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Petrica L, Gadalean F, Muntean DM, Jianu DC, Vlad D, Dumitrascu V, Bob F, Milas O, Suteanu-Simulescu A, Glavan M, Ursoniu S, Balint L, Mogos-Stefan M, Ienciu S, Cretu OM, Popescu R, Gluhovschi C, Iancu L, Vlad A. Mitochondrial DNA and Inflammation Are Associated with Cerebral Vessel Remodeling and Early Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus. Biomolecules 2024; 14:499. [PMID: 38672515 PMCID: PMC11048277 DOI: 10.3390/biom14040499] [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: 02/06/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Cerebrovascular disease accounts for major neurologic disabilities in patients with type 2 diabetes mellitus (DM). A potential association of mitochondrial DNA (mtDNA) and inflammation with cerebral vessel remodeling in patients with type 2 DM was evaluated. A cohort of 150 patients and 30 healthy controls were assessed concerning urinary albumin/creatinine ratio (UACR), synaptopodin, podocalyxin, kidney injury molecule-1 (KIM-1), N-acetyl-β-(D)-glucosaminidase (NAG), interleukins IL-17A, IL-18, IL-10, tumor necrosis factor-alpha (TNFα), intercellular adhesion molecule-1 (ICAM-1). MtDNA-CN and nuclear DNA (nDNA) were quantified in peripheral blood and urine by qRT-PCR. Cytochrome b (CYTB) gene, subunit 2 of NADH dehydrogenase (ND2), and beta 2 microglobulin nuclear gene (B2M) were assessed by TaqMan assays. mtDNA-CN was defined as the ratio of the number of mtDNA/nDNA copies, through analysis of the CYTB/B2M and ND2/B2M ratio; cerebral Doppler ultrasound: intima-media thickness (IMT)-the common carotid arteries (CCAs), the pulsatility index (PI) and resistivity index (RI)- the internal carotid arteries (ICAs) and middle cerebral arteries (MCAs), the breath-holding index (BHI). The results showed direct correlations of CCAs-IMT, PI-ICAs, PI-MCAs, RI-ICAs, RI-MCAs with urinary mtDNA, IL-17A, IL-18, TNFα, ICAM-1, UACR, synaptopodin, podocalyxin, KIM-1, NAG, and indirect correlations with serum mtDNA, IL-10. BHI correlated directly with serum IL-10, and serum mtDNA, and negatively with serum IL-17A, serum ICAM-1, and NAG. In neurologically asymptomatic patients with type 2 DM cerebrovascular remodeling and impaired cerebrovascular reactivity may be associated with mtDNA variations and inflammation from the early stages of diabetic kidney disease.
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Affiliation(s)
- Ligia Petrica
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- Centre for Cognitive Research in Neuropsychiatric Pathology (Neuropsy-Cog), Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
- Center for Translational Research and Systems Medicine, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Florica Gadalean
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Danina Mirela Muntean
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- Center for Translational Research and Systems Medicine, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
- Department of Functional Sciences III, Division of Pathophysiology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Dragos Catalin Jianu
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- Centre for Cognitive Research in Neuropsychiatric Pathology (Neuropsy-Cog), Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
- Department of Neurosciences VIII, Division of Neurology I, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Daliborca Vlad
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
- Department of Biochemistry and Pharmacology IV, Division of Pharmacology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Victor Dumitrascu
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
- Department of Biochemistry and Pharmacology IV, Division of Pharmacology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Flaviu Bob
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Oana Milas
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Anca Suteanu-Simulescu
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Mihaela Glavan
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Sorin Ursoniu
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- Centre for Cognitive Research in Neuropsychiatric Pathology (Neuropsy-Cog), Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
- Center for Translational Research and Systems Medicine, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
- Department of Functional Sciences III, Division of Public Health and History of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Lavinia Balint
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Maria Mogos-Stefan
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Silvia Ienciu
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Octavian Marius Cretu
- Department of Surgery I, Division of Surgical Semiology I, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania;
- Emergency Clinical Municipal Hospital Timisoara, 300041 Timisoara, Romania
| | - Roxana Popescu
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
- Department of Microscopic Morphology II, Division of Cell and Molecular Biology II, “Victor Babes”, University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Cristina Gluhovschi
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
| | - Lavinia Iancu
- Department of Internal Medicine II, Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.P.); (F.B.); (O.M.); (A.S.-S.); (M.G.); (L.B.); (M.M.-S.); (S.I.); (C.G.); (L.I.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
| | - Adrian Vlad
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania; (D.M.M.); (D.C.J.); (D.V.); (V.D.); (S.U.); (R.P.); (A.V.)
- County Emergency Hospital Timisoara, 300723 Timisoara, Romania
- Department of Internal Medicine II, Division of Diabetes, Nutrition, and Metabolic Diseases, “Victor Babes” University of Medicine and Pharmacy, No. 2, Eftimie Murgu Sq., 300041 Timisoara, Romania
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Santulli G, Visco V, Ciccarelli M, Ferrante MNV, De Masi P, Pansini A, Virtuoso N, Pirone A, Guerra G, Verri V, Macina G, Taurino A, Komici K, Mone P. Frail hypertensive older adults with prediabetes and chronic kidney disease: insights on organ damage and cognitive performance - preliminary results from the CARYATID study. Cardiovasc Diabetol 2024; 23:125. [PMID: 38600564 PMCID: PMC11007948 DOI: 10.1186/s12933-024-02218-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Hypertension and chronic kidney disease (CKD) pose significant public health challenges, sharing intertwined pathophysiological mechanisms. Prediabetes is recognized as a precursor to diabetes and is often accompanied by cardiovascular comorbidities such as hypertension, elevating the risk of pre-frailty and frailty. Albuminuria is a hallmark of organ damage in hypertension amplifying the risk of pre-frailty, frailty, and cognitive decline in older adults. We explored the association between albuminuria and cognitive impairment in frail older adults with prediabetes and CKD, assessing cognitive levels based on estimated glomerular filtration rate (eGFR). METHODS We conducted a study involving consecutive frail older patients with hypertension recruited from March 2021 to March 2023 at the ASL (local health unit of the Italian Ministry of Health) of Avellino, Italy, followed up after three months. Inclusion criteria comprised age over 65 years, prior diagnosis of hypertension without secondary causes, prediabetes, frailty status, Montreal Cognitive Assessment (MoCA) score < 26, and CKD with eGFR > 15 ml/min. RESULTS 237 patients completed the study. We examined the association between albuminuria and MoCA Score, revealing a significant inverse correlation (r: 0.8846; p < 0.0001). Subsequently, we compared MoCA Score based on eGFR, observing a significant difference (p < 0.0001). These findings were further supported by a multivariable regression analysis, with albuminuria as the dependent variable. CONCLUSIONS Our study represents the pioneering effort to establish a significant correlation between albuminuria and eGFR with cognitive function in frail hypertensive older adults afflicted with prediabetes and CKD.
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Affiliation(s)
- Gaetano Santulli
- Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein - Mount Sinai Diabetes Research Center (ES-DRC), Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York, NY, USA.
- Department of Molecular Pharmacology, Einstein Institute for Neuroimmunology and Inflammation (INI), Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY, USA.
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Fisciano, Italy.
- International Translational Research and Medical Education (ITME) Consortium, Academic Research Unit, Naples, Italy.
| | - Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | | | | | | | - Nicola Virtuoso
- Cardiology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | | | - Germano Guerra
- International Translational Research and Medical Education (ITME) Consortium, Academic Research Unit, Naples, Italy
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | | | | | | | - Klara Komici
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Pasquale Mone
- Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein - Mount Sinai Diabetes Research Center (ES-DRC), Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York, NY, USA.
- ASL Avellino, Avellino, Italy.
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
- Casa di Cura "Montevergine", Mercogliano, Avellino, Italy.
