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Chachaj A, Stanimirova I, Chabowski M, Gomułkiewicz A, Hodurek P, Glatzel-Plucińska N, Olbromski M, Piotrowska A, Kuzan A, Grzegrzółka J, Ratajczak-Wielgomas K, Nowak A, Szahidewicz-Krupska E, Wiśniewski J, Bromke MA, Podhorska-Okołów M, Gamian A, Janczak D, Dzięgiel P, Szuba A. Sodium accumulation in the skin is associated with higher density of skin lymphatic vessels in patients with arterial hypertension. Adv Med Sci 2023; 68:276-289. [PMID: 37639949 DOI: 10.1016/j.advms.2023.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/20/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Recent studies, conducted mainly on the rodent model, have demonstrated that regulatory pathway in the skin provided by glycosaminoglycans, nuclear factor of activated T cells 5 (NFAT5), vascular endothelial growth factor C (VEGF-C) and process of lymphangiogenesis may play an important role in extrarenal regulation of sodium (Na+) balance, body water volume, and blood pressure. We aimed to investigate the concentrations and relations among the main factors of this pathway in human skin to confirm that this regulatory axis also exists in humans. PATIENTS AND METHODS Skin specimens from patients diagnosed with arterial hypertension and from control group were histologically and molecularly examined. RESULTS The primary hypertensive and control groups did not differ in Na+ concentrations in the skin. However, the patients with hypertension and higher skin Na+ concentration had significantly greater density of skin lymphatic vessels. Higher skin Na+concentration was associated with higher skin water content. In turn, skin water content correlated with factors associated with lymphangiogenesis, i.e. NFAT5, VEGF-C, and podoplanin (PDPN) mRNA expression in the skin. The strong mutual pairwise correlations of the expressions of NFAT5, VEGF-C, vascular endothelial growth factor D (VEGF-D) and PDPN mRNA were noted in the skin in all of the studied groups. CONCLUSIONS Our study confirms that skin interstitium and the lymphatic system may be important players in the pathophysiology of arterial hypertension in humans. Based on the results of our study and existing literature in this field, we propose the hypothetical model which might explain the phenomenon of salt-sensitivity.
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Affiliation(s)
- Angelika Chachaj
- Department of Angiology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland.
| | | | - Mariusz Chabowski
- Department of Surgery, 4th Military Hospital in Wroclaw, Wroclaw, Poland; Department of Nursing and Obstetrics, Division of Anesthesiological and Surgical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Gomułkiewicz
- Division of Histology and Embryology, Department of Human Embryology and Morphology, Wroclaw Medical University, Wroclaw, Poland
| | - Paweł Hodurek
- Department of Medical Biochemistry, Wroclaw Medical University, Wroclaw, Poland
| | - Natalia Glatzel-Plucińska
- Division of Histology and Embryology, Department of Human Embryology and Morphology, Wroclaw Medical University, Wroclaw, Poland
| | - Mateusz Olbromski
- Division of Histology and Embryology, Department of Human Embryology and Morphology, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra Piotrowska
- Division of Histology and Embryology, Department of Human Embryology and Morphology, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra Kuzan
- Department of Medical Biochemistry, Wroclaw Medical University, Wroclaw, Poland
| | - Jędrzej Grzegrzółka
- Division of Histology and Embryology, Department of Human Embryology and Morphology, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Ratajczak-Wielgomas
- Division of Histology and Embryology, Department of Human Embryology and Morphology, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra Nowak
- Division of Histology and Embryology, Department of Human Embryology and Morphology, Wroclaw Medical University, Wroclaw, Poland
| | - Ewa Szahidewicz-Krupska
- Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Wiśniewski
- Wroclaw University of Science and Technology, Faculty of Chemistry, Wroclaw, Poland
| | - Mariusz A Bromke
- Department of Medical Biochemistry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Andrzej Gamian
- Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Dariusz Janczak
- Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Dzięgiel
