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Dalbeni A, Garbin M, Zoncapè M, Romeo S, Cattazzo F, Mantovani A, Cespiati A, Fracanzani AL, Tsochatzis E, Sacerdoti D, Mantovani A, Lombardi R. Glomerular Hyperfiltration: A Marker of Fibrosis Severity in Metabolic Associated Steatotic Liver Disease in an Adult Population. Int J Mol Sci 2023; 24:15837. [PMID: 37958820 PMCID: PMC10649990 DOI: 10.3390/ijms242115837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
Glomerular hyperfiltration (GH) is an increase in the glomerular filtration rate, possibly progressing to chronic kidney disease (CKD). Metabolic-associated steatotic liver disease (MASLD) is linked to an increased risk of CKD, especially if fibrosis is present; however, the association between GH and MASLD has not been explored. To evaluate GH prevalence in MASLD and its possible correlation with liver fibrosis. 772 consecutive patients with ultrasound MASLD (mean age 47.3 ± 8.9 years, 67.1% males) were enrolled. GH was defined as estimated glomerular filtration rate (eGFR) greater than the upper quartile of values in the cohort. Liver stiffness measurement (LSM) by FibroScan ≥ 7.2 kPa suggested liver fibrosis. GH was present in 20% of patients, liver fibrosis in 30%. In total, 53.4% of the cohort was obese, 40.9% hypertensive, 36.3% diabetic and 70.8% dyslipidaemic. GH patients compared to non-GH were significantly younger (38.4 ± 8.3 vs. 49.5 ± 7.7, p < 0.001), with higher prevalence of LSM > 7.2 kPa (35.5% vs. 29%, p < 0.001), without any difference in metabolic comorbidities. In multivariate analysis, age (OR 0.85, CI 95% 0.82-0.87) and significant fibrosis (OR 1.83; CI 95%1.10-3.03) remained independently associated with GH, regardless of the presence of metabolic alterations and nephrotoxic drugs. GH, an early marker of renal damage, is highly prevalent in MASLD and is associated with hepatic fibrosis. GH may be considered an early marker of both liver and renal disease and its recognition could prompt the management of risk factors aimed at preventing the progression of both hepatic and renal disease.
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Affiliation(s)
- Andrea Dalbeni
- General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy; (A.D.); (M.G.); (M.Z.); (S.R.); (F.C.); (A.M.)
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
| | - Marta Garbin
- General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy; (A.D.); (M.G.); (M.Z.); (S.R.); (F.C.); (A.M.)
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
| | - Mirko Zoncapè
- General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy; (A.D.); (M.G.); (M.Z.); (S.R.); (F.C.); (A.M.)
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
- UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London NW3 2PF, UK; (E.T.); (R.L.)
| | - Sara Romeo
- General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy; (A.D.); (M.G.); (M.Z.); (S.R.); (F.C.); (A.M.)
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
| | - Filippo Cattazzo
- General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy; (A.D.); (M.G.); (M.Z.); (S.R.); (F.C.); (A.M.)
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
| | - Anna Mantovani
- General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy; (A.D.); (M.G.); (M.Z.); (S.R.); (F.C.); (A.M.)
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
- UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London NW3 2PF, UK; (E.T.); (R.L.)
| | - Annalisa Cespiati
- SC Medicina ad Indirizzo Metabolico, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Anna Ludovica Fracanzani
- SC Medicina ad Indirizzo Metabolico, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Emmanouil Tsochatzis
- UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London NW3 2PF, UK; (E.T.); (R.L.)
| | - David Sacerdoti
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
| | - Alessandro Mantovani
- Endocrinology Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
| | - Rosa Lombardi
- UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London NW3 2PF, UK; (E.T.); (R.L.)
- SC Medicina ad Indirizzo Metabolico, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
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Ould Setti M, Voutilainen A, Niskanen L, Tuomainen TP. The association between renal hyperfiltration and mortality is not mediated by diabetes mellitus. Int Urol Nephrol 2023; 55:2639-2645. [PMID: 36952107 PMCID: PMC10499930 DOI: 10.1007/s11255-023-03562-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/16/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Renal hyperfiltration (RHF), recently established as a risk factor for mortality, is linked to current and subsequent diabetes mellitus (DM). DM could be seen as a mediator in the pathway between RHF and mortality. However, the mediating role of DM in the relationship between RHF and mortality is unclear. METHODS AND RESULTS Based on a cohort of 2682 Finnish men from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) followed-up for 35 years, we evaluated the association between RHF and mortality, with DM as a mediator, following two methods: a classic mediation analysis approach, using Cox regression, and a counterfactual framework for mediation analysis, using g-computation, Cox regression, and logistic regression. RHF is associated with an increased risk of mortality. This association was not mediated by DM. Under a counterfactual framework and on a hazard ratio scale, RHF association with mortality had a total effect of 1.54 (95% confidence interval, 1.26-1.98) and a controlled direct effect of 1.66 (1.34-2.16). CONCLUSION An association between RHF and mortality risk, independent of DM, was established. RHF should be considered, managed, and followed-up as a mortality-associated condition, regardless of the status of DM. We suggest clinicians to consider including RHF screening in routine clinical care, especially diabetic care.
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Affiliation(s)
- Mounir Ould Setti
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1., 70210, Kuopio, Finland.
- Global Database Studies, IQVIA, Espoo, Finland.