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Sharma A, Choi J, Sim L, Dey A, Mohan M, Kantharidis P, Dietz L, Sandner P, de Haan JB. Ameliorating diabetes-associated atherosclerosis and diabetic nephropathy through modulation of soluble guanylate cyclase. Front Cardiovasc Med 2023; 10:1220095. [PMID: 37502180 PMCID: PMC10368983 DOI: 10.3389/fcvm.2023.1220095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/28/2023] [Indexed: 07/29/2023] Open
Abstract
Diabetes mellitus (DM) is an independent risk factor for micro- and macrovascular complications such as nephropathy and atherosclerosis respectively, which are the major causes of premature morbidity and mortality in Type 1 and Type 2 diabetic patients. Endothelial dysfunction is the critical first step of vascular disease and is characterized by reduced bioavailability of the essential endothelial vasodilator, nitric oxide (NO), coupled with an elevation in inflammation and oxidative stress. A novel pathway to bolster NO activity is to upregulate soluble guanylate cyclase (sGC), an enzyme responsible for mediating the protective actions of NO. Two classes of sGC modulators exist, activators and stimulators, with differing sensitivity to oxidative stress. In this study, we investigated the therapeutic effects of the sGC stimulator BAY 41-2272 (Bay 41) and the sGC activator BAY 60-2770 (Bay 60) on endpoints of atherosclerosis and renal disease as well as inflammation and oxidative stress in diabetic Apolipoprotein E knockout (ApoE-/-) mice. We hypothesized that under oxidative conditions known to accompany diabetes, sGC activation might be more efficacious than sGC stimulation in limiting diabetic vascular complications. We demonstrate that Bay 60 not only significantly decreased nitrotyrosine staining (P < 0.01) and F4/80 positive cells by 75% (P < 0.05), but it also significantly reduced total plaque area (P < 0.05) and improved endothelial function (P < 0.01). Our data suggest an important anti-atherogenic role for Bay 60 accompanied by reduced oxidative stress and inflammation under diabetic settings. Treatment with the stimulator Bay 41, on the other hand, had minimal effects or caused no changes with respect to cardiovascular or renal pathology. In the kidneys, treatment with Bay 60 significantly lessened urinary albuminuria, mesangial expansion and nitrotyrosine staining under diabetic conditions. In summary, our head-to-head comparator is the first preclinical study to show that a sGC activator is more efficacious than a sGC stimulator for the treatment of diabetes-associated vascular and renal complications.
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Affiliation(s)
- Arpeeta Sharma
- Cardiovascular Inflammation and Redox Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Diabetes, Monash University, Central Clinical School, Melbourne, VIC, Australia
| | - Judy Choi
- Cardiovascular Inflammation and Redox Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Lachlan Sim
- Cardiovascular Inflammation and Redox Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Abhiroop Dey
- Cardiovascular Inflammation and Redox Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Muthukumar Mohan
- Department of Diabetes, Monash University, Central Clinical School, Melbourne, VIC, Australia
| | - Phillip Kantharidis
- Department of Diabetes, Monash University, Central Clinical School, Melbourne, VIC, Australia
| | - Lisa Dietz
- Pharmaceuticals Research and Development, Bayer AG, Wuppertal, Germany
| | - Peter Sandner
- Pharmaceuticals Research and Development, Bayer AG, Wuppertal, Germany
- Institute of Pharmacology, Hannover Medical School, Hanover, Germany
| | - Judy B. de Haan
- Cardiovascular Inflammation and Redox Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, University of Melbourne, Parkville, VIC, Australia
- Department Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Baker Department Cardiovascular Research, Translation and Implementation, La Trobe University, Melbourne, VIC, Australia
- Faculty of Science, Engineering and Technology, Swinburne University, Melbourne, VIC, Australia
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Ghobrial EE, Said AM, Abd El Shaheed GF, Shaalan YM. Urinary N-Acetyl-β-D glucosaminidase (uNAG) levels as an early marker for diabetic nephropathy in children with type 1 diabetes. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2022. [DOI: 10.1186/s43054-022-00126-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Abstract
Background
Diabetic nephropathy is considered a major complication among patients with type 1 diabetes. In the present study, we aimed to evaluate urinary N-acetyl-beta-D-glucosaminidase levels (uNAG) in patients with type 1 diabetes mellitus (DM).
Methods
This cross-sectional study of 60 patients with type 1 DM, was categorized into two groups (normoalbuminuria and microalbuminuria) and 30 healthy controls. uNAG was measured in all cases and controls.
Results
Patients with type 1 DM showed increased mean uNAG values compared to controls. Interestingly, increased NAG levels were found in diabetic patients without early signs of glomerular damage (normoalbuminuric). The severity of renal disease, poor glycemic control, and duration of diabetes were all proportional to uNAG increased levels.
Conclusions
NAG measurement is a useful, noninvasive tool for assessing renal involvement in children with diabetes and for early diagnosis of developing nephropathy.
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Brobak KM, Andreassen RM, Melsom T, Høieggen A, Norvik JV, Solbu MD. Associations of urinary orosomucoid, N-acetyl-β-D-glucosaminidase, and albumin with blood pressure and hypertension after 7 years. The Tromsø Study. Blood Press 2022; 31:270-283. [PMID: 36193001 DOI: 10.1080/08037051.2022.2128043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Purpose: Subclinical chronic kidney disease is known to exacerbate hypertension and progression of kidney damage. In order to initiate timely interventions, early biomarkers for this vicious circle are needed. Our aim was to describe the cross-sectional associations of urinary orosomucoid and urinary N-acetyl-β-D-glucosaminidase (NAG) with blood pressure and the longitudinal associations of urinary orosomucoid and NAG to hypertension after 7 years, and to compare the strength of these associations to the urinary albumin excretion (UAE).Material and methods: The Tromsø Study is a population-based, prospective study of inhabitants of the municipality of Tromsø, Northern Norway. Morning spot urine samples were collected on three consecutive days in the Tromsø 6 survey (2007-2008). We assessed the cross-sectional associations of urinary orosomucoid, NAG and UAE with blood pressure in Tromsø 6. In a cohort of participants attending Tromsø 6 and Tromsø 7 (2015-2016), we studied whether urinary biomarkers were longitudinally associated with hypertension.Results: A total of 7197 participants with a mean age of 63.5 years (SD 9.2), and a mean blood pressure of 141/78 mmHg (SD 23.0/10.6), were included in the study. Orosomucoid and UAE, but not NAG, was significantly associated with systolic and diastolic blood pressure in all the crude and multivariable cross-sectional analyses. Orosomucoid had consistently, although marginally, stronger associations with blood pressure. Incident hypertension at follow-up (Tromsø 7) was consistently significantly associated with urinary orosomucoid, but not urinary NAG or UAE. However, the standardized regression coefficients for orosomucoid were only marginally stronger than the standardized regression coefficients for ACR.Conclusion: In a cohort from the general population urine orosomucoid had a stronger cross-sectional association with blood pressure than UAE. After 7 years, urine orosomucoid showed the strongest association with incident hypertension. There were varying and weak associations between U-NAG, blood pressure and hypertension.
