinto
- Department of Radiology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - B Lindholm
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - P Stenvinkel
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - J J Carrero
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Carrero JJ, Avesani CM. Pros and Cons of Body Mass Index as a Nutritional and Risk Assessment Tool in Dialysis Patients. Semin Dial 2014; 28:48-58. [DOI: 10.1111/sdi.12287] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Juan Jesús Carrero
- Divisions of Renal Medicine and Baxter Novum; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
- Center for Molecular Medicine; Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm Sweden
| | - Carla Maria Avesani
- Department of Applied Nutrition; Nutrition Institute; Rio de Janeiro State University; Rio de Janeiro Brazil
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Abete P, Adlbrecht C, Assimakopoulos SF, Côté N, Dullaart RP, Evsyukova HV, Fang TC, Goswami N, Hinghofer-Szalkay H, Ho YL, Hoebaus C, Hülsmann M, Indridason OS, Kholová I, Lin YH, Maniscalco M, Mathieu P, Mizukami H, Ndrepepa G, Roessler A, Sánchez-Ramón S, Santamaria F, Schernthaner GH, Scopa CD, Sharp KM, Skuladottir GV, Steichen O, Stenvinkel P, Tejera-Alhambra M, Testa G, Visseren FL, Westerink J, Witasp A, Yagihashi S, Ylä-Herttuala S. Research update for articles published in EJCI in 2011. Eur J Clin Invest 2013. [DOI: 10.1111/eci.12131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Pasquale Abete
- Dipartimento di Scienze Mediche Traslazionali; Università degli Studi di Napoli “Federico II”; Naples Italy
| | - Christopher Adlbrecht
- Division of Cardiology; Department of Internal Medicine II; Medical University of Vienna; Vienna Austria
| | | | - Nancy Côté
- Department of Surgery; Laboratoire d'Études Moléculaires des Valvulopathies (LEMV); Institut Universitaire de Cardiologie et de Pneumologie de Québec/Research Center; Laval University; Québec Canada
| | - Robin P.F. Dullaart
- Department of Endocrinology; University of Groningen and University Medical Centre Groningen; Groningen The Netherlands
| | - Helen V. Evsyukova
- Department of Hospital Therapy; Medical Faculty; St Petersburg State University; St. Petersburg Russia
| | - Te-Chao Fang
- Division of Nephrology; Department of Internal Medicine; Buddhist Tzu Chi General Hospital; Hualien Taiwan
| | - Nandu Goswami
- Institute of Physiology; Medical University of Graz; Austria
| | | | - Yi-Lwun Ho
- Department of Internal Medicine; National Taiwan University Hospital and National Taiwan University College of Medicine; Taipei Taiwan
| | - Clemens Hoebaus
- Department of Medicine II; Angiology, Medical University and General Hospital of Vienna; Vienna Austria
| | - Martin Hülsmann
- Division of Cardiology; Department of Internal Medicine II; Medical University of Vienna; Vienna Austria
| | - Olafur S. Indridason
- Internal Medicine Services; Landspitali - The National University Hospital of Iceland; Reykjavik Iceland
| | - Ivana Kholová
- Pathology; Fimlab Laboratories; Tampere University Hospital; Tampere Finland
| | - Yen-Hung Lin
- Department of Internal Medicine; National Taiwan University Hospital and National Taiwan University College of Medicine; Taipei Taiwan
| | - Mauro Maniscalco
- Section of Respiratory Diseases; Hospital “S. Maria della Pietà”; Casoria Naples Italy
| | - Patrick Mathieu
- Department of Surgery; Laboratoire d'Études Moléculaires des Valvulopathies (LEMV); Institut Universitaire de Cardiologie et de Pneumologie de Québec/Research Center; Laval University; Québec Canada
| | - Hiroki Mizukami
- Department of Pathology and Molecular Medicine; Hirosaki University Graduate School of Medicine; Hirosaki Japan
