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Mu Y, Yang Y, Jiang S, Liu C, Han Y, Jiang J, Wang Y. Benefits of Puerarin on Metabolic Syndrome and Its Associated Cardiovascular Diseases in Rats Fed a High-Fat/High-Sucrose Diet. Nutrients 2024; 16:1273. [PMID: 38732519 PMCID: PMC11085683 DOI: 10.3390/nu16091273] [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: 03/11/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular diseases (CVDs) that has become a global public health problem. Puerarin (PUE), the principal active compound of Pueraria lobata, has the effects of regulating glucose and lipid metabolism and protecting against cardiovascular damage. This study aimed to investigate whether dietary supplementation with PUE could ameliorate MetS and its associated cardiovascular damage. Rats were randomly divided into three groups: the normal diet group (NC), the high-fat/high-sucrose diet group (HFHS), and the HFHS plus PUE diet group (HFHS-PUE). The results showed that PUE-supplemented rats exhibited enhanced glucose tolerance, improved lipid parameters, and reduced blood pressure compared to those on the HFHS diet alone. Additionally, PUE reversed the HFHS-induced elevations in the atherogenic index (AI) and the activities of serum lactate dehydrogenase (LDH) and creatine kinase (CK). Ultrasonic evaluations indicated that PUE significantly ameliorated cardiac dysfunction and arterial stiffness. Histopathological assessments further confirmed that PUE significantly mitigated cardiac remodeling, arterial remodeling, and neuronal damage in the brain. Moreover, PUE lowered systemic inflammatory indices including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII). In conclusion, dietary supplementation with PUE effectively moderated metabolic disorders, attenuated systemic inflammation, and minimized cardiovascular damage in rats with MetS induced by an HFHS diet. These results provide novel insights into the potential benefits of dietary PUE supplementation for the prevention and management of MetS and its related CVDs.
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Affiliation(s)
| | | | | | | | | | - Jiandong Jiang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Yuhong Wang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
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2
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Liu XF, Li Y, Ju S, Zhou YL, Qiang JW. Network Analysis and Nomogram in the Novel Classification and Prognosis Prediction of Advanced Schistosomiasis Japonica. Am J Trop Med Hyg 2023; 108:569-577. [PMID: 36689944 PMCID: PMC9978554 DOI: 10.4269/ajtmh.22-0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/25/2022] [Indexed: 01/24/2023] Open
Abstract
Clinical classification of advanced schistosomiasis japonica is important for treatment options and prognosis prediction. Network analysis was used to solve the problem of complexity and co-occurrence complications in classification of advanced schistosomiasis. A total of 4,125 retrospective patients were enrolled and divided randomly into a training cohort (n = 2,888) and a validation cohort (n = 1,237). Network analysis was used to cluster the isolated complications of advanced schistosomiasis. The accuracy of the network was evaluated. Nomograms based on the clustered complications were built to predict 1- to 5-year survival rates in advanced schistosomiasis. The predictive performance of the nomogram was also evaluated and validated. Fifteen isolated complications were identified: metabolic syndromes, minimal hepatic encephalopathy, hepatic encephalopathy, chronic obstructive pulmonary disease, pulmonary hypertension, respiratory failure, right heart failure, gastroesophageal variceal bleeding, gastrointestinal ulcer bleeding, splenomegaly, fibrosis, chronic kidney disease, ascites, colorectal polyp, and colorectal cancer. Through network analysis, three major clustered complications were achieved-namely, schistosomal abnormal metabolic syndromes (related to chronic metabolic abnormalities), schistosomal abnormal hemodynamics syndromes (related to severe portal hypertension and portosystemic shunting), and schistosomal inflammatory granulomatous syndromes (related to granulomatous inflammation). The nomograms showed a good performance in prognosis prediction of advanced schistosomiasis. The novel classification-based nomogram was useful in predicting the survival rate in advanced schistosomiasis japonica.
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Affiliation(s)
- Xue-Fei Liu
- Department of Radiology, Jinshan Hospital, Fudan University, 201508, Shanghai, China
| | - Ying Li
- Department of Radiology, Jinshan Hospital, Fudan University, 201508, Shanghai, China
- Address correspondence to Ying Li, Longhang road 1508#, Shanghai, China (Ying Li), or Jin-Wei Qiang, Longhang road 1508#, Shanghai, China (Jin-Wei Qiang). E-mails: or
| | - Shuai Ju
- Department of Interventional Radiology, Jinshan Hospital, Fudan University, 201508, Shanghai, China
| | - Yan-Li Zhou
- Department of Nuclear Medicine, Jinshan Hospital, Fudan University, 201508, Shanghai, China
| | - Jin-Wei Qiang
- Department of Radiology, Jinshan Hospital, Fudan University, 201508, Shanghai, China
- Address correspondence to Ying Li, Longhang road 1508#, Shanghai, China (Ying Li), or Jin-Wei Qiang, Longhang road 1508#, Shanghai, China (Jin-Wei Qiang). E-mails: or
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3
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Luo S, Zhao Y, Zhu S, Liu L, Cheng K, Ye B, Han Y, Fan J, Xia M. Flavonifractor plautii Protects Against Elevated Arterial Stiffness. Circ Res 2023; 132:167-181. [PMID: 36575982 DOI: 10.1161/circresaha.122.321975] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Dysbiosis of gut microbiota plays a pivotal role in vascular dysfunction and microbial diversity was reported to be inversely correlated with arterial stiffness. However, the causal role of gut microbiota in the progression of arterial stiffness and the specific species along with the molecular mechanisms underlying this change remain largely unknown. METHODS Participants with elevated arterial stiffness and normal controls free of medication were matched for age and sex. The microbial composition and metabolic capacities between the 2 groups were compared with the integration of metagenomics and metabolomics. Subsequently, Ang II (angiotensin II)-induced and humanized mouse model were employed to evaluate the protective effect of Flavonifractor plautii (F plautii) and its main effector cis-aconitic acid. RESULTS Human fecal metagenomic sequencing revealed a significantly high abundance and centrality of F plautii in normal controls, which was absent in the microbial community of subjects with elevated arterial stiffness. Moreover, blood pressure only mediated part of the effect of F plautii on lower arterial stiffness. The microbiome of normal controls exhibited an enhanced capacity for glycolysis and polysaccharide degradation, whereas, those of subjects with increased arterial stiffness were characterized by increased biosynthesis of fatty acids and aromatic amino acids. Integrative analysis with metabolomics profiling further suggested that increased cis-aconitic acid served as the main effector for the protective effect of F plautii against arterial stiffness. Replenishment with F plautii and cis-aconitic acid improved elastic fiber network and reversed increased pulse wave velocity through the suppression of MMP-2 (matrix metalloproteinase-2) and inhibition of MCP-1 (monocyte chemoattractant protein-1) and NF-κB (nuclear factor kappa-B) activation in both Ang II-induced and humanized model of arterial stiffness. CONCLUSIONS Our translational study identifies a novel link between F plautii and arterial function and raises the possibility of sustaining vascular health by targeting gut microbiota.
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Affiliation(s)
- Shiyun Luo
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Yawen Zhao
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Shanshan Zhu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Ludi Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China.,Department of Statistics and Epidemiology (L.L., B.Y.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Ken Cheng
- XJTLU Wisdom Lake Academy of Pharmacy, Xi'an Jiaotong-Liverpool University, Suzhou, China (K.C., Y.H.)
| | - Bingqi Ye
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China.,Department of Statistics and Epidemiology (L.L., B.Y.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Yueyuan Han
- XJTLU Wisdom Lake Academy of Pharmacy, Xi'an Jiaotong-Liverpool University, Suzhou, China (K.C., Y.H.)
| | - Jiahua Fan
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Min Xia
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
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4
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Su HY, Hsu BG, Lin YL, Wang CH, Lai YH. Serum adipocyte fatty acid-binding protein level is positively associated with aortic stiffness in nondialysis chronic kidney disease patients: A cross-sectional study. Medicine (Baltimore) 2022; 101:e29558. [PMID: 35866771 PMCID: PMC9302354 DOI: 10.1097/md.0000000000029558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aortic stiffness (AS) is a major predictor of cardiovascular disease and mortality in patients with chronic kidney disease (CKD) and adipocyte fatty acid-binding protein (A-FABP) is a novel adipokine that is positively correlated with AS in the general population. Therefore, we investigated the correlation between serum A-FABP levels and AS in nondialysis CKD patients. Fasting blood samples and baseline characteristics were obtained in 270 patients with nondialysis CKD. Serum A-FABP concentrations were determined by enzyme immunoassay and carotid-femoral pulse wave velocity (cfPWV) measurements were acquired using a validated tonometry system. Patients with cfPWV >10 m/s formed the AS group, while those with values ≤10 m/s comprised the comparison group. Among 270 CKD patients, 92 patients (34.1%) were in the AS group. Compared to those in the comparison group, patients in the AS group were older (P < .001), had a higher prevalence of diabetes, along with higher serum A-FABP level (P < .001), larger waist circumference (P = .004), and lower estimated glomerular filtration rate (P = .001) but higher levels of body fat mass (P = .010), systolic blood pressure (P < .001), fasting glucose (P = .014), blood urea nitrogen (P = .009), and serum creatinine (P = .004). The serum log-A-FABP level was positively associated with log-cfPWV (β = 0.178, P = .001) in nondialysis CKD patients and multivariable logistic regression analysis identified serum A-FABP (P = .006), age (P = .001), and systolic blood pressure (P = .015) as independent predictors of AS in nondialysis-dependent CKD patients. Elevated A-FABP levels may be a significant predictor of AS in nondialysis CKD patients.
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Affiliation(s)
- Hsiao-Yuan Su
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Bang-Gee Hsu
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yu-Li Lin
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chih-Hsien Wang
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yu-Hsien Lai
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- * Correspondence: Yu-Hsien Lai, MD, PhD, Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Chung-Yang Road, 97004 Hualien, Taiwan (e-mail: )
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5
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Lin Y, Kong J, Tian T, Zhong X, Zhang S, Zhou H, Xiong Z, Zhao J, Huang Y, Liu M, Dong Y, Zheng J, Diao X, Wu J, Qin H, Hu Y, Wang X, Zhuang X, Liao X. Identification of Novel Phenotypes Correlated with CKD: A Phenotype-Wide Association Study. Int J Med Sci 2022; 19:1920-1928. [PMID: 36438912 PMCID: PMC9682501 DOI: 10.7150/ijms.63973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background: A comprehensive understanding of phenotypes related to CKD will facilitate the identification and management of CKD. We aimed to panoramically test and validate associations between multiple phenotypes and CKD using a phenotype-wide association study (PheWAS). Methods: 15,815 subjects from cross-sectional cohorts of the National Health and Nutrition Examination Survey (1999-2006) were randomly 50:50 split into training and testing sets. CKD was defined as eGFR < 60 mL/min/1.73m2. We performed logistic regression analyses between each of 985 phenotypes with CKD in the training set (false discovery rate < 1%) and validated in the testing set (false discovery rate < 1% ). Random forest (RF) model, Nagelkerke's Pseudo-R2, and the area under the receiver operating characteristic (AUROC) were used to validate the identified phenotypes. Results: We identified 18 phenotypes significantly related to CKD, among which retinol, red cell distribution width (RDW), and C-peptide were less researched. The top 5 identified phenotypes were blood urea nitrogen (BUN), homocysteine (HCY), retinol, parathyroid hormone (PTH), and osmolality in RF importance ranking. Besides, BUN, HCY, PTH, retinol, and uric acid were the most important phenotypes based on Pseudo-R2. AUROC of the RF model was 0.951 (full model) and 0.914 (top 5 phenotypes). Conclusion: Our study demonstrated associations between multiple phenotypes with CKD from a holistic view, including 3 novel phenotypes: retinol, RDW, and C-peptide. Our findings provided valid evidence for the identification of novel biomarkers for CKD.
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Affiliation(s)
- Yifen Lin
- Cardiology department, First affiliated hospital of Sun Yat-Sen University.,NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University)
| | - Jianqiu Kong
- Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital
| | - Ting Tian
- Department of Statistical Science, School of Mathematics, Southern China Center for Statistical Science, Sun Yat-Sen University
| | - Xiangbin Zhong
- Cardiology department, First affiliated hospital of Sun Yat-Sen University.,NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University)
| | - Shaozhao Zhