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Association of Autofluorescent Advanced Glycation End Products (AGEs) with Frailty Components in Chronic Kidney Disease (CKD): Data from a Single-Center Cohort Study. Cells 2023; 12:cells12030438. [PMID: 36766780 PMCID: PMC9913604 DOI: 10.3390/cells12030438] [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: 12/17/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is characterized by an overproduction and accumulation of advanced glycation end products (AGEs). Because AGEs may play a role in the development of malnutrition and sarcopenia, two essential components of frailty, we evaluated whether they may also contribute to the onset of frailty in CKD patients. METHODS We performed a cross-sectional analysis of 117 patients. AGEs were quantified using a fluorescence spectrophotometer and soluble receptor for AGE (sRAGE) isoforms by ELISA. We defined frailty according to the frailty phenotype (FP) proposed by Fried. RESULTS The average age of patients was 80 ± 11 years, 70% were male, and the mean eGFR was 25 + 11 mL/min/1.73m2. Frailty was diagnosed in 51 patients, and 40 patients were classified as pre-frail. AGEs and RAGE isoforms seem not to correlate with overall frailty. Instead, AGEs were associated with specific frailty domains, inversely associated with BMI (R = -0.22, p = 0.016) and directly associated with gait test time (R = 0.17, p = 0.049). AGEs were also associated with involuntary weight loss (OR 1.84 p = 0.027), independent of age and sex. CONCLUSIONS AGEs are associated with some pivotal components of the frailty phenotype, although they are not associated with frailty overall.
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Waqas K, Chen J, Lu T, van der Eerden BCJ, Rivadeneira F, Uitterlinden AG, Voortman T, Zillikens MC. Dietary advanced glycation end-products (dAGEs) intake and its relation to sarcopenia and frailty - The Rotterdam Study. Bone 2022; 165:116564. [PMID: 36150657 DOI: 10.1016/j.bone.2022.116564] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/18/2022] [Accepted: 09/19/2022] [Indexed: 11/02/2022]
Abstract
Studies on mice have shown a relationship between dietary intake of advanced glycation end-products (dAGEs) and deterioration of musculoskeletal health, but human studies are absent. We investigated the relationship between dietary intake of carboxymethyllysine (dCML) - an AGE prototype - and risk of sarcopenia at baseline and after 5 years of follow-up and a single evaluation of physical frailty in participants from the population-based Rotterdam Study. Appendicular lean mass (ALM) was obtained using insight dual-energy X-ray absorptiometry and hand grip strength (HGS) using a hydraulic hand dynamometer. Subjects with both low ALM and weak HGS were classified as having sarcopenia. Frailty (yes/no) was defined by presence of ≥3 and pre-frailty by presence of 1 or 2 components namely, exhaustion, weakness, slowness, weight loss or low physical activity. dCML was calculated using a food frequency questionnaire and dAGE databases. Logistic regression analysis was used to evaluate the odds of physical frailty and prevalent sarcopenia at baseline and follow-up and incident sarcopenia. 2782 participants with an age 66.4 ± 9.9 years and dCML intake 3.3 ± 1.3 mg/day, had data on sarcopenia at both time points. Of whom 84 had sarcopenia at baseline and 73 developed sarcopenia at follow-up. We observed an association of one SD increase in dCML intake with prevalent sarcopenia at baseline [odds ratio, OR = 1.27 (1.01-1.59)] and no association of dCML with incident sarcopenia at 5-year follow-up [OR = 1.12 (0.86-1.44)]. For frailty we analyzed 3577 participants, of whom 1972 were pre-frail and 158 were frail. We observed no association of dCML with either pre-frailty [OR = 0.99 (0.91-1.07)] or frailty [OR = 1.01 (0.83-1.22)] when non-frail subjects were used as reference. Our results show an association of dAGEs with sarcopenia cross-sectionally but not longitudinally where inconclusive findings are observed possibly due to a very low incidence of sarcopenia. There was no association with frailty cross-sectionally.