| | - Gjin Ndrepepa
- Herz- und Kreislauferkrankungen; Deutsches Herzzentrum München; Technische Universität; Munich Germany
| | | | | | - Francesca Santamaria
- Department of Translational Medical Sciences; Federico II University; Naples Italy
| | | | | | | | - Gudrun V. Skuladottir
- Department of Physiology; Faculty of Medicine; School of Health Sciences; University of Iceland; Reykjavik Iceland
| | - Olivier Steichen
- Internal Medicine Department; Assistance Publique-Hôpitaux de Paris; Tenon Hospital; Paris France
- Faculty of Medicine; Université Pierre et Marie Curie-Paris 6; Paris France
| | - Peter Stenvinkel
- Divisions of Renal Medicine and Baxter Novum; Department of Clinical Science; Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - Marta Tejera-Alhambra
- Laboratory of Neuroimmunology; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | - Gianluca Testa
- Dipartimento di Medicina e Scienze della Salute; Università del Molise; Campobasso Italy
| | - Frank L.J. Visseren
- Department of Vascular Medicine; University Medical Center Utrecht; Utrecht The Netherlands
| | - Jan Westerink
- Department of Vascular Medicine; University Medical Center Utrecht; Utrecht The Netherlands
| | - Anna Witasp
- Divisions of Renal Medicine and Baxter Novum; Department of Clinical Science; Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - Soroku Yagihashi
- Department of Pathology and Molecular Medicine; Hirosaki University Graduate School of Medicine; Hirosaki Japan
| | - Seppo Ylä-Herttuala
- A.I.Virtanen Institute for Molecular Sciences; University of Eastern Finland; Kuopio Finland
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Cordeiro AC, Qureshi AR, Lindholm B, Amparo FC, Tito-Paladino-Filho A, Perini M, Lourenço FS, Pinto IMF, Amodeo C, Carrero JJ. Visceral fat and coronary artery calcification in patients with chronic kidney disease. Nephrol Dial Transplant 2013; 28 Suppl 4:iv152-9. [PMID: 23832273 DOI: 10.1093/ndt/gft250] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Abdominal fat is a metabolically active tissue which has been associated with cardiovascular events and death in chronic kidney disease (CKD) patients. We explore here the association between surrogates of abdominal fat and coronary artery calcium score (CACs). METHODS Cross-sectional analysis of 232 non-dialysis-dependent CKD patients Stages 3-5 (median age 60 [25th-75th percentile 52-67] years; 60% men). Visceral adipose tissue (VAT) and CACs were assessed by computed tomography. Surrogates of abdominal fat included VAT and waist circumference (WC). RESULTS VAT was positively associated with CACs in univariate analysis (ρ = 0.23). Across increasing VAT quartiles, patients were older, more often men and smokers. Although increasing VAT quartiles associated with higher glomerular filtration rate and leptin, better nutritional status (subjective global assessment) as well as larger muscle stores and strength, they were also more insulin resistant (HOMA-IR), dyslipidemic and inflamed (C-reactive protein and white blood cells). In addition, CACs were incrementally higher. Clinically evident coronary artery calcification (CACs ≥ 10 Agatston) was present in 63% of the patients. Both increased visceral fat (odd ratio 1.60 [95% CI 1.23-2.09] per standard deviation increase) and increased WC (1.05 [1.01-1.12] per cm increase), augmented the odds to present calcification. Such associations remained statistically significant after extensive multivariate adjustment for confounders. CONCLUSIONS Abdominal fat is associated with coronary artery calcification in non-dialysis dependent CKD patients, supporting its potential role as a cardiovascular risk factor in uremia.
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Affiliation(s)
- Antonio Carlos Cordeiro
- Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
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Glintborg D, Hermann AP, Rasmussen LM, Andersen M. Plasma osteoprotegerin is associated with testosterone levels but unaffected by pioglitazone treatment in patients with polycystic ovary syndrome. J Endocrinol Invest 2013; 36:460-5. [PMID: 23211475 DOI: 10.3275/8767] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Increased osteoprotegerin (OPG) levels are associated with increased cardiovascular risk and decreased bone resorption. Pioglitazone treatment reduces the inflammatory state but may decrease bone mineral density (BMD). OPG levels during pioglitazone treatment have not previously been evaluated in polycystic ovary syndrome (PCOS). RESEARCH DESIGN AND METHODS Plasma OPG levels were measured in 30 PCOS patients before and after randomized treatment with 30 mg pioglitazone/placebo for 16 weeks. Fourteen age- and body mass index-matched healthy women were included as controls. Clinical and hormonal evaluations and whole body dual-energy X-ray absorptiometry scans were performed in all participants. RESULTS OPG levels were comparable in PCOS patients [12.0 (10.5-14.6) ng/ml] and controls [12.9 (11.7-14.9) ng/ml]. In PCOS patients (no.=30), OPG levels were positively associated with testosterone (r=0.43), PRL (r=0.47), Pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (r=0.43), and hip BMD, whereas inverse associations were found between OPG levels and triglyceride (r=-0.49) and free fatty acid levels during euglycemic clamps (r=-0.38), all p<0.05. Pioglitazone treatment significantly decreased inflammatory markers, insulin sensitivity, and BMD without affecting OPG levels. CONCLUSIONS OPG levels were comparable in PCOS patients and controls and unchanged during insulin sensitizing treatment with pioglitazone. OPG levels were associated with BMD in PCOS. Future studies need to evaluate OPG as a marker of cardiovascular disease in PCOS.
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Affiliation(s)
- D Glintborg
- Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, 3rd floor, DK-5000 Odense C, Denmark.
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11
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Carrero JJ, Stenvinkel P, Cuppari L, Ikizler TA, Kalantar-Zadeh K, Kaysen G, Mitch WE, Price SR, Wanner C, Wang AY, ter Wee P, Franch HA. Etiology of the Protein-Energy Wasting Syndrome in Chronic Kidney Disease: A Consensus Statement From the International Society of Renal Nutrition and Metabolism (ISRNM). J Ren Nutr 2013; 23:77-90. [DOI: 10.1053/j.jrn.2013.01.001] [Citation(s) in RCA: 458] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 01/15/2013] [Indexed: 01/17/2023] Open
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12
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Relationship between bone mineral density and serum osteoprotegerin in patients with chronic heart failure. PLoS One 2012; 7:e44242. [PMID: 22957004 PMCID: PMC3431321 DOI: 10.1371/journal.pone.0044242] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 07/31/2012] [Indexed: 12/25/2022] Open
Abstract
Purpose Heart failure (HF) had been reported with increased risk of hip fractures. However, the relationship between circulating biomarkers and bone mineral density (BMD) in chronic HF remained unclear. Methods This is a cross-sectional study which recruited stable chronic HF from registry of the Heart Failure Center of National Taiwan University Hospital. Patients underwent dual-energy x-ray absorptiometry (DEXA) measurements at hip and lumbar spines and biochemical assessments including B-type natriuretic peptide (BNP-32), myostatin, follistatin and osteoprotegerin (OPG). Results A total of 115 stable chronic HF individuals with left ventricular ejection fraction (EF) <45% (74% of male, mean age at 59) were recruited with 24 patients in NYHA class I, 73 patients in NYHA class II and 18 patients in NYHA class III. Results of BMD showed that Z scores of hip in NYHA III group (−0.12±1.15) was significantly lower than who were NYHA II (0.58±1.04). Serum OPG was significantly higher in subjects of NYHA III (9.3±4.6 pmol/l) than NYHA II (7.4±2.8 pmol/l) or NYHA I (6.8±3.6 pmol/l) groups. There’s a significant negative association between log transformed serum OPG and trochanteric BMD (R = −0.299, P = 0.001), which remained significant after multivariate analysis. Conclusions Our study demonstrated an inverse association between serum OPG and trochanteric BMD in patients with HF. OPG may be a predictor of BMD and an alternative to DEXA for identifying at risk HF patients for osteoporosis.
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