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Jin J, Woo H, Jang Y, Lee WK, Kim JG, Lee IK, Park KG, Choi YK. Novel Asian-Specific Visceral Adiposity Indices Are Associated with Chronic Kidney Disease in Korean Adults. Diabetes Metab J 2023; 47:426-436. [PMID: 36872065 PMCID: PMC10244194 DOI: 10.4093/dmj.2022.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/17/2022] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND The Chinese visceral adiposity index (CVAI) and new visceral adiposity index (NVAI) are novel indices of visceral adiposity used to predict metabolic and cardiovascular diseases in Asian populations. However, the relationships of CVAI and NVAI with chronic kidney disease (CKD) have not been investigated. We aimed to characterize the relationships of CVAI and NVAI with the prevalence of CKD in Korean adults. METHODS A total of 14,068 participants in the 7th Korea National Health and Nutrition Examination Survey (6,182 men and 7,886 women) were included. Receiver operating characteristic (ROC) analyses were employed to compare the associations between indices of adiposity and CKD, and a logistic regression model was used to characterize the relationships of CVAI and NVAI with CKD prevalence. RESULTS The areas under the ROC curves for CVAI and NVAI were significantly larger than for the other indices, including the visceral adiposity index and lipid accumulation product, in both men and women (all P<0.001). In addition, high CVAI or NVAI was significantly associated with a high CKD prevalence in both men (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.31 to 3.48 in CVAI and OR, 6.47; 95% CI, 2.91 to 14.38 in NVAI, P<0.05) and women (OR, 4.87; 95% CI, 1.85 to 12.79 in CVAI and OR, 3.03; 95% CI, 1.35 to 6.82 in NVAI, P<0.05); this association remained significant after adjustment for multiple confounding factors in men and women. CONCLUSION CVAI and NVAI are positively associated with CKD prevalence in a Korean population. CVAI and NVAI may be useful for the identification of CKD in Asian populations, including in Korea.
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Affiliation(s)
- Jonghwa Jin
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Hyein Woo
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Youngeun Jang
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Won-Ki Lee
- Center of Biostatistics, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Jung-Guk Kim
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - In-Kyu Lee
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Keun-Gyu Park
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Yeon-Kyung Choi
- Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
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Barbieri D, Goicoechea M, Verde E, García-Prieto A, Verdalles Ú, Pérez de José A, Delgado A, Sánchez-Niño MD, Ortiz A. Obesity, chronic kidney disease progression and the role of the adipokine C1q/TNF related protein-3. Nefrologia 2023; 43:328-334. [PMID: 36517365 DOI: 10.1016/j.nefroe.2022.02.009] [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: 11/08/2021] [Accepted: 02/07/2022] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION AND AIMS Obesity is a risk factor for incident chronic kidney disease (CKD). C1q/TNF related protein 3 (CTRP3) is an adipokine with multiple effects and may modulate the association between obesity and vascular diseases. The aim of the study is to explore potential links between obesity, CTRP3 levels and CKD progression. METHODS Patients with stage 3 and 4 CKD without previous cardiovascular events were enrolled and divided into groups according to body mass index (BMI) and sex. Demographic, clinical, analytical data and CTRP3 levels were collected at baseline. During follow-up, renal events (defined as dialysis initiation, serum creatinine doubling or a 50% decrease in estimated glomerular filtration rate were registered). RESULTS 81 patients were enrolled. 27 were obese and 54 non-obese. Baseline CTRP3 was similar between both groups (90.1±23.8 vs 84.5±6.2; p=0.28). Of the sum, 54 were men and 27 women, with higher CTRP3 in women (81.4±24.7 vs 106±24.7;p<0.01). During a mean follow-up of 68 months, 15 patients had a renal event. Patients in the higher CTRP3 tertile had less events but without statistical significance (p=0.07). Obese patients in the higher CTRP3 tertile significantly had less renal events (p=0.049). By multiple regression analysis CTRP3 levels could not predict renal events (HR 0.98; CI95% 0.96-1.06). CONCLUSIONS CTRP3 levels are higher in woman than men in patients with CKD, with similar levels between obese and non obese. Higher CTRP3 levels at baseline were associated with better renal outcomes in obese patients.