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Affiliation(s)
- Karl M Brobak
- Section of Nephrology, University Hospital of North Norway, Tromsø, Norway.,Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Runa M Andreassen
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway.,Helgeland Hospital Trust, Sandnessjøen, Norway
| | - Toralf Melsom
- Section of Nephrology, University Hospital of North Norway, Tromsø, Norway.,Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Aud Høieggen
- Department of Nephrology, Oslo University Hospital Ullevål, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jon V Norvik
- Section of Nephrology, University Hospital of North Norway, Tromsø, Norway.,Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marit D Solbu
- Section of Nephrology, University Hospital of North Norway, Tromsø, Norway.,Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway
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6
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Belli M, Barone L, Bellia A, Sergi D, Lecis D, Prandi FR, Milite M, Galluccio C, Muscoli S, Romeo F, Barillà F. Treatment of HFpEF beyond the SGLT2-Is: Does the Addition of GLP-1 RA Improve Cardiometabolic Risk and Outcomes in Diabetic Patients? Int J Mol Sci 2022; 23:ijms232314598. [PMID: 36498924 PMCID: PMC9737325 DOI: 10.3390/ijms232314598] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a common clinical syndrome frequently seen in elderly patients, the incidence of which is steadily increasing due to an ageing population and the increasing incidence of diseases, such as diabetes, hypertension, obesity, chronic renal failure, and so on. It is a multifactorial disease with different phenotypic aspects that share left ventricular diastolic dysfunction, and is the cause of about 50% of hospitalizations for heart failure in the Western world. Due to the complexity of the disease, no specific therapies have been identified for a long time. Sodium-Glucose Co-Transporter 2 Inhibitors (SGLT2-Is) and Glucagon-Like Peptide Receptor Agonists (GLP-1 RAs) are antidiabetic drugs that have been shown to positively affect heart and kidney diseases. For SGLT2-Is, there are precise data on their potential benefits in heart failure with reduced ejection fraction (HFrEF) as well as in HFpEF; however, insufficient evidence is available for GLP-1 RAs. This review addresses the current knowledge on the cardiac effects and potential benefits of combined therapy with SGLT2-Is and GLP-1RAs in patients with HFpEF.
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Affiliation(s)
- Martina Belli
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
- Cardiovascular Imaging Unit, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Lucy Barone
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Alfonso Bellia
- Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Domenico Sergi
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Dalgisio Lecis
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Francesca Romana Prandi
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
- Department of Cardiology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Marialucia Milite
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Chiara Galluccio
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Saverio Muscoli
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Francesco Romeo
- Department of Departmental Faculty of Medicine, UniCamillus-Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
| | - Francesco Barillà
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
- Correspondence:
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7
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Venkatesan A, Roy A, Kulandaivel S, Natesan V, Kim SJ. p-Coumaric Acid Nanoparticles Ameliorate Diabetic Nephropathy via Regulating mRNA Expression of KIM-1 and GLUT-2 in Streptozotocin-Induced Diabetic Rats. Metabolites 2022; 12:metabo12121166. [PMID: 36557204 PMCID: PMC9785963 DOI: 10.3390/metabo12121166] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Diabetic nephropathy (DN) has become a leading cause of end-stage renal failure worldwide. The goal of the current study was to examine the protective effects of chitosan-loaded p-Coumaric acid nanoparticles (PCNPs) in nephrotoxicity induced by streptozotocin (STZ). Because of the antidiabetic, anti-inflammatory, and antioxidant properties of PCNPs, the development of DN may be considerably decreased. In this study, the rats received a single intraperitoneal injection (i.p.) of STZ (45 mg/kg) to induce DN. PCNPs were given orally 80 mg/kg b.w to the rats for a duration of four weeks. Body weight, kidney weight, blood glucose, and insulin levels were measured at the end of the experiment. Serum and urine parameters were also examined, along with the histological, immunobiological, and tumor necrosis factor (TNF) and interleukin-6 (IL-6) expression of the nephrotic rats. To comprehend the impact of PCNPs, the expression patterns of the kidney injury molecule (KIM-1) and glucose transporter-2 (GLUT-2) were evaluated. Administration of PCNPs significantly increased body weight, decreased kidney weight and also ameliorated blood glucose levels in the nephropathic rats. The administration of PCNPs also reverted the levels of urea, serum creatinine, urinary NAG, β-glucuronidase and albumin to near-normal levels. The administration of PCNPs also caused the levels of serum and urine parameters to return to near-normal levels. Additionally, the PCNP-treated rats had markedly reduced TNF-α, IL-6, and KIM-1 expressions as well as enhanced GLUT-2 mRNA expression. Our findings clearly showed that PCNP administration prevents the onset of DN in rats by lowering hyperglycemia, decreasing inflammation, and improving the expression of GLUT-2 mRNA in nephropathic rats.
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Affiliation(s)
- Amalan Venkatesan
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar 608002, Tamil Nadu, India
| | - Anitha Roy
- Department of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
- Department of Pharmacology, Saveetha College of Allied Health Sciences, Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai 602105, Tamil Nadu, India
| | - Srinivasan Kulandaivel
- Department of Pharmaceutical Chemistry, Nandha College of Pharmacy, Erode 638052, Tamil Nadu, India
| | - Vijayakumar Natesan
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar 608002, Tamil Nadu, India
- Correspondence: (V.N.); (S.-J.K.)
| | - Sung-Jin Kim
- Department of Pharmacology and Toxicology, Metabolic Diseases Research Laboratory, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea
- Correspondence: (V.N.); (S.-J.K.)
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8
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Jakkula SK, Maddury J, Nakka S, Kumar A. Effect of Dapagliflozin on Left Ventricular Diastolic Function in Diabetics - A Prospective Interventional Study. INDIAN JOURNAL OF CARDIOVASCULAR DISEASE IN WOMEN 2022. [DOI: 10.25259/mm_ijcdw_439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objectives:
In patients with established heart failure, the SGLT2 inhibitor dapagliflozin found to alleviate the risk of worsening heart failure or cardiovascular mortality regardless of the presence of Diabetes Mellitus. To evaluate the effect of Dapagliflozin on Left Ventricular Diastolic function in Patients with Type 2 Diabetes Mellitus, to study the baseline Diastolic function in patients with type 2 diabetes mellitus and to study the Diastolic function at rest and after exercise in patients with type 2 diabetes mellitus 24 weeks after taking Dapagliflozin.
Materials and Methods:
It is a Prospective interventional Pilot study with study population consisting of T2DM who are 18 years and older with HbA1C between 7.0% to 10% and LV diastolic dysfunction of at least grade 1 on resting echocardiography. Baseline diastolic function was measured. Dapagliflozin 10 mg once daily was given to all patients for 24 weeks and then left ventricular diastolic function was measured by e’, E/A ratio, E/e’ at 24 weeks from baseline as assessed by Stress Echocardiography.
Results:
Diastolic Dysfunction grading between Baseline and post 24 weeks treatment with dapagliflozin, using Marginal Homogeneity Test showed p value <0.001 which is highly significant. Comparision of e’ at rest for baseline and post 24 weeks of treatment with dapagliflozin showed statistical significance. The e’ after exercise for baseline and post 24 weeks of treatment showed p value of <0.01. Comparision of E/e’ at rest and after exercise for baseline and post 24 weeks showed statistical significance.
Conclusion:
The diastolic function has been significantly improved after 24 weeks of using dapagliflozin. The diastolic function parameters between age and sex groups at baseline and post 24 weeks of treatment with dapagliflozin does not correlate.
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Affiliation(s)
- Sri Kiran Jakkula
- Department of Cardiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India,
| | - Jyotsna Maddury
- Department of Cardiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India,
| | - Srikanth Nakka
- Department of Cardiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India,
| | - Achukatla Kumar
- Department of Cardiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India,
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ÖZBİÇER S, YÜKSEL G, Deniz URGUN Ö. Triglyceride glucose index is independently associated with aortic intima-media thickness in patients without known atherosclerotic cardiovascular disease or diabetes. Diab Vasc Dis Res 2022; 19:14791641221136203. [PMID: 36270638 PMCID: PMC9597021 DOI: 10.1177/14791641221136203] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance. We aimed to investigate the relationship between the TyG index and aortic intima-media thickness (IMT) in individuals without diabetes mellitus and atherosclerotic cardiovascular disease undergoing transoesophageal echocardiography due to suspected structural heart disease.Methods: One hundred twenty-two patients enrolled in the study between January 2021 and June 2021. Patients were divided into two groups according to their median IMT; patients with an IMT equal to or less than 1.42 mm were low IMT group, and higher than 1.42 mm were high IMT group. Triglyceride-glucose index were higher in the high IMT group (8.69 ± 0.59 vs. 8.37 ± 0.53, p = .003).Results: Triglyceride-glucose index was correlated with IMT (r = 0.259, p = .005) and in binary logistic regression analysis age and TyG was independently associated with having high IMT (β = 0.076, exp(B)=1.079 95%CI = 1.041-1.118, p < .001 and β = 0.847, exp(B)= 2.334 95%CI= 1.048-5.199, p = .038, respectively).Conclusion: We found an independent relationship between TyG and IMT of the thoracic aorta, an early marker of subclinical atherosclerosis in patients without known atherosclerotic cardiovascular disease or diabetes. Therefore, the TyG index can identify high-risk subjects in the general population.
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Affiliation(s)
- Süleyman ÖZBİÇER
- Department of Cardiology, University of Health Sciences Adana
City Training and Research Hospital, Adana, Turkey
- Süleyman ÖZBİÇER, Department of Cardiology,
University of Health Sciences Adana City Training and Research Hospital, Mithat
Özsan Bulvarı Kışla Mah. 4522 Sok. No:1, 01230, Yüreğir/ADANA, Adana, Turkey.
| | - Gülhan YÜKSEL
- Department of Cardiology, University of Health Sciences Adana
City Training and Research Hospital, Adana, Turkey
| | - Örsan Deniz URGUN
- Department of Cardiology, University of Health Sciences Adana
City Training and Research Hospital, Adana, Turkey
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Huoxue Qianyang Qutan Recipe Protects against Early Renal Damage Induced by Obesity-Related Hypertension via the SIRT1/NF- κB/IL-6 Pathway: Integrating Network Pharmacology and Experimental Validation-Based Strategy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9599090. [PMID: 35668772 PMCID: PMC9166942 DOI: 10.1155/2022/9599090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/13/2022] [Indexed: 11/28/2022]
Abstract
Obesity is recognized as not only a major contributing factor to cardiovascular diseases but also an independent risk factor for end-stage renal disease. Previous studies have found that Huoxue Qianyang Qutan Recipe (HQQR) could reduce urinary microalbumin in patients with obesity-related hypertension (OBH). However, the renal protective activity of HQQR in OBH and its molecular targets involved remains ambiguous. In this work, we investigate the mechanism of HQQR against OBH-induced early renal damage using integrating network pharmacology and experimental validation-based strategy. First, via network pharmacology, IL-6 is identified as one of the key targets of HQQR against early renal damage in hypertension, and inhibition of inflammation is a crucial process. Second, in in vivo experiments, HQQR can lower blood pressure, lose weight, and restore metabolic abnormalities in OBH rats, which could be associated with the effects on protecting early renal damage. Finally, in the mechanism, HQQR increases SIRT1 mRNA and protein expression consistent with reduction of NF-κB acetylation and suppressed the p65-mediated inflammatory signaling pathway. As a result, HQQR robustly inhibits OBH-induced renal inflammation by reducing IL-6 mRNA and protein levels in the renal tissue and the release of IL-6 in serum of OBH rats. This study aims to provide a multimethod (network pharmacology-animal experiment) and multilevel (component-target-pathway) strategy for the prevention and treatment of OBH-induced target organ damage by traditional Chinese medicine.
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11
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Tanaka SI, Fujioka Y, Tsujino T, Ishida T, Hirata KI. Association between urinary N-acetyl-β-glucosaminidase activity–urinary creatinine concentration ratio and risk of disability and all-cause mortality. PLoS One 2022; 17:e0265637. [PMID: 35333903 PMCID: PMC8956177 DOI: 10.1371/journal.pone.0265637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/07/2022] [Indexed: 12/03/2022] Open
Abstract
Background Recent studies have suggested that chronic kidney disease is associated with cardiovascular disease, dementia, and frailty, all of which cause disability and early death. We investigated whether increased activity of urinary N-acetyl-β-glucosaminidase (NAG), a marker of kidney injury, is associated with risk of disability or all-cause mortality in a general population. Methods Follow-up data from the Hidaka Cohort Study, a population-based cohort study of members of a Japanese rural community, were obtained via questionnaires completed by participants or their relatives. Multivariable analyses were used to investigate relations between urinary NAG activity–urinary creatinine concentration ratio and risk of disability or all-cause mortality. Results A total of 1182 participants were followed up for a median of 12.4 years. The endpoints were receipt of support under the public long-term care insurance program, and all-cause mortality. A total of 122 participants (10.3%) were reported to be receiving long-term care and 230 (19.5%) had died. After adjustment for cardiovascular risk factors along with physical activity, and using the quartile 1 results as a reference, the odds ratio (OR) for disability was 2.12 [95% confidence interval (95% confidence interval [CI]), 1.04–4.33; p = 0.038) and the hazard ratio (HR) for all-cause mortality was 1.65 (95% CI, 1.05–2.62; p = 0.031) in participants with urinary NAG/creatinine ratio in quartile 4. Similar results were obtained in participants without proteinuria: OR for disability, 2.46 (95% CI, 1.18–5.16; p = 0.017); and HR for all-cause mortality, 1.62 (95% CI, 1.00–2.63; p = 0.049). Conclusions Increased urinary NAG/creatinine ratio was associated with risk of disability or all-cause mortality in a general population.
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Affiliation(s)
- Shin-ichiro Tanaka
- Department of Internal Medicine, Toyooka Hospital Hidaka Medical Center, Toyooka, Hyogo, Japan
- * E-mail:
| | - Yoshio Fujioka
- Division of Clinical Nutrition, Faculty of Nutrition, Kobe Gakuin University, Kobe, Japan
| | - Takeshi Tsujino
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe, Japan
| | - Tatsuro Ishida
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-ichi Hirata
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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12
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Liu Q, Zong R, Li H, Yin X, Fu M, Yao L, Sun J, Yang F. Distribution of urinary N-acetyl-beta-D-glucosaminidase and the establishment of reference intervals in healthy adults. J Clin Lab Anal 2021; 35:e23748. [PMID: 33709460 PMCID: PMC8128320 DOI: 10.1002/jcla.23748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Urinary N-acetyl-beta-D-glucosaminidase (NAG) plays an important role in the early diagnosis and progression of diseases related to renal tubular injury. We detected the urinary NAG concentration, assessed the preliminary statistics of its distribution, and established reference intervals for healthy adults in China using the rate method. METHODS A total of 1,095 reference individuals (aged 20 to 79 years) met the requirements for inclusion in this study. Urinary NAG concentrations were detected using an AU5800 automatic biochemical analyzer with its matched reagents. The Kolmogorov-Smirnov test was used to analyze the normality of the data. According to the guidelines of C28-A3 and WS/T 402-2012, the reference intervals of urinary NAG were established using the nonparametric percentile method (unilateral 95th percentile). RESULTS The urinary NAG data showed a non-normal distribution. The distribution of urinary NAG was significantly different by sex and age. Therefore, the reference intervals of urinary NAG were established using the rate method: males (aged 20-59 years) <19.4 U/L (90% CI: 18.0-20.3 U/L); males (aged 60-79 years) <22.3 U/L (90% CI: 20.2-22.6 U/L); females (aged 20-59 years) <15.7 U/L (90% CI: 15.2-16.5 U/L); and females (aged 60-79 years) <21.4 U/L (90% CI: 20.3-22.3 U/L). CONCLUSIONS We established preliminary reference intervals of urinary NAG for healthy adults in China to provide guidance for health screening, auxiliary diagnosis, and treatment monitoring of renal tubule-related diseases.