- Division of Histology and Embryology, Department of Human Embryology and Morphology, Wroclaw Medical University, Wroclaw, Poland; Department of Physiotherapy, Wroclaw University, School of Physical Education, Wroclaw, Poland
| | - Andrzej Szuba
- Department of Angiology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland
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Cannone V, Scott CG, Decker PA, Larson NB, Palmas W, Taylor KD, Wang TJ, Gupta DK, Bielinski SJ, Burnett JC. A favorable cardiometabolic profile is associated with the G allele of the genetic variant rs5068 in African Americans: The Multi-Ethnic Study of Atherosclerosis (MESA). PLoS One 2017; 12:e0189858. [PMID: 29253899 PMCID: PMC5734753 DOI: 10.1371/journal.pone.0189858] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/04/2017] [Indexed: 11/18/2022] Open
Abstract
In whites, the minor G allele of the atrial natriuretic peptide (ANP) genetic variant rs5068 is associated with higher circulating levels of ANP and B-type natriuretic peptide (BNP), lower risk of hypertension, higher high-density lipoprotein (HDL) cholesterol plasma levels, and lower prevalence of obesity and metabolic syndrome. The observed phenotype is consistent with the blood pressure lowering and metabolic properties of ANP and BNP. The cardiovascular and metabolic phenotype associated with rs5068 genotypes in African Americans is undefined. We genotyped 1631 African Americans in the Multi-Ethnic Study of Atherosclerosis (MESA) for rs5068 and investigated their phenotype. Genotype frequencies of rs5068 were 93.2% AA (n = 1520), 6.7% AG (n = 110) and 0.1% GG (n = 1). All subsequent analyses are AG + GG versus AA genotype. Using a Bonferroni corrected level of significance of 0.005, the prevalence of metabolic syndrome (23% vs 38%, age-sex-adjusted p = 0.002) and triglycerides plasma values (76 vs 90 mg/dl, age-sex-BMI adjusted p = 0.004) were both significantly lower in the AG+GG genotypes. In the AG+GG genotypes, the prevalence of diabetes (8% vs 18%, age-sex-BMI-adjusted p = 0.02) and insulin plasma levels tended to be lower (4.8 vs 5.7 μU/ml, age-sex-BMI adjusted p = 0.04) whereas HDL-cholesterol levels tended to be higher (55 vs 50 mg/dl, age-sex-BMI-adjusted p = 0.04). No association was found with hypertension. The association between the rs5068 G allele and a favorable metabolic phenotype is now shown in African Americans. The rs5068 AG+GG genotypes are associated with lower prevalence of metabolic syndrome and lower triglycerides values.
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Affiliation(s)
- Valentina Cannone
- Cardiorenal Research Laboratory, Mayo Clinic, Rochester, Minnesota, United States of America
- Division of Clinical Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
- * E-mail:
| | - Christopher G. Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Paul A. Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Nicholas B. Larson
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Walter Palmas
- Department of Medicine Columbia University College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Kent D. Taylor
- Los Angeles Biomedical Research Institute (LA BioMed), Institute for Translational Genomics and Population Sciences, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Thomas J. Wang
- Vanderbilt Translational and Clinical Cardiovascular Research Center and Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Deepak K. Gupta
- Vanderbilt Translational and Clinical Cardiovascular Research Center and Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Suzette J. Bielinski
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - John C. Burnett
- Cardiorenal Research Laboratory, Mayo Clinic, Rochester, Minnesota, United States of America
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Fu S, Ping P, Luo L, Ye P. Deep analyses of the associations of a series of biomarkers with insulin resistance, metabolic syndrome, and diabetes risk in nondiabetic middle-aged and elderly individuals: results from a Chinese community-based study. Clin Interv Aging 2016; 11:1531-1538. [PMID: 27822025 PMCID: PMC5094606 DOI: 10.2147/cia.s109583] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The current study was designed to perform deep analyses of the associations of biomarkers, including high-sensitivity C-reactive protein (hs-CRP), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and homocysteine (Hcy), with insulin resistance (IR), metabolic syndrome (MetS), and diabetes risk and evaluate the abilities of biomarkers to identify IR, MetS, and diabetes risk in Chinese