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Affiliation(s)
- Komal Waqas
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Jinluan Chen
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - T Lu
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - B C J van der Eerden
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Division of Human Nutrition & Health, Wageningen University & Research, Wageningen, the Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
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3
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Gillery P. HbA 1c and biomarkers of diabetes mellitus in Clinical Chemistry and Laboratory Medicine: ten years after. Clin Chem Lab Med 2022; 61:861-872. [PMID: 36239682 DOI: 10.1515/cclm-2022-0894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/10/2022] [Indexed: 11/15/2022]
Abstract
Since its discovery in the late 1960s, HbA1c has proven to be a major biomarker of diabetes mellitus survey and diagnosis. Other biomarkers have also been described using classical laboratory methods or more innovative, non-invasive ones. All biomarkers of diabetes, including the historical glucose assay, have well-controlled strengths and limitations, determining their indications in clinical use. They all request high quality preanalytical and analytical methodologies, necessitating a strict evaluation of their performances by external quality control assessment trials. Specific requirements are needed for point-of-care testing technologies. This general overview, which describes how old and new tools of diabetes mellitus biological survey have evolved over the last decade, has been built through the prism of papers published in Clinical Chemistry and Laboratory Medicine during this period.
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Affiliation(s)
- Philippe Gillery
- Laboratory of Biochemistry-Pharmacology-Toxicology, Biology and Pathology Department, University Hospital of Reims, Reims, France.,Laboratory of Medical Biochemistry and Molecular Biology, UMR CNRS/ URCA n°7369, Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
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4
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Wu X, Chen X, Ye A, Cao J, He R, Pan M, Jin F, Ma H, Zhou W. Multi-tissue metabolomic profiling reveals potential mechanisms of cocoon yield in silkworms (Bombyx mori) fed formula feed versus mulberry leaves. Front Mol Biosci 2022; 9:977047. [PMID: 36060262 PMCID: PMC9428324 DOI: 10.3389/fmolb.2022.977047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
Use of formula feed (FF) for silkworms for all instars, has promoted transformation and progress in traditional sericulture. However, the cocoon yield of FF silkworms has failed to reach that of silkworms fed mulberry leaves (ML). The biological mechanisms underlying this phenomenon have not been well described. This study aimed to identify metabolic mechanisms and potential biomarkers relating to the poor cocoon yield of FF silkworms. In this study, silkworms received treatments of either ML (ML group) or FF (FF group) for all instars. At the 3rd day of the 5th instar, the midgut (MG), hemolymph (HL) and posterior silk gland (PSG) were collected for the metabolome profiles detection. The remaining silkworms were fed ML or FF until cocooning for investigation. The whole cocoon yield (WCY) was significantly higher in the FF group than the ML group (p < 0.05), whereas the cocoon shell weight (CSW) and cocoon shell rate (CSR) were significantly lower in the FF group (p < 0.05). A total of 845, 867 and 831 metabolites were qualified and quantified in the MG, HL and PSG of the FF silkworms, respectively. Correspondingly, 789, 833 and 730 metabolites were quantified in above three tissues of the ML group. Further, 230, 249 and 304 significantly different metabolites (SDMs) were identified in the MG, HL and PSG between the FF and ML group, respectively. Eleven metabolic pathways enriched by the SDMs were mutual among the three tissues. Among them, cysteine and methionine metabolism, arginine biosynthesis, and arginine and proline metabolism were the top three pathways with the highest impact value in the PSG. Six biomarkers were obtained through biomarker analysis and Pearson correlation calculation. Among them, homocitrulline, glycitein, valyl-threonine, propyl gallate and 3-amino-2,3-dihydrobenzoic acid were positively correlated with WCY, but negatively correlated with CSW and CSR (p < 0.05). An opposite correlation pattern was observed between 3-dimethylallyl-4-hydroxyphenylpyruvate and the three cocoon performance traits. Overall, three key metabolic pathways and six biomarkers associated with cocoon yield were interpreted, and should provide directions for formula feed optimization in factory-raised silkworms.