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Affiliation(s)
- Qian Liu
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Ruyuan Zong
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Huan Li
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Xiaoxiao Yin
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Mei Fu
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Li Yao
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Jin Sun
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Fumeng Yang
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
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13
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Bae J, Won YJ, Lee BW. Non-Albumin Proteinuria (NAP) as a Complementary Marker for Diabetic Kidney Disease (DKD). Life (Basel) 2021; 11:life11030224. [PMID: 33802211 PMCID: PMC7998887 DOI: 10.3390/life11030224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/06/2021] [Accepted: 03/06/2021] [Indexed: 11/16/2022] Open
Abstract
Diabetic kidney disease (DKD) is one of the most common forms of chronic kidney disease. Its pathogenic mechanism is complex, and it can affect entire structures of the kidney. However, conventional approaches to early stage DKD have focused on changes to the glomerulus. Current standard screening tools for DKD, albuminuria, and estimated glomerular filtration rate are insufficient to reflect early tubular injury. Therefore, many tubular biomarkers have been suggested. Non-albumin proteinuria (NAP) contains a wide range of tubular biomarkers and is convenient to measure. We reviewed the clinical meanings of NAP and its significance as a marker for early stage DKD.
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Affiliation(s)
- Jaehyun Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary’s Hospital, Incheon KS006, Korea; (J.B.); (Y.J.W.)
| | - Young Jun Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary’s Hospital, Incheon KS006, Korea; (J.B.); (Y.J.W.)
| | - Byung-Wan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul KS013, Korea
- Correspondence:
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14
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Han E, Cho Y, Kim KW, Lee YH, Kang ES, Cha BS, Lee BW. Hepatic fibrosis is associated with total proteinuria in Korean patients with type 2 diabetes. Medicine (Baltimore) 2020; 99:e21038. [PMID: 32871978 PMCID: PMC7437801 DOI: 10.1097/md.0000000000021038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The association between non-alcoholic fatty liver disease (NAFLD) and diabetic kidney disease assessed using either albuminuria or proteinuria remains controversial. This study aimed to investigate the association between hepatic steatosis or fibrosis and albuminuria or proteinuria in Korean patients with type 2 diabetes mellitus (T2D).We enrolled 1108 patients with T2D and categorized as 3 groups; non-proteinuria (NP), isolated non-albumin proteinuria (iNAP), and albuminuria. Urinary albumin and protein levels were assessed as urinary albumin-to-creatinine ratio (uACR) and urinary protein-to-creatinine ratio (uPCR), respectively. Hepatic steatosis and fibrotic burden were assessed using the NAFLD liver fat score, Fibrosis-4 calculator (FIB-4) index, and NAFLD fibrosis score (NFS).The prevalence of significant steatosis was similar among groups (NP: 74.6% vs iNAP: 70.3% vs albuminuria: 79.9%, P = .085). The prevalence of significant fibrosis was significantly higher in the iNAP (18.7%) and albuminuria (16.5%) groups than in the NP group (9.5%, P = .001). Both uPCR and uACR showed a correlation with NFS (uPCR: r = 0.123, P < .001; uACR: r = 0.064, P = .033). In multivariate logistic regression analysis, uPCR ≥150 mg/g was found to have a stronger association with hepatic fibrosis than uACR ≥30 mg/g (adjusted odds ratio 1.55 [95% CI 1.03-2.33] vs adjusted odds ratio 1.16 [95% CI, 0.72-1.87]).In conclusion, patients with iNAP and albuminuria had a higher prevalence of hepatic fibrosis than those without proteinuria. Total proteinuria was associated with advanced liver fibrosis, whereas albuminuria was related to hepatic steatosis.
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Affiliation(s)
- Eugene Han
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu
| | - Yongin Cho
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung-won Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bong-Soo Cha
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byung-wan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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15
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Chang H, Liu Q, Bai WF, Bai YC, Jia XY, Gao C, Liu QL, Shi SL, Zhou HB. Protective effects of Amygdalus mongolica on rats with renal fibrosis based on serum metabolomics. JOURNAL OF ETHNOPHARMACOLOGY 2020; 257:112858. [PMID: 32278030 DOI: 10.1016/j.jep.2020.112858] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/26/2020] [Accepted: 04/06/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Renal fibrosis (RF) is a common outcome of various progressive chronic kidney diseases (CKDs) and, thus, seriously endangers human health. As the active ingredient of Amygdalus mongolica, amygdalin inhibits RF. Furthermore, our previous studies demonstrated that n-butanol extract (BUT) and petroleum ether extract (PET), which are effective components of A. mongolica, have an anti-renal fibrosis effect. However, their potential mechanisms of action are unclear and need further verification. AIMS OF THE STUDY The aims of this study were to further investigate the effects and potential mechanisms of A. mongolica extracts in the treatment of RF. MATERIALS AND METHODS The animals were divided into the control group, RF model group, PET group and BUT group. The RF rat model was established through unilateral ureteral obstruction (UUO). Biochemical indicators, including blood urea nitrogen (BUN), serum creatinine (Scr), and hydroxyproline (HYP, a routine marker of fibrosis), and the antioxidant index (including superoxide dismutase (SOD) and malondialdehyde (MDA)) were measured to evaluate the anti-RF effects of the extracts of A. mongolica. The histomorphology of renal tissue was observed and scored by HE and Masson staining. A serum metabonomic analysis based on UPLC-Q-TOF/MS was performed to assess the changes in the metabolic profile among the different groups. RESULTS The results showed that PET and BUT significantly improved tubulointerstitial damage and fibrosis by reducing the levels of Scr, BUN, HYP, and MDA and increasing the level of SOD. Moreover, no significant differences in efficacy were observed between the BUT and PET groups. According to the metabolomics analysis, seventy-four potential biomarkers were identified, and eight crucial biomarkers were further selected. These key biomarkers significantly contributed to RF progression by participating in six metabolic pathways, including pathways involved in arginine and proline metabolism, histidine metabolism, nicotinamide metabolism, pentose and glucuronate interconversion, ascorbate and aldarate metabolism, and amino sugar and nucleotide sugar metabolism. In addition, eight key biomarkers and six crucial biomarkers were restored to levels similar to those observed in controls following the treatment with PET and BUT, respectively. CONCLUSIONS The outcomes of these studies demonstrate the renoprotective effects of A. mongolica extracts in rats with RF and revealed the mechanism underlying these antifibrotic effects on metabolic activity for the first time.
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Affiliation(s)
- Hong Chang
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, 014040, China.
| | - Qing Liu
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, 014040, China.
| | - Wan-Fu Bai
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, 014040, China.
| | - Ying-Chun Bai
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, 014040, China.
| | - Xiao-Ye Jia
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, 014040, China.
| | - Chen Gao
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, 014040, China.
| | - Quan-Li Liu
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, 014040, China; Academician Work Station for Efficacy, Pharmacology and Safety Evaluation of Mongolian Medicine, Baotou Medical College, Baotou, Inner Mongolia, 014040, China.
| | - Song-Li Shi
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, 014040, China; Academician Work Station for Efficacy, Pharmacology and Safety Evaluation of Mongolian Medicine, Baotou Medical College, Baotou, Inner Mongolia, 014040, China.
| | - Hong-Bing Zhou
- Department of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, 014040, China.