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Affiliation(s)
- Diego Barbieri
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Marian Goicoechea
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Eduardo Verde
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana García-Prieto
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Úrsula Verdalles
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Pérez de José
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Andrés Delgado
- Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Alberto Ortiz
- Nephrology Department, ISS-Fundación Jimenez Díaz, Univerisdad Autonoma de Madrid, Madrid, Spain
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Anti-obesity properties of probiotics; a considerable medical nutrition intervention: Findings from an umbrella meta-analysis. Eur J Pharmacol 2022; 928:175069. [PMID: 35659967 DOI: 10.1016/j.ejphar.2022.175069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/09/2022] [Accepted: 05/24/2022] [Indexed: 11/22/2022]
Abstract
Although several studies have indicated that consumption of probiotics is effective in the treatment of obesity, the results in this regard have yielded controversial findings. The current umbrella meta-analysis was performed to evaluate the effects of probiotics supplementation on obesity indices in adults. Scopus, PubMed, Web of Science, Embase and Google Scholar were searched for relevant studies published till November 2021. Meta-analysis was conducted using the random-effects model. Sensitivity and subgroup analyses were performed. In total, 29 meta-analyses with 14,366 participants, including 112, 78, and 38 unique trials for body mass index (BMI), body weight (BW), and waist circumference (WC), were included in the study, respectively. The findings demonstrated that the probiotics supplementation was significantly effective on decreasing of BMI (ES = -0.21; 95% CI: -0.30, -0.13, p < 0.001; I2 = 83.0%, p < 0.001), BW (ES = -0.38, 95% CI: -0.60, -0.16; p < 0.001; I2 = 81.8%, p < 0.001), and WC (ES = -0.60; 95% CI: -0.89, -0.31; p < 0.001; I2 = 89.1%, p < 0.001). Greater effects on BW were observed when intervention duration was >8 weeks and on obese individuals. BMI was also greatly modified in participants with metabolic syndrome and when intervention duration lasted for ≥12 weeks. The methodological quality (AMSTAR2) was moderate in 83%, low in 10%, and critically low in 7% of included studies. The current umbrella meta-analysis indicated that supplementation of probiotics in adults led to a meaningful reduction in BW, BMI, and WC. Therefore, our findings strongly recommend supplementation with probiotics as a potent intervention in the management of obesity.
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Barbieri D, Goicoechea M, Verde E, García-Prieto A, Verdalles Ú, Pérez de José A, Delgado A, Sánchez-Niño MD, Ortiz A. Obesity, chronic kidney disease progression and the role of the adipokine C1q/TNF related protein-3. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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5
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Effects of probiotics fermented milk products on obesity measure among adults: A systematic review and meta-analysis of clinical trials. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104494] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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6
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Moustakim R, El Ayachi M, Mziwira M, Belahsen R. Undiagnosed chronic kidney disease and its associated risk factors in an agricultural Moroccan adult's population. Nephrol Ther 2020; 16:147-152. [PMID: 32278735 DOI: 10.1016/j.nephro.2019.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 12/07/2019] [Accepted: 12/08/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Chronic kidney disease is among the major non-communicable diseases with increasing prevalence. This study aimed to estimate the prevalence of chronic kidney disease and its associated risk factors among Moroccan population sample from Sidi Bennour province. METHODS An observational, descriptive and analytical study was conducted in an agricultural community of Morocco. A sample of 182 subjects aged 18 or older, randomly selected from the province health care centers. The information on the participants was collected using a structured questionnaire, blood samples were collected and the serum creatinine was determined. Subsequent glomerular filtration rate (eGFR) was estimated by the modification of diet in renal disease formula and the chronic kidney disease was defined by an eGFR<60 mL/min/1.73 m2. RESULTS The participants mean age was 53.58±12.06 years, with a sex ratio of 0.30 and the prevalence of chronic kidney disease was 4.4%. The risk factors associated with chronic kidney disease were age, hypertension, and nephrotoxic treatment, that are significantly correlated with renal impairment (P=0.006 for age, P=0.008 for hypertension and P=0.001 for nephrotoxic medication used respectively). CONCLUSIONS The study data show that chronic kidney disease should be of important consideration in any strategy to address non-communicable diseases and associated risk factors.