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1., 70210, Kuopio, Finland
| | - Leo Niskanen
- Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1., 70210, Kuopio, Finland
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Lee S, Yang HK, Lee HJ, Park DJ, Kong SH, Park SK. Cross-phenotype association analysis of gastric cancer: in-silico functional annotation based on the disease-gene network. Gastric Cancer 2023; 26:517-527. [PMID: 36995485 DOI: 10.1007/s10120-023-01380-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/02/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND A gene or variant has pleiotropic effects, and genetic variant identification across multiple phenotypes can provide a comprehensive understanding of biological pathways shared among different diseases or phenotypes. Discovery of genetic loci associated with multiple diseases can simultaneously support general interventions. Several meta-analyses have shown genetic associations with gastric cancer (GC); however, no study has identified associations with other phenotypes using this approach. METHODS Here, we applied disease network analysis and gene-based analysis (GBA) to examine genetic variants linked to GC and simultaneously associated with other phenotypes. We conducted a single-nucleotide polymorphism (SNP) level meta-analysis and GBA through a systematic genome-wide association study (GWAS) linked to GC, to integrate published results for the SNP variants and group them into major GC-associated genes. We then performed disease network and expression quantitative trait loci (eQTL) analyses to evaluate cross-phenotype associations and expression levels of GC-related genes. RESULTS Seven genes (MTX1, GBAP1, MUC1, TRIM46, THBS3, PSCA, and ABO) were associated with GC as well as blood urea nitrogen (BUN), glomerular filtration rate (GFR), and uric acid (UA). In addition, 17 SNPs regulated the expression of genes located on 1q22, 24 SNPs regulated the expression of PSCA on 8q24.3, and rs7849820 regulated the expression of ABO on 9q34.2. Furthermore, rs1057941 and rs2294008 had the highest posterior causal probabilities of being a causal candidate SNP in 1q22, and 8q24.3, respectively. CONCLUSIONS These findings identified seven GC-associated genes exhibiting a cross-association with GFR, BUN, and UA.
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Affiliation(s)
- Sangjun Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-Ro, Jongro-Gu, Seoul, 03080, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Han-Kwang Yang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hyuk-Joon Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Do Joong Park
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Seong-Ho Kong
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-Ro, Jongro-Gu, Seoul, 03080, Korea.
- Cancer Research Institute, Seoul National University, Seoul, Korea.
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea.
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Denis L, Bodard S, Hingot V, Chavignon A, Battaglia J, Renault G, Lager F, Aissani A, Hélénon O, Correas JM, Couture O. Sensing ultrasound localization microscopy for the visualization of glomeruli in living rats and humans. EBioMedicine 2023; 91:104578. [PMID: 37086650 PMCID: PMC10149190 DOI: 10.1016/j.ebiom.2023.104578] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Estimation of glomerular function is necessary to diagnose kidney diseases. However, the study of glomeruli in the clinic is currently done indirectly through urine and blood tests. A recent imaging technique called Ultrasound Localization Microscopy (ULM) has appeared. It is based on the ability to record continuous movements of individual microbubbles in the bloodstream. Although ULM improved the resolution of vascular imaging up to tenfold, the imaging of the smallest vessels had yet to be reported. METHODS We acquired ultrasound sequences from living humans and rats and then applied filters to divide the data set into slow-moving and fast-moving microbubbles. We performed a double tracking to highlight and characterize populations of microbubbles with singular behaviors. We decided to call this technique "sensing ULM" (sULM). We used post-mortem micro-CT for side-by-side confirmation in rats. FINDINGS In this study, we report the observation of microbubbles flowing in the glomeruli in living humans and rats. We present a set of analysis tools to extract quantitative information from individual microbubbles, such as remanence time or normalized distance. INTERPRETATION As glomeruli play a key role in kidney function, it would be possible that their observation yields a deeper understanding of the kidney. It could also be a tool to diagnose kidney diseases in patients. More generally, it will bring imaging capabilities closer to the functional units of organs, which is a key to understand most diseases, such as cancer, diabetes, or kidney failures. FUNDING This study was funded by the European Research Council under the European Union Horizon H2020 program (ERC Consolidator grant agreement No 772786-ResolveStroke).
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Affiliation(s)
- Louise Denis
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France.
| | - Sylvain Bodard
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France; AP-HP, Hôpital Necker Enfants Malades, Service d'Imagerie Adulte, F-75015, Paris, France; Université de Paris Cité, F-75006, Paris, France
| | - Vincent Hingot
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France
| | - Arthur Chavignon
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France
| | - Jacques Battaglia
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France
| | - Gilles Renault
- Université de Paris, Institut Cochin, INSERM, CNRS, F-75014, Paris, France
| | - Franck Lager
- Université de Paris, Institut Cochin, INSERM, CNRS, F-75014, Paris, France
| | - Abderrahmane Aissani
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France
| | - Olivier Hélénon
- AP-HP, Hôpital Necker Enfants Malades, Service d'Imagerie Adulte, F-75015, Paris, France; Université de Paris Cité, F-75006, Paris, France
| | - Jean-Michel Correas
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France; AP-HP, Hôpital Necker Enfants Malades, Service d'Imagerie Adulte, F-75015, Paris, France; Université de Paris Cité, F-75006, Paris, France
| | - Olivier Couture
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France
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Setti MO, Kacimi SEO, Niskanen L, Virtanen J, Tuomainen TP. Synergic Interaction of Vitamin D Deficiency and Renal Hyperfiltration on Mortality in Middle-Aged Men. J Ren Nutr 2022; 32:692-701. [DOI: 10.1053/j.jrn.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/11/2022] Open
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