community-dwelling middle-aged and elderly residents. PARTICIPANTS AND METHODS A total of 396 participants older than 45 years underwent physical examinations and laboratory analyses following standardized protocol. RESULTS Serum hs-CRP concentrations were able to identify MetS, Chinese diabetes risk score (CDRS) ≥4, high-density lipoprotein-cholesterol (HDL-c) <0.9/1.0 mmol/L, and HDL-c <1.0/1.3 mmol/L (P<0.05 for all). Serum NT-proBNP concentrations were able to identify homeostasis model assessment of IR >1.5, CDRS ≥4, overweight, and blood pressure (BP) ≥140/90 mmHg (P<0.05 for all). Serum Hcy concentrations were able to identify CDRS ≥4, general obesity, overweight, and BP ≥140/90 mmHg (P<0.05 for all). Serum hs-CRP concentrations were independently associated with MetS as well as HDL-c <1.0/1.3 mmol/L and HDL-c <0.9/1.0 mmol/L (P<0.05 for all). Serum NT-proBNP concentrations were independently associated with BP ≥140/90 mmHg (P<0.05). Serum Hcy concentrations were independently associated with CDRS ≥4 (P<0.05). CONCLUSION Serum HDL-c levels were the major determinant of the associations between serum hs-CRP levels and MetS and the key link between inflammation and MetS. There was no other association of these biomarkers with IR, MetS, and diabetes risk after full adjustment.
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Affiliation(s)
- Shihui Fu
- Department of Geriatric Cardiology; Department of Cardiology and Hainan Branch
| | - Ping Ping
- Department of Pharmaceutical Care, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | | | - Ping Ye
- Department of Geriatric Cardiology
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Gupta DK, de Lemos JA, Ayers CR, Berry JD, Wang TJ. Racial Differences in Natriuretic Peptide Levels: The Dallas Heart Study. JACC-HEART FAILURE 2015; 3:513-519. [PMID: 26071618 DOI: 10.1016/j.jchf.2015.02.008] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 02/13/2015] [Accepted: 02/14/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The purpose of this study was to assess whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels differ according to race/ethnicity. BACKGROUND Natriuretic peptides (NP) are hormones with natriuretic, diuretic, and vasodilatory effects. Experimental NP deficiency promotes salt-sensitive hypertension and cardiac hypertrophy, conditions that are more common among black individuals. METHODS We examined plasma NT-proBNP levels according to race/ethnicity in 3,148 individuals (51% black, 31% white, 18% Hispanic) free of prevalent cardiovascular disease in the Dallas Heart Study. NT-proBNP values in the bottom sex-specific quartile were defined as low. Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates and magnetic resonance imaging measurements of cardiac structure and function. RESULTS Hypertension was present in 41%, 25%, and 16% of black, white, and Hispanic individuals, respectively. Unadjusted NT-proBNP levels were lowest in black (median: 24 pg/ml; interquartile range [IQR]: 10 to 52 pg/ml) as compared with Hispanic (30 pg/ml; IQR: 14 to 59 pg/ml) and white individuals (32 pg/ml; IQR: 16 to 62 pg/ml), p < 0.0001. In multivariable-adjusted models, black individuals still had significantly lower NT-proBNP levels (-39% [95% confidence interval: -46% to -31%]; p < 0.0001) and greater odds of having low NT-proBNP (odds ratio: 2.46 [95% confidence interval: 1.86 to 3.26]), compared with white individuals. In contrast, NT-proBNP levels did not significantly differ between Hispanic and white individuals (p = 0.28). The finding of lower NT-proBNP levels in black individuals was similar when analyses were restricted to healthy participants without cardiovascular risk factors. CONCLUSIONS In this multiethnic cohort, NT-proBNP levels differ substantially according to race/ethnicity. Despite a higher prevalence of hypertension, black individuals had significantly lower NP levels than white and Hispanic individuals. A relative NP "deficiency" among black individuals may lead to greater susceptibility to salt retention and hypertension.
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Affiliation(s)
- Deepak K Gupta
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - James A de Lemos
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Colby R Ayers
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jarett D Berry
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Thomas J Wang
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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