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Affiliation(s)
- Rachida Moustakim
- Laboratory of biotechnology, biochemistry and nutrition, Training and research unit on nutrition and food sciences, Chouaib Doukkali University, School of sciences, El Jadida, 24000 Morocco
| | - Mohammed El Ayachi
- Laboratory of biotechnology, biochemistry and nutrition, Training and research unit on nutrition and food sciences, Chouaib Doukkali University, School of sciences, El Jadida, 24000 Morocco
| | | | - Rekia Belahsen
- Laboratory of biotechnology, biochemistry and nutrition, Training and research unit on nutrition and food sciences, Chouaib Doukkali University, School of sciences, El Jadida, 24000 Morocco.
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Askarpour M, Hadi A, Miraghajani M, Symonds ME, Sheikhi A, Ghaedi E. Beneficial effects of l-carnitine supplementation for weight management in overweight and obese adults: An updated systematic review and dose-response meta-analysis of randomized controlled trials. Pharmacol Res 2020; 151:104554. [DOI: 10.1016/j.phrs.2019.104554] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/07/2019] [Accepted: 11/16/2019] [Indexed: 10/25/2022]
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8
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Early Renal Dysfunction in Obese Patients with Insulin Resistance. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2019. [DOI: 10.2478/rjdnmd-2019-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background and aims. Obese individuals have insulin resistance status assessed in the present study by the HOMA index (“Homeostasis model assessment”). This prospective study assessed renal disorders in the insulin resistance in obese patients.
Material and Methods. The study included 73 young obese patients. The assessment included the HOMA index before meal and parameters of renal function (glomerular filtration rate, albuminuria, β2-microglobulinuria).
Results. In young obese, insulin-resistance patients, glomerular hyperfiltration and β2-microglobulinuria are found in 77.0 and 93.4% of cases respectively. The albuminuria is noted in some cases, which reduces diagnostic value.
Conclusions. In young obese patients with insulin resistance, glomerular hyperfiltration and β2-microglobulinuria are main diagnostic markers of renal dysfunction.
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Sinna MM, Altaf FMN, Mosa OF. Serum and Urinary NGAL and Cystatin C Levels as Diagnostic Tools for Acute Kidney Injury and Chronic Kidney Disease: A Histobiochemical Comparative Study. Curr Pharm Des 2019; 25:1122-1133. [PMID: 31096894 DOI: 10.2174/1381612825666190516080920] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/02/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND High global incidence of acute kidney injury (AKI) is an observable complication in critically ill patients. Long-term disease and medication complexity contribute to devastating chronic kidney disease (CKD), diminishing quality of life. OBJECTIVES To establish new biomarkers to guide patient care and facilitate novel therapeutics development. METHODS Serum and urinary levels of creatinine, CysC, and NGAL were estimated in 86 renal patients and compared with healthy controls for AKI and CKD categorization. Creatinine and CysC measurements were used to estimate GFR. Kidney biopsies were prepared for light microscopy for further characterization. Patients' demographic data were used in group association studies. RESULTS Thirty-six patients met the criteria for AKI and 50 for CKD. Both mean serum and urine creatinine levels were significantly elevated by 2.8 and 2.6, respectively, from baseline in 48 h in the AKI group but not CKD group. Mean serum Cystatin C (CysC) values were higher than controls but similar in both disease states, while urine levels were slightly higher in CKD patients, and remained steady by the end of the follow-up (EF-Up). Further, a significant 2.9-fold and 5.5-fold (p=0.001) increase in serum NGAL in AKI and CKD, respectively, and a dramatic 7.1-factor reduction in AKI group, but no appreciable change in the CKD group from admission to EF-Up were observed. Similarly, urine NGAL level for AKI and CKD increased 3.2-fold and 6-fold respectively, on admission, which decreased moderately with the AKI group (2.5-fold) but increased by a factor of 1-8 (10.7- fold; p=0.001) at EF-Up. ROC assessment curve revealed relatively higher NGAL performance at good predictive values than CysC (p < 0.009). CONCLUSION Our data demonstrated creatinine elevation by a factor > 2 in 48 h in AKI group but not CKD group, which returned close to normal levels by the EF-Up, an indication of abrupt renal injury in AKI, compared with a persistent effect in the CKD group. Both serum and urine NGAL sensitivity and specificity provided powerful discriminative tool between AKI and CKD by reduction in the AKI group and an increase in the CKD group by the EF-UP, thus, contributing in establishing the basis for AKI and CKD classification. CysC, however, displayed less sensitivity than NGAL, indicating effects by enigmatic non-specific factors.
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Affiliation(s)
- Mustafa M Sinna
- Anatomy Department, College of Medicine, Umm Al Qura University, El-Abidia, Makkah, Saudi Arabia
| | - Faris M N Altaf
- Anatomy Department, College of Medicine, Umm Al Qura University, El-Abidia, Makkah, Saudi Arabia
| | - Osama F Mosa
- Public Health Department, Health Sciences College at Leith, Umm Al Qura University, Al-Lieth, Makkah, Saudi Arabia
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10
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Association between Take-Out Food Consumption and Obesity among Chinese University Students: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061071. [PMID: 30934650 PMCID: PMC6465988 DOI: 10.3390/ijerph16061071] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/21/2019] [Accepted: 03/23/2019] [Indexed: 12/25/2022]
Abstract
Background: The frequency of take-out food consumption has increased rapidly among Chinese college students, which has contributed to high obesity prevalence. However, the relationships between take-out food consumption, body mass index (BMI), and other individual factors influencing eating behavior among college students are still unclear. This study explored the association of take-out food consumption with gender, BMI, physical activity, preference for high-fat and high-sugar (HFHS) food, major category, and degree level among Chinese college students. Methods: Cross-sectional data were collected from 1220 college students in Beijing, China, regarding information about take-out food consumption, physical activity, and preference for HFHS food using a self-reported questionnaire. The logistic linear regression model was used to analyze the association between take-out food consumption and personal and lifestyle characteristics. Results: Out of 1220 college students, 11.6% of college students were overweight or obese. Among the personal and lifestyle characteristics, high frequency of take-out food consumption was significantly associated with a non-medical major, high preference for HFHS food, degree level, and higher BMI, but not physical activity. Conclusion: Among Chinese college students, consumption of take-out food may be affected by major category, preference for HFHS food, degree level, and BMI. This could provide guidance on restrictions of high take-out food consumption, which contributes to high obesity prevalence and high risk for metabolic diseases.
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11
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Contreras Villamizar KM, Afanador Rubio DC, González González CA, García Padilla PK, Rodríguez Sánchez MP. Gastric sleeve surgery in hemodialysis: A case report. Int J Surg Case Rep 2019; 57:19-21. [PMID: 30875624 PMCID: PMC6416668 DOI: 10.1016/j.ijscr.2019.02.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/07/2019] [Accepted: 02/25/2019] [Indexed: 12/19/2022] Open
Abstract
Obese patients with end-stage renal disease on hemodialysis, decreases the access to kidney transplantation. Bariatric surgery has proven to be safe and effective for weight loss. Dialysis-dependency does not independently increase the risk for adverse outcomes after bariatric surgery. The estimation of DW through BIA is an effective method for avoiding complications generated by excessive or deficient ultrafiltration.
Introduction Morbid obesity in chronic kidney disease patients on hemodialysis limits access to renal transplantation. We report here a case of a surgical procedure for weight reduction in a hemodialysis patient and adjustment of dry weight through bioelectrical impedance. Case presentation A 44-year-old male with CKD on hemodialysis for 26 years. After 3 years on dialysis, he underwent a cadaveric kidney transplant. However, after 8 years of transplant, he loses the kidney graft and returns to dialysis treatment. The patient’s BMI increased to 42 kg/m2 and he had difficult-to-control hypertension and severe sleep apnea. Behavioral, nutritional and pharmacologic measures were not sufficient to achieve an adequate weight control. Thus, a surgical procedure for weight reduction was considered. The patient underwent a laparoscopic gastric sleeve without any complications. Dry weight was adjusted through bioelectrical impedance before each hemodialysis session. The patient did not display hypotension, cramps, or fluid overload. After a 30 kg weight loss, the patient’s BMI was 28.3 kg/m2, allowing registration on the kidney transplant waitlist. Discussion Obesity in CKD restricts access to kidney transplant waitlist. Bariatric surgery has proven to be safe and effective for sustained weight loss and it seems that the fact that a patient is dialysis dependent does not independently increase post-operatory complications. Conclusion Surgical procedures for weight reduction in dialysis patients does not independently increase the risk for adverse outcomes after bariatric surgery. The estimation of DW through BIA is an effective method for avoiding complications generated by excessive or deficient ultrafiltration.
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Affiliation(s)
- Kateir Mariel Contreras Villamizar
- Nephrology Unit, Internal Medicine Department, Hospital Universitario San Ignacio, Medical School, Pontificia Universidad Javeriana, Colombia.
| | - Diana Carolina Afanador Rubio
- Nephrology Unit, Internal Medicine Department, Hospital Universitario San Ignacio, Medical School, Pontificia Universidad Javeriana, Colombia
| | - Camilo Alberto González González
- Nephrology Unit, Internal Medicine Department, Hospital Universitario San Ignacio, Medical School, Pontificia Universidad Javeriana, Colombia
| | - Paola Karina García Padilla
- Nephrology Unit, Internal Medicine Department, Hospital Universitario San Ignacio, Medical School, Pontificia Universidad Javeriana, Colombia
| | - Martha Patricia Rodríguez Sánchez
- Nephrology Unit, Internal Medicine Department, Hospital Universitario San Ignacio, Medical School, Pontificia Universidad Javeriana, Colombia
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Mitchell NS, Scialla JJ, Yancy WS. Are low-carbohydrate diets safe in diabetic and nondiabetic chronic kidney disease? Ann N Y Acad Sci 2019; 1461:25-36. [PMID: 30644556 DOI: 10.1111/nyas.13997] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/04/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022]
Abstract
Diabetes mellitus and obesity both contribute to chronic kidney disease (CKD) and diabetic kidney disease (DKD), and they can accelerate the loss of kidney function. Dietary intake can potentially have wide-reaching effects on the risk of CKD/DKD and their progression by reducing weight and blood pressure, improving glycemic control, reducing hyperfiltration, and modulating inflammation. Low-carbohydrate (LC) diets can reduce weight and improve glycemic control, but the relatively higher protein content also raises concern in CKD/DKD. Empiric evidence supporting the kidney-related benefits or risks of LC diets is needed to understand the balance of these potential harms and benefits for patients with DKD and is the subject of our review.
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Affiliation(s)
- Nia S Mitchell
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina.,Duke Diet and Fitness Center, Duke University Health System, Durham, North Carolina
| | - Julia J Scialla
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - William S Yancy
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina.,Duke Diet and Fitness Center, Duke University Health System, Durham, North Carolina.,Department of Veterans Affairs, Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina
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13
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Barbieri D, Goicoechea M, Sánchez-Niño MD, Ortiz A, Verde E, Verdalles U, Pérez de José A, Delgado A, Hurtado E, Sánchez-Cámara L, Lopez-Lazareno N, García-Prieto A, Luño J. Obesity and chronic kidney disease progression-the role of a new adipocytokine: C1q/tumour necrosis factor-related protein-1. Clin Kidney J 2018; 12:420-426. [PMID: 31198543 PMCID: PMC6543966 DOI: 10.1093/ckj/sfy095] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Indexed: 01/09/2023] Open
Abstract
Background Obesity is a risk factor for incident chronic kidney disease (CKD) in the general population. C1q/tumour necrosis factor-related protein 1 (CTRP1) is a new adipokine with multiple vascular and metabolic effects and may modulate the association between obesity and vascular diseases. The aim of the study is to explore potential links between obesity, CTRP1 levels and CKD progression. Methods Patients with Stages 3 and 4 CKD without previous cardiovascular events were enrolled and divided into two groups according to body mass index (BMI). Demographic, clinical and analytical data and CTRP1 levels were collected at baseline. During follow-up, renal events [defined as dialysis initiation, serum creatinine doubling or a 50% decrease in estimated glomerular filtration rate (Modification of Diet in Renal Disease)] were registered. Results A total of 71 patients with CKD were divided into two groups: 25 obese (BMI >30 kg/m2) and 46 non-obese. CTRP1 in plasma at baseline was higher in obese patients [median (interquartile range) 360 (148) versus 288 (188) ng/mL, P = 0.041]. No significant association was found between CTRP1 levels and CKD stage, presence of diabetes, aldosterone and renin levels, or blood pressure. Obese patients had higher systolic blood pressure (P = 0.018) and higher high-sensitivity C-reactive protein (P = 0.019) and uric acid (P = 0.003) levels, without significant differences in the percentage of diabetic patients or albuminuria. During a mean follow-up of 65 months, 14 patients had a renal event. Patients with CTRP1 in the lowest tertile had more renal events, both in the overall sample (log rank: 5.810, P = 0.016) and among obese patients (log rank: 5.405, P = 0.020). Higher CTRP1 levels were associated with slower renal progression (hazard ratio 0.992, 95% confidence interval 0.986–0.998; P = 0.001) in a model adjusted for obesity, aspirin, albuminuria and renal function. Conclusions CTRP1 levels are higher in obese than in non-obese patients with CKD. High CTRP1 levels may have a renal protective role since they were associated with slower kidney disease progression. Interventional studies are needed to explore this hypothesis.
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Affiliation(s)
- Diego Barbieri
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Marian Goicoechea
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.,Spanish Kidney Research Network (REDinREN), Madrid, Spain
| | - Maria Dolores Sánchez-Niño
- Spanish Kidney Research Network (REDinREN), Madrid, Spain.,Nephrology Department, IIS-Fundación Jimenez Diaz UAM, Madrid, Spain
| | - Alberto Ortiz
- Spanish Kidney Research Network (REDinREN), Madrid, Spain.,Nephrology Department, IIS-Fundación Jimenez Diaz UAM, Madrid, Spain
| | - Eduardo Verde
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Ursula Verdalles
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Ana Pérez de José
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Andrés Delgado
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Esther Hurtado
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Luis Sánchez-Cámara
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Nieves Lopez-Lazareno
- Biochemistry Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Ana García-Prieto
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - José Luño
- Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.,Spanish Kidney Research Network (REDinREN), Madrid, Spain
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Mao S, Wu L. Association between MCP-1 2518 A>G gene polymorphism and chronic kidney disease. Int Urol Nephrol 2018; 50:2245-2253. [PMID: 30109559 DOI: 10.1007/s11255-018-1955-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 08/07/2018] [Indexed: 01/10/2023]
Abstract
Monocyte chemoattractant protein-1 (MCP-1) is involved in the pathogenesis of chronic kidney diseases (CKD). MCP-1 2518 A>G gene polymorphism is associated with MCP-1 status. We performed a meta-analysis to assess the association between MCP-1 2518 A>G gene polymorphism and CKD risk. The eligible studies regarding the relationship between MCP-1 2518 A>G gene polymorphism and CKD risk were searched through electronic databases. The pooled odds ratios (ORs) and its 95% confidence intervals (CIs) were calculated by using a fixed-effects model, or in the presence of heterogeneity, a random-effects model. A total of 2415 cases and 2011 controls were recruited in our investigation. A allele/GG genotype was not associated with CKD risk in overall populations, Asians, Caucasians, and Africans. AA/AG genotype was not associated with the risk of CKD in overall populations, Asians, Caucasians, and Africans. AA genotype was associated with a lower risk of CKD in Caucasians (OR 0.816, 95% CI 0.703-0.947). AG genotype was associated with a higher risk of CKD in Caucasians (OR 1.230, 95% CI 1.042-1.452). There was no marked publication bias. In conclusion, AA genotype may be a protective factor against CKD susceptibility in Caucasians. AG genotype may be a risk factor for CKD risk in Caucasians. However, more studies are needed in the future.
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Affiliation(s)
- Song Mao
- Department of Pediatrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
| | - Liangxia Wu
- Department of Pediatrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
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Sugiyama S, Jinnouchi H, Kurinami N, Hieshima K, Yoshida A, Jinnouchi K, Tanaka M, Nishimura H, Suzuki T, Miyamoto F, Kajiwara K, Jinnouchi T. Impact of Dapagliflozin Therapy on Renal Protection and Kidney Morphology in Patients With Uncontrolled Type 2 Diabetes Mellitus. J Clin Med Res 2018; 10:466-477. [PMID: 29707088 PMCID: PMC5916535 DOI: 10.14740/jocmr3419w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 04/03/2018] [Indexed: 02/06/2023] Open
Abstract
Background We examined whether the sodium-glucose cotransporter-2 inhibitor (SGLT2i) dapagliflozin can improve urine albumin-to-creatinine ratio (UACR) associated with a reduction in body weight or body fat in patients with type 2 diabetes mellitus (T2DM). Methods We prospectively recruited T2DM patients having inadequate glycemic control (hemoglobin A1c (HbA1c) > 7.0%) not on SGLT2i therapy. We treated the patients with add-on dapagliflozin treatment or intensification of non-SGLT2 inhibitor therapies for 6 months. We measured UACR, urine N-acetyl-β-glucosaminidase (uNAG), and body composition including total body fat mass (TBFM) as assessed by bioelectrical impedance analysis. We also investigated changes in length and radiation attenuation properties of the kidneys and abdominal fat area using computed tomography. Results We enrolled 62 patients with a mean HbA1c of 8.0%. The HbA1c and fasting blood glucose were significantly decreased in both the dapagliflozin-group and non-SGLT2i-group, with no significant difference between the two groups. Dapagliflozin treatment, but not non-SGLT2i treatment, significantly decreased UACR and uNAG. The changes in UACR and uNAG were significantly greater in the dapagliflozin group compared with the non-SGLT2i group. Dapagliflozin treatment, but not non-SGLT2i treatment, significantly decreased the body weight, TBFM, and abdominal fat area and significantly increased kidney length and radiation attenuation. The percentage change in UACR was significantly correlated with changes in TBFM, but not with body weight. By multivariate logistic regression analysis, dapagliflozin treatment was significantly associated with the improvement of UACR. Conclusions Add-on treatment with dapagliflozin exhibited significant renoprotective effects, with improvement of UACR and uNAG and increased kidney length and radiation attenuation in patients with uncontrolled T2DM.
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Affiliation(s)
- Seigo Sugiyama
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Cardiovascular Division, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,These authors contributed equally to this study
| | - Hideaki Jinnouchi
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Cardiovascular Division, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan.,These authors contributed equally to this study
| | | | - Kunio Hieshima
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Akira Yoshida
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | | | - Motoko Tanaka
- Department of Nephrology, Akebono Clinic, Kumamoto, Japan
| | | | - Tomoko Suzuki
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Fumio Miyamoto
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Keizo Kajiwara
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Cardiovascular Division, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Tomio Jinnouchi
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Cardiovascular Division, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
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