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Barbosa J, Faria J, Garcez F, Leal S, Afonso LP, Nascimento AV, Moreira R, Queirós O, Carvalho F, Dinis-Oliveira RJ. Repeated Administration of Clinical Doses of Tramadol and Tapentadol Causes Hepato- and Nephrotoxic Effects in Wistar Rats. Pharmaceuticals (Basel) 2020; 13:ph13070149. [PMID: 32664348 PMCID: PMC7407499 DOI: 10.3390/ph13070149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/18/2022] Open
Abstract
Tramadol and tapentadol are fully synthetic and extensively used analgesic opioids, presenting enhanced therapeutic and safety profiles as compared with their peers. However, reports of adverse reactions, intoxications and fatalities have been increasing. Information regarding the molecular, biochemical, and histological alterations underlying their toxicological potential is missing, particularly for tapentadol, owing to its more recent market authorization. Considering the paramount importance of liver and kidney for the metabolism and excretion of both opioids, these organs are especially susceptible to toxicological damage. In the present study, we aimed to characterize the putative hepatic and renal deleterious effects of repeated exposure to therapeutic doses of tramadol and tapentadol, using an in vivo animal model. Male Wistar rats were randomly divided into six experimental groups, composed of six animals each, which received daily single intraperitoneal injections of 10, 25 or 50 mg/kg tramadol or tapentadol (a low, standard analgesic dose, an intermediate dose and the maximum recommended daily dose, respectively). An additional control group was injected with normal saline. Following 14 consecutive days of administration, serum, urine and liver and kidney tissue samples were processed for biochemical, metabolic and histological analysis. Repeated administration of therapeutic doses of both opioids led to: (i) increased lipid and protein oxidation in liver and kidney, as well as to decreased total liver antioxidant capacity; (ii) decreased serum albumin, urea, butyrylcholinesterase and complement C3 and C4 levels, denoting liver synthesis impairment; (iii) elevated serum activity of liver enzymes, such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and γ-glutamyl transpeptidase, as well as lipid profile alterations, also reflecting hepatobiliary commitment; (iv) derangement of iron metabolism, as shown through increases in serum iron, ferritin, haptoglobin and heme oxygenase-1 levels. In turn, elevated serum cystatin C, decreased urine creatinine output and increased urine microalbumin levels were detected upon exposure to tapentadol only, while increased serum amylase and urine N-acetyl-β-D-glucosaminidase activities were observed for both opioids. Collectively, these results are compatible with kidney injury. Changes were also found in the expression levels of liver- and kidney-specific toxicity biomarker genes, upon exposure to tramadol and tapentadol, correlating well with alterations in lipid profile, iron metabolism and glomerular and tubular function. Histopathological analysis evidenced sinusoidal dilatation, microsteatosis, mononuclear cell infiltrates, glomerular and tubular disorganization, and increased Bowman's spaces. Although some findings are more pronounced upon tapentadol exposure, our study shows that, when compared with acute exposure, prolonged administration of both opioids smooths the differences between their toxicological effects, and that these occur at lower doses within the therapeutic range.
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Affiliation(s)
- Joana Barbosa
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (J.F.); (F.G.); (S.L.); (A.V.N.); (R.M.); (O.Q.)
- UCIBIO, REQUIMTE—Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Correspondence: (J.B.); (R.J.D.-O.); Tel.: +351-224-157-216 (J.B.); +351-224-157-216 (R.J.D.-O.)
| | - Juliana Faria
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (J.F.); (F.G.); (S.L.); (A.V.N.); (R.M.); (O.Q.)
- UCIBIO, REQUIMTE—Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
| | - Fernanda Garcez
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (J.F.); (F.G.); (S.L.); (A.V.N.); (R.M.); (O.Q.)
| | - Sandra Leal
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (J.F.); (F.G.); (S.L.); (A.V.N.); (R.M.); (O.Q.)
- Department of Biomedicine, Unit of Anatomy, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Luís Pedro Afonso
- Department of Pathology, Portuguese Institute of Oncology of Porto, 4200-072 Porto, Portugal;
| | - Ana Vanessa Nascimento
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (J.F.); (F.G.); (S.L.); (A.V.N.); (R.M.); (O.Q.)
| | - Roxana Moreira
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (J.F.); (F.G.); (S.L.); (A.V.N.); (R.M.); (O.Q.)
| | - Odília Queirós
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (J.F.); (F.G.); (S.L.); (A.V.N.); (R.M.); (O.Q.)
| | - Félix Carvalho
- UCIBIO, REQUIMTE—Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
| | - Ricardo Jorge Dinis-Oliveira
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (J.F.); (F.G.); (S.L.); (A.V.N.); (R.M.); (O.Q.)
- UCIBIO, REQUIMTE—Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Correspondence: (J.B.); (R.J.D.-O.); Tel.: +351-224-157-216 (J.B.); +351-224-157-216 (R.J.D.-O.)
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Petrica L, Pusztai AM, Vlad M, Vlad A, Gadalean F, Dumitrascu V, Vlad D, Velciov S, Gluhovschi C, Bob F, Ursoniu S, Petrica M, Matusz P, Cretu O, Radu D, Milas O, Secara A, Simulescu A, Popescu R, Jianu DC. MiRNA Expression is Associated with Clinical Variables Related to Vascular Remodeling in the Kidney and the Brain in Type 2 Diabetes Mellitus Patients. Endocr Res 2020; 45:119-130. [PMID: 31724439 DOI: 10.1080/07435800.2019.1690505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: The association of vascular remodeling in the kidney and the brain with a particular microRNAs (miRNA) profile is not well studied.Methods: Seventy-six patients with Type 2 diabetes and 11 healthy subjects were assessed concerning urine albumin: creatinine ratio (UACR), biomarkers of podocyte injury and of proximal tubule (PT) dysfunction. MiRNA were quantified in blood and urine by a real-time PCR System. Cerebrovascular ultrasound measurements were performed in the carotid and middle cerebral arteries.Results: MiRNA21 and miRNA124 correlated positively with nephrin, podocalyxin, synaptopodin, urinary N-acetyl-D-glucosaminidase (NAG), urinary kidney-injury molecule-1 (KIM-1), UACR, and negatively with eGFR; miRNA125a, 126, 146a, 192 correlated negatively with nephrin, podocalyxin, synaptopodin, urinary NAG, urinary KIM-1, UACR, and directly with eGFR. Plasma miRNA-21 and miRNA192 correlated directly with cerebral hemodynamics parameters of atherosclerosis and arteriosclerosis. MiRNA-124, 125a, 126, 146a showed negative correlations with the same parameters.Conclusions: In Type 2 diabetes patients there is an association of vascular remodeling in the brain and the kidney with a specific miRNAs pattern. Cerebrovascular changes occur even in normoalbuminuric patients, with 'high-to-normal' levels of podocyte injury and PT dysfunction biomarkers. These phenomena may be explained by the variability of miRNA expression within the two organs in early DKD.
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Affiliation(s)
- Ligia Petrica
- Dept. of Nephrology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- "Victor Babes" University of Medicine and Pharmacy, Centre of Translational and Systems Medicine, Timisoara, Romania
| | - Agneta-Maria Pusztai
- Dept. of Anatomy and Embryology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Mihaela Vlad
- Dept. of Endocrinology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Adrian Vlad
- Dept. of Diabetes and Metabolic Diseases, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Florica Gadalean
- Dept. of Nephrology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Victor Dumitrascu
- Dept. of Pharmacology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Daliborca Vlad
- Dept. of Pharmacology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Silvia Velciov
- Dept. of Nephrology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Cristina Gluhovschi
- Dept. of Nephrology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Flaviu Bob
- Dept. of Nephrology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Sorin Ursoniu
- Dept. of Public Health Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Maxim Petrica
- Dept. of Neurology, "Pius Brinzeu" County Emergency Hospital, Timisoara, Romania
| | - Petru Matusz
- Dept. of Anatomy and Embryology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Octavian Cretu
- Dept. of Surgery I, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Daniela Radu
- Dept. of Surgery II, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Oana Milas
- Dept. of Nephrology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alina Secara
- Dept. of Nephrology, "Pius Brinzeu" County Emergency Hospital, Timisoara, Romania
| | - Anca Simulescu
- Dept. of Nephrology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Roxana Popescu
- Dept. of Cellular and Molecular Biology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Dragos Catalin Jianu
- Dept. of Neurology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
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18
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Proteinuria is Associated with Carotid Artery Atherosclerosis in Non-Albuminuric Type 2 Diabetes: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9010136. [PMID: 31947845 PMCID: PMC7019294 DOI: 10.3390/jcm9010136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/18/2019] [Accepted: 12/31/2019] [Indexed: 12/13/2022] Open
Abstract
The association of specific urinary proteins other than albumin with cardiovascular (CV) outcomes in patients with type 2 diabetes (T2D) has been shown. In this respect, CV outcomes may differ in non-albuminuric T2D patients who were considered as a low risk group, according to the presence of proteinuria. We investigated the association between proteinuria and atherosclerosis assessed by carotid artery intima-media thickness (CIMT) in non-albuminuric T2D patients. 2047 T2D patients whose urine albumin-to-creatinine ratio was below 30 mg/g were recruited and classified into a non-proteinuria (NP, uPCR < 150 mg/g, n = 1865) group and a non-albuminuric proteinuria (NAP, uPCR ≥ 150 mg/g, n = 182) group. CIMT was compared between the two groups and logistic regression analysis was conducted to verify whether proteinuria could predict deteriorated CIMT status. In this cross-sectional study, mean CIMT of the NAP group were significantly thicker than those of the NP group (0.73 ± 0.16 vs. 0.70 ± 0.14, p = 0.016). The presence of proteinuria is associated with deteriorated CIMT after the adjustment for conventional risk factors (odds ratio, 2.342; 95% confidence interval, 1.082-5.070, p = 0.030) in regression analysis. We postulated that the measurement of urinary protein in conjunction with albumin might be helpful for predicting atherosclerosis, especially for non-albuminuric patients.
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19
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Cho Y, Lee YH, Kang ES, Cha BS, Lee BW. Glucometabolic characteristics and higher vascular complication risk in Korean patients with type 2 diabetes with non-albumin proteinuria. J Diabetes Complications 2019; 33:585-591. [PMID: 31151790 DOI: 10.1016/j.jdiacomp.2019.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/18/2019] [Accepted: 04/22/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE We investigated the clinical relevance of non-albumin proteinuria (NAP) in Korean patients with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS We enrolled 883 T2D patients who had both their urinary albumin-to-creatinine ratio (uACR) and protein-to-creatinine ratio (uPCR) measured. We classified the patients into non-proteinuria (NP; uPCR <150 mg/g and uACR <30 mg/g), isolated NAP (iNAP; uPCR ≥150 mg/g and uACR <30 mg/g), and albuminuria (uACR ≥30 mg/g) groups. The associations between uPCR, uACR, and several indices of glucose metabolism were investigated. RESULTS The glucometabolic pathophysiology of iNAP (96 [10.9%]) group was more associated with a decrease in homeostatic model assessment (HOMA)-beta value (aOR 1.89 [95% CI, 1.21-2,96]) than with an increase in HOMA-insulin resistance (aOR 1.29 [95% CI, 0.83-2.01]). uPCR ≥150 mg/g was also found to have more consistent and stronger association with vascular complications than uACR ≥30 mg/g (aOR 1.44 [95% CI, 1.03-2.02] vs. 1.26 [95% CI, 0.89-1.79]). CONCLUSIONS The nephropathy of iNAP may be mainly attributed to decreased beta cell function. Furthermore, uPCR might be a more sensitive urinary biomarker than uACR for the detection of vascular complications in T2D patients.
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Affiliation(s)
- Yongin Cho
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Bong-Soo Cha
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Byung-Wan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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20
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Hu Y, Li TT, Zhou W, Lu TT, Li FF, Ding B, Liu BL, Xie XJ, Ma JH. Lipoprotein-associated phospholipase A2 is a risk factor for diabetic kidney disease. Diabetes Res Clin Pract 2019; 150:194-201. [PMID: 30904742 DOI: 10.1016/j.diabres.2019.03.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/04/2019] [Accepted: 03/14/2019] [Indexed: 01/15/2023]
Abstract
AIMS This study aimed to determine the association between lipoprotein-associated phospholipase A2 (Lp-PLA2), a marker for inflammation in the vessel wall and independently associated with atherosclerosis, and the incidence of diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D). METHODS A total of 1452 patients were enrolled in this retrospective cross‑sectional study. We recruited patients with T2D who were tested for glycated hemoglobin, fasting and 2 h post-meal serum C-peptide, blood lipid profile, 24 h urine albumin excretion rate (UAER), blood creatine, blood albumin, uric acid, and Lp-PLA2. RESULTS Among the patients with T2D, 40.3% were diagnosed with DKD and the correlation between DKD and Lp-PLA2 was the most significant one compared to other diabetic complications (odds ratio = 1.651, P < 0.001). Plasma Lp-PLA2 level in patients with DKD was significantly higher and increased Lp-PLA2 level was independently associated with the incidence of DKD after adjustment for age, gender, duration of diabetes, glycated hemoglobin, body mass index, blood lipids, blood pressure, presence of coronary heart disease and carotid plaque, and use of statins (odds ratio = 1.545, P = 0.013). Lp-PLA2 was found to be positively correlated with UAER (r = 0.123, P < 0.001) and negatively correlated with estimated glomerular filtration rate (eGFR) (r = -0.71, P = 0.009). CONCLUSIONS Increased plasma level of Lp-PLA2 is associated with incidence and development of DKD in patients with T2D. Lp-PLA2 should be considered as a biomarker for early detection and follow-up of DKD. TRIAL REGISTRATION clinicaltrials.gov, No. NCT03362112, Registered 30 November 2017, retrospectively registered.
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Affiliation(s)
- Yun Hu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Ting-Ting Li
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Wei Zhou
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, Yixing, China
| | - Ting-Ting Lu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Feng-Fei Li
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Bo Ding
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Bing-Li Liu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Xiao-Jing Xie
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China.
| | - Jian-Hua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China.
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21
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Han E, Kim MK, Lee YH, Kim HS, Lee BW. Association between nonalbumin proteinuria and renal tubular damage of N-acetyl-β-d-glucosaminidase and its clinical relevance in patients with type 2 diabetes without albuminuria. J Diabetes Complications 2019; 33:255-260. [PMID: 30236543 DOI: 10.1016/j.jdiacomp.2018.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/08/2018] [Accepted: 09/11/2018] [Indexed: 12/22/2022]
Abstract
AIM Although albuminuria and urinary N-acetyl-β-d-glucosaminidase (uNAG) are known as progression markers of diabetic kidney disease, there is limited information regarding the association between urinary nonalbumin proteinuria (NAP) and uNAG and the clinical relevance thereof in patients without albuminuria. METHODS This cross-sectional study included samples from 244 consecutive patients with type 2 diabetes mellitus (T2D) without albuminuria. Proteinuria and albuminuria were defined according to protein-to-creatinine ratio (uPCR) and albumin-to-creatinine ratio (uACR), respectively. NAP was indirectly calculated by the difference between uPCR and uACR. RESULTS NAP and uNAG excretion were significantly correlated (r = 0.525, P < 0.001). Individuals whose NAP levels were in the highest tertile had a longer duration of diabetes, uncontrolled hyperglycemia, and impaired insulin stimulation (all P < 0.05), although more patients in the highest NAP tertile were prescribed insulin and sulfonylurea. Multiple linear regression analyses revealed associations among uNAG, diabetes duration, and waist circumference. CONCLUSIONS T2D patients without albuminuria excrete proteinuria and that presence of the protein in urine is associated with uNAG. NAP was positively correlated with T2D duration and waist circumference, but negatively correlated with body mass index. Lean, but centrally obese, T2D patients in late diabetes experience more tubular damage, regardless of the presence of albuminuria.
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Affiliation(s)
- Eugene Han
- Division of Endocrinology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Mi-Kyung Kim
- Division of Endocrinology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Yong-Ho Lee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Soon Kim
- Division of Endocrinology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Byung-Wan Lee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Cardoso CRL, Salles GC, Leite NC, Salles GF. Prognostic impact of carotid intima-media thickness and carotid plaques on the development of micro- and macrovascular complications in individuals with type 2 diabetes: the Rio de Janeiro type 2 diabetes cohort study. Cardiovasc Diabetol 2019; 18:2. [PMID: 30630491 PMCID: PMC6327523 DOI: 10.1186/s12933-019-0809-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/03/2019] [Indexed: 12/18/2022] Open
Abstract
Background The prognostic importance of carotid atherosclerosis in individuals with diabetes is unsettled. We aimed to evaluate the relationships between parameters of carotid atherosclerosis and the future occurrence of micro- and cardiovascular complications in individuals with type 2 diabetes. Methods Ultrasonographic parameters of carotid atherosclerosis, intima-media thickness (CIMT) and plaques, were measured at baseline in 478 participants who were followed-up for a median of 10.8 years. Multivariate Cox analysis was used to examine the associations between carotid parameters and the occurrence of microvascular (retinopathy, renal, and peripheral neuropathy) and cardiovascular complications (total cardiovascular events [CVEs] and cardiovascular mortality), and all-cause mortality. The improvement in risk stratification was assessed by using the C-statistic and the integrated discrimination improvement (IDI) index. Results During follow-up, 116 individuals had a CVE and 115 individuals died (56 from cardiovascular diseases); 131 newly-developed or worsened diabetic retinopathy, 156 achieved the renal composite outcome (94 newly developed microalbuminuria and 78 deteriorated renal function), and 83 newly-developed or worsened peripheral neuropathy. CIMT, either analysed as a continuous or as a categorical variable, and presence of plaques predicted CVEs occurrence and renal outcomes, but not mortality or other microvascular complications. Individuals with an increased CIMT and plaques had a 1.5- to 1.8-fold increased risk of CVEs and a 1.6-fold higher risk of renal outcome. CIMT and plaques modestly improved cardiovascular risk discrimination over classic risk factors, with IDIs ranging from 7.8 to 8.4%; but more markedly improved renal risk discrimination, with IDIs from 14.8 to 18.5%. Conclusions Carotid atherosclerosis parameters predicted cardiovascular and renal outcomes, and improved renal risk stratification. Ultrasonographic carotid imaging may be useful in type 2 diabetes management.
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Affiliation(s)
- Claudia R L Cardoso
- Department of Internal Medicine, School of Medicine, University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco, 255, Cidade Universitária, Rio de Janeiro, CEP 21941-913, Brazil
| | - Guilherme C Salles
- Civil Engineering Program, COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Nathalie C Leite
- Department of Internal Medicine, School of Medicine, University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco, 255, Cidade Universitária, Rio de Janeiro, CEP 21941-913, Brazil
| | - Gil F Salles
- Department of Internal Medicine, School of Medicine, University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco, 255, Cidade Universitária, Rio de Janeiro, CEP 21941-913, Brazil.
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Soga F, Tanaka H, Tatsumi K, Mochizuki Y, Sano H, Toki H, Matsumoto K, Shite J, Takaoka H, Doi T, Hirata KI. Impact of dapagliflozin on left ventricular diastolic function of patients with type 2 diabetic mellitus with chronic heart failure. Cardiovasc Diabetol 2018; 17:132. [PMID: 30296931 PMCID: PMC6174555 DOI: 10.1186/s12933-018-0775-z] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/01/2018] [Indexed: 12/21/2022] Open
Abstract
Background The objective of this study was to investigate the impact of sodium glucose cotransporter type 2 (SGLT2) inhibitors on left ventricular (LV) diastolic function of type 2 diabetes mellitus (T2DM) patients with heart failure (HF). Methods This trial was a prospective multicenter study of 58 T2DM patients with stable HF at five institutions in Japan. Patients who had been taking at least one antidiabetic drugs other than SGLT2 inhibitors started the administration of 5 mg/day of dapagliflozin. The physical examinations, blood tests, and echocardiography were performed at baseline and 6 months after administration of dapagliflozin. The primary endpoint was defined as a change in mitral inflow E and mitral e′ annular velocities (E/e′) between baseline and 6 months after the administration of dapagliflozin. The secondary end points consisted of a change in brain natriuretic peptide (BNP), LV mass index (LVMI) and left atrial volume index (LAVI). Results E/e′ significantly decreased from 9.3 to 8.5 cm/s (p = 0.020) 6 months after administration of dapagliflozin. LAVI and LVMI significantly decreased from 31 to 26 mL/m2 (p = 0.001), and from 75.0 to 67.0 g/m2 (p < 0.001), respectively, 6 months after administration of dapagliflozin. No significant change was observed in BNP (from 27.9 to 28.9 pg/mL; p = 0.132) 6 months after administration of dapagliflozin, except for a significant decrease from 168.8 to 114.3 pg/mL (p = 0.012) in patients with BNP ≥ 100 pg/mL. Conclusion This prospective multicenter trial showed the beneficial effect of SGLT2 inhibitors on LV diastolic functional parameters for T2DM patients with HF. Our findings may thus offer a new insight into the management of T2DM patients. Trial registration UMIN000019789, Registered 28 September 2014, Date of registration: 11/14/2015, Date of enrolment of the first participant to the trial: 6/15/2016, Date of enrolment of the last participant to the trial: 12/9/2017
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Affiliation(s)
- Fumitaka Soga
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Kazuhiro Tatsumi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.,Tatsumi Clinic, Himeji, Japan
| | - Yasuhide Mochizuki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.,Division of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Hiroyuki Sano
- Division of Cardiology, Aijinkai Takatsuki Hospital, Takatsuki, Japan
| | - Hiromi Toki
- Division of Cardiology, Kobe Red Cross Hospital, Kobe, Japan
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Junya Shite
- Division of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Hideyuki Takaoka
- Division of Cardiology, Aijinkai Takatsuki Hospital, Takatsuki, Japan
| | - Tomofumi Doi
- Division of Cardiology, Kobe Red Cross Hospital, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Lee M, Hong N, Lee YH, Kang ES, Cha BS, Lee BW. Elevated N-acetyl-β-d-glucosaminidase, a urinary tubular damage marker, is a significant predictor of carotid artery atherosclerosis in type 1 diabetes, independent of albuminuria: A cross-sectional study. J Diabetes Complications 2018; 32:777-783. [PMID: 29980431 DOI: 10.1016/j.jdiacomp.2018.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 05/03/2018] [Accepted: 05/27/2018] [Indexed: 01/07/2023]
Abstract
AIMS Recent evidence has shown that renal tubulointerstitial injuries play an important role in diabetic nephropathy. In this study, we evaluated the association between urinary N-acetyl-β-d-glucosaminidase (uNAG), an early renal tubular damage marker, and carotid artery atherosclerosis in patients with type 1 diabetes (T1D). METHODS This was a cross-sectional study of 88 patients with T1D. Demographic and laboratory data; urinary indices, including urinary NAG-to-creatinine ratio (uNCR), and albumin-to-creatinine ratio (uACR); and carotid ultrasonography were investigated. RESULTS Eighty-eight subjects were divided into three groups based on uNCR tertiles. Subjects belonging to the highest tertile of uNCR had the highest average mean and maximum carotid intima-media thickness (IMT). An elevated uNCR was also significantly correlated with increased average mean and maximum carotid IMT, whereas an elevated uACR was not. Even after adjusting for confounding factors, uNCR continued to be a meaningful predictive marker for increased average mean and maximum IMT. Conversely, the uACR could not predict carotid IMT after adjustment for confounding factors. CONCLUSIONS Elevated levels of uNAG are significantly associated with carotid artery atherosclerosis in patients with T1D independently of albuminuria, a marker of glomerular damage.
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Affiliation(s)
- Minyoung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Namki Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Eun Seok Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Bong Soo Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Byung-Wan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
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