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Affiliation(s)
- Xuehui Wu
- Institute of Sericulture and Tea, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, China
| | - Xuedong Chen
- Institute of Sericulture and Tea, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, China
| | - Aihong Ye
- Institute of Sericulture and Tea, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, China
| | - Jinru Cao
- Institute of Sericulture and Tea, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, China
| | - Ruimin He
- Shengzhou Mulsun Biotech Co., Ltd., Shengzhou, Zhejiang, China
| | - Meiliang Pan
- Zhejiang Provincial Agricultural Technology Extension and Service Center, Hangzhou, Zhejiang, China
| | - Feng Jin
- Shengzhou Mulsun Biotech Co., Ltd., Shengzhou, Zhejiang, China
| | - Huanyan Ma
- Zhejiang Provincial Agricultural Technology Extension and Service Center, Hangzhou, Zhejiang, China
| | - Wenlin Zhou
- Institute of Sericulture and Tea, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, China
- *Correspondence: Wenlin Zhou,
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Diallo AM, Jaisson S, Barriquand R, Lukas C, Barraud S, Decoudier B, Francois M, Ly S, Mahmoudi R, Arndt C, Nazeyrollas P, Gillery P, Delemer B. Association Between the Tissue and Circulating Advanced Glycation End-Products and the Micro- and Macrovascular Complications in Type 1 Diabetes: The DIABAGE Study. Diabetes Ther 2022; 13:1531-1546. [PMID: 35779209 PMCID: PMC9309113 DOI: 10.1007/s13300-022-01285-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 05/18/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Type 1 diabetes is associated with an increased risk of vascular complications. We aimed to investigate the association between serum and tissue advanced glycation end-products (AGEs) and micro- and macrovascular complications in type 1 diabetes (T1D). METHODS We conducted a cross-sectional study on 196 adults with T1D (mean age 44.53 ± 16, mean duration of diabetes 22 ± 12 years, mean HbA1c 8 ± 1.2%). AGEs were measured in blood serum (i.e., carboxymethyllysine (CML), methylglyoxal-hydroimidazolone-1 (MGH1), and pentosidine) and by measurement of skin autofluorescence (SAF). Associations between AGEs levels and vascular complications were analyzed using binary logistic regression. Correlations between AGEs and pulse wave velocity (PWV) were also assessed by linear regressions. Significant differences were set for p values less than 0.05. RESULTS We found positive associations between different AGEs and vascular complications. SAF was associated with both microangiopathy (retinopathy: OR = 1.92, p = 0.011; neuropathy: OR = 2.02, p = 0.04; any microangiopathy: OR = 2.83, p < 0.0001) and macroangiopathy (coronaropathy: OR = 3.11, p = 0.009; any macroangiopathy: OR = 2.78, p = 0.003). For circulating AGEs, pentosidine was significantly associated with coronaropathy (OR = 1.61, p = 0.01) and any macroangiopathy (OR = 1.52, p = 0.005) while MGH1 was associated with nephropathy (OR 1.72, p = 0.03). Furthermore, a significant linear correlation was found between PWV and SAF (r = 0.43, p < 0.001), pentosidine (r = 0.28, p < 0.001), and MGH1 (r = 0.16, p = 0.031), but not for CML (r = 0.03, p = 0.598). CONCLUSIONS Skin autofluorescence appears to be a useful marker for investigating both micro- and macrovascular complications in T1D. In this study, pentosidine was associated with macroangiopathy and MGH1 with nephropathy among the circulating AGEs. Furthermore, the correlations between PWV and AGEs may suggest their value in early prediction of vascular complications in T1D.
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Affiliation(s)
- Alpha M Diallo
- Service d'Endocrinologie, Diabète et Nutrition, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France.
- Laboratoire de recherche en Santé Publique, Vieillissement, Qualité de vie et Réadaptation des Sujets Fragiles, EA 3797, Université de Reims Champagne-Ardenne, Reims, France.
| | - Stéphane Jaisson
- Laboratoire de Biochimie et de Biologie Moléculaire, CNRS/URCA UMR N° 7369 MEDyC, Faculté de Médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Romain Barriquand
- Service d'Endocrinologie, Diabète et Nutrition, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France
| | - Céline Lukas
- Service d'Endocrinologie, Diabète et Nutrition, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France
| | - Sara Barraud
- Service d'Endocrinologie, Diabète et Nutrition, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France
- CRESTIC EA 3804, Université de Reims Champagne Ardenne, UFR Sciences Exactes et Naturelles, Moulin de la Housse, BP 1039, 51687, Reims CEDEX 2, France
| | - Bénédicte Decoudier
- Service d'Endocrinologie, Diabète et Nutrition, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France
| | - Maud Francois
- Service d'Endocrinologie, Diabète et Nutrition, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France
| | - Sang Ly
- Service d'Endocrinologie, Diabète et Nutrition, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France
| | - Rachid Mahmoudi
- Laboratoire de recherche en Santé Publique, Vieillissement, Qualité de vie et Réadaptation des Sujets Fragiles, EA 3797, Université de Reims Champagne-Ardenne, Reims, France
- Service de Gériatrie, CHU de Reims, 48 rue Cognacq Jay, 51092, Reims, France
| | - Carl Arndt
- Service d'Ophtalmologie, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France
| | - Pierre Nazeyrollas
- Laboratoire de recherche en Santé Publique, Vieillissement, Qualité de vie et Réadaptation des Sujets Fragiles, EA 3797, Université de Reims Champagne-Ardenne, Reims, France
- Service de Cardiologie, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France
| | - Philippe Gillery
- Laboratoire de Biochimie et de Biologie Moléculaire, CNRS/URCA UMR N° 7369 MEDyC, Faculté de Médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Brigitte Delemer
- Service d'Endocrinologie, Diabète et Nutrition, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France
- CRESTIC EA 3804, Université de Reims Champagne Ardenne, UFR Sciences Exactes et Naturelles, Moulin de la Housse, BP 1039, 51687, Reims CEDEX 2, France
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6
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Perazza LR, Brown-Borg HM, Thompson LV. Physiological Systems in Promoting Frailty. Compr Physiol 2022; 12:3575-3620. [PMID: 35578945 DOI: 10.1002/cphy.c210034] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Frailty is a complex syndrome affecting a growing sector of the global population as medical developments have advanced human mortality rates across the world. Our current understanding of frailty is derived from studies conducted in the laboratory as well as the clinic, which have generated largely phenotypic information. Far fewer studies have uncovered biological underpinnings driving the onset and progression of frailty, but the stage is set to advance the field with preclinical and clinical assessment tools, multiomics approaches together with physiological and biochemical methodologies. In this article, we provide comprehensive coverage of topics regarding frailty assessment, preclinical models, interventions, and challenges as well as clinical frameworks and prevalence. We also identify central biological mechanisms that may be at play including mitochondrial dysfunction, epigenetic alterations, and oxidative stress that in turn, affect metabolism, stress responses, and endocrine and neuromuscular systems. We review the role of metabolic syndrome, insulin resistance and visceral obesity, focusing on glucose homeostasis, adenosine monophosphate-activated protein kinase (AMPK), mammalian target of rapamycin (mTOR), and nicotinamide adenine dinucleotide (NAD+ ) as critical players influencing the age-related loss of health. We further focus on how immunometabolic dysfunction associates with oxidative stress in promoting sarcopenia, a key contributor to slowness, weakness, and fatigue. We explore the biological mechanisms involved in stem cell exhaustion that affect regeneration and may contribute to the frailty-associated decline in resilience and adaptation to stress. Together, an overview of the interplay of aging biology with genetic, lifestyle, and environmental factors that contribute to frailty, as well as potential therapeutic targets to lower risk and slow the progression of ongoing disease is covered. © 2022 American Physiological Society. Compr Physiol 12:1-46, 2022.
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Affiliation(s)
- Laís R Perazza
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
| | - Holly M Brown-Borg
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - LaDora V Thompson
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
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7
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Picca A, Coelho-Junior HJ, Calvani R, Marzetti E, Vetrano DL. Biomarkers shared by frailty and sarcopenia in older adults: A systematic review and meta-analysis. Ageing Res Rev 2022; 73:101530. [PMID: 34839041 DOI: 10.1016/j.arr.2021.101530] [Citation(s) in RCA: 104] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/04/2021] [Accepted: 11/21/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Physical frailty and sarcopenia show extensive clinical similarities. Whether biomarkers exist that are shared by the two conditions is presently unclear. METHODS We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association of frailty and/or sarcopenia with biomarkers as a primary or secondary outcome in adults aged 60 years and older. Only studies published in English that defined frailty using a validated scale and/or questionnaire and diagnosed sarcopenia according to the presence of muscle atrophy plus dynapenia or low physical function were included. Studies were identified from a systematic search of MEDLINE and SCOPUS databases from inception through August 2020. The quality of reporting of each study was assessed by using the Quality Assessment Tool for Observational Cohort, Cross-Sectional and Case-Control studies of the National Institute of Health. A meta-analysis was conducted when at least three studies investigated the same biomarker in both frailty and sarcopenia. Pooled effect size was calculated based on standard mean differences and random-effect models. Sensitivity analysis was performed based on age and the setting where the study was conducted. RESULTS Eighty studies (58 on frailty and 22 on sarcopenia) met the inclusion criteria and were included in the qualitative analysis. Studies on frailty included 33,160 community-dwellers, hospitalized, or institutionalized older adults (60-88 years) from 21 countries. Studies on sarcopenia involved 4904 community-living and institutionalized older adults (68-87.6 years) from 9 countries. Several metabolic, inflammatory, and hematologic markers were found to be shared between the two conditions. Albumin and hemoglobin were negatively associated with both frailty and sarcopenia. Interleukin 6 was associated with frailty and sarcopenia only in people aged < 75. Community-dwelling older adults with frailty and sarcopenia had higher levels of tumor necrosis factor alpha compared with their robust and non-sarcopenic counterparts. CONCLUSIONS A set of metabolic, hematologic, and inflammatory biomarkers was found to be shared by frailty and sarcopenia. These findings fill a knowledge gap in the quest of biomarkers for these conditions and provide a rationale for biomarker selection in studies on frailty and sarcopenia.
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Affiliation(s)
- Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | | | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Department of Geriatrics and Orthopedics, Rome, Italy
| | - Davide Liborio Vetrano
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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8
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Bourron O, Phan F, Diallo MH, Hajage D, Aubert CE, Carlier A, Salem JE, Funck-Brentano C, Kemel S, Cluzel P, Redheuil A, Davaine JM, Massy Z, Mentaverri R, Bonnefont-Rousselot D, Gillery P, Jaisson S, Vermeer C, Lacorte JM, Bouziri N, Laroche S, Amouyal C, Hartemann A. Circulating Receptor Activator of Nuclear Factor kB Ligand and triglycerides are associated with progression of lower limb arterial calcification in type 2 diabetes: a prospective, observational cohort study. Cardiovasc Diabetol 2020; 19:140. [PMID: 32948184 PMCID: PMC7501627 DOI: 10.1186/s12933-020-01122-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 09/12/2020] [Indexed: 12/15/2022] Open
Abstract
Background Lower limb arterial calcification is a frequent, underestimated but serious complication of diabetes. The DIACART study is a prospective cohort study designed to evaluate the determinants of the progression of lower limb arterial calcification in 198 patients with type 2 diabetes. Methods Lower limb arterial calcification scores were determined by computed tomography at baseline and after a mean follow up of 31.20 ± 3.86 months. Serum RANKL (Receptor Activator of Nuclear factor kB Ligand) and bone remodeling, inflammatory and metabolic parameters were measured at baseline. The predictive effect of these markers on calcification progression was analyzed by a multivariate linear regression model. Results At baseline, mean ± SD and median lower limb arterial calcification scores were, 2364 ± 5613 and 527 respectively and at the end of the study, 3739 ± 6886 and 1355 respectively. Using multivariate analysis, the progression of lower limb arterial log calcification score was found to be associated with (β coefficient [slope], 95% CI, p-value) baseline log(calcification score) (1.02, 1.00–1.04, p < 0.001), triglycerides (0.11, 0.03–0.20, p = 0.007), log(RANKL) (0.07, 0.02–0.11, p = 0.016), previous ischemic cardiomyopathy (0.36, 0.15–0.57, p = 0.001), statin use (0.39, 0.06–0.72, p = 0.023) and duration of follow up (0.04, 0.01–0.06, p = 0.004). Conclusion In patients with type 2 diabetes, lower limb arterial calcification is frequent and can progress rapidly. Circulating RANKL and triglycerides are independently associated with this progression. These results open new therapeutic perspectives in peripheral diabetic calcifying arteriopathy. Trial registration NCT02431234
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Affiliation(s)
- Olivier Bourron
- Sorbonne Université, Paris, France. .,Assistance Publique-Hôpitaux de Paris (APHP), Diabetology Department, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France. .,Institute of Cardiometabolism and Nutrition ICAN, Paris, France. .,INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Paris 06, France. .,Diabetology Department, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, Paris, France.
| | - Franck Phan
- Sorbonne Université, Paris, France.,Assistance Publique-Hôpitaux de Paris (APHP), Diabetology Department, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France.,Institute of Cardiometabolism and Nutrition ICAN, Paris, France.,INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Paris 06, France
| | - Mamadou Hassimiou Diallo
- Unité de Recherche Clinique Salpêtrière - Charles Foix, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, 75013, Paris, France
| | - David Hajage
- Département de Santé, Centre de Pharmacoépidémiologie (Cephepi), CIC-1421, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 75013, Paris, France
| | - Carole-Elodie Aubert
- Assistance Publique-Hôpitaux de Paris (APHP), Diabetology Department, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France
| | - Aurélie Carlier
- Sorbonne Université, Paris, France.,Assistance Publique-Hôpitaux de Paris (APHP), Diabetology Department, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France.,Institute of Cardiometabolism and Nutrition ICAN, Paris, France
| | - Joe-Elie Salem
- Sorbonne Université, Paris, France.,Department of Pharmacology and CIC-1421, AP-HP La Pitié Salpêtrière Charles Foix University Hospital, Paris, France.,INSERM, CIC-1901, Paris, France.,Institute of Cardiometabolism and Nutrition ICAN, Paris, France
| | - Christian Funck-Brentano
- Sorbonne Université, Paris, France.,Department of Pharmacology and CIC-1421, AP-HP La Pitié Salpêtrière Charles Foix University Hospital, Paris, France.,INSERM, CIC-1901, Paris, France.,Institute of Cardiometabolism and Nutrition ICAN, Paris, France
| | - Salim Kemel
- Sorbonne Université, Paris, France.,Laboratoire d'Imagerie Biomédicale INSERM_1146, CNRS_7371, Paris, France.,Assistance Publique-Hôpitaux de Paris (APHP), Department of Radiology, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France
| | - Philippe Cluzel
- Sorbonne Université, Paris, France.,Institute of Cardiometabolism and Nutrition ICAN, Paris, France.,Laboratoire d'Imagerie Biomédicale INSERM_1146, CNRS_7371, Paris, France.,Assistance Publique-Hôpitaux de Paris (APHP), Department of Radiology, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France
| | - Alban Redheuil
- Sorbonne Université, Paris, France.,Institute of Cardiometabolism and Nutrition ICAN, Paris, France.,Laboratoire d'Imagerie Biomédicale INSERM_1146, CNRS_7371, Paris, France.,Assistance Publique-Hôpitaux de Paris (APHP), Department of Radiology, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France
| | | | - Ziad Massy
- Division of Nephrology, Ambroise Paré Hospital, AP-HP, Université Paris-Saclay, Paris, France
| | - Romuald Mentaverri
- INSERM_1088, Centre Universitaire de Recherche en Santé, Université de Picardie Jules Verne, Amiens, France
| | - Dominique Bonnefont-Rousselot
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France.,UTCBS, CNRS UMR8258 - INSERM_1267, Faculty of Pharmacy of Paris, University of Paris, Paris, France
| | - Philippe Gillery
- University of Reims- Champagne-Ardenne, CNRS, MEDyC UMR 7369, Reims, France.,Laboratory of Biochemisry-Pharmacology-Toxicology, University Hospital of Reims, Maison Blanche Hospital, Reims, France
| | - Stéphane Jaisson
- University of Reims- Champagne-Ardenne, CNRS, MEDyC UMR 7369, Reims, France.,Laboratory of Biochemisry-Pharmacology-Toxicology, University Hospital of Reims, Maison Blanche Hospital, Reims, France
| | - Cees Vermeer
- Cardiovascular Research Institute CARIM, Maastricht University, Maastricht, The Netherlands
| | - Jean-Marc Lacorte
- Sorbonne Université, Paris, France.,Department of Endocrine and Oncologic Biochemistry, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.,INSERM U1166, Paris, France
| | - Nesrine Bouziri
- Sorbonne University, ACTION Study Group, INSERM, UMRS 1166, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
| | - Suzanne Laroche
- Sorbonne Université, Paris, France.,Assistance Publique-Hôpitaux de Paris (APHP), Diabetology Department, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France.,Institute of Cardiometabolism and Nutrition ICAN, Paris, France
| | - Chloé Amouyal
- Sorbonne Université, Paris, France.,Assistance Publique-Hôpitaux de Paris (APHP), Diabetology Department, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France.,Institute of Cardiometabolism and Nutrition ICAN, Paris, France
| | - Agnes Hartemann
- Sorbonne Université, Paris, France.,Assistance Publique-Hôpitaux de Paris (APHP), Diabetology Department, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France.,Institute of Cardiometabolism and Nutrition ICAN, Paris, France.,INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Paris 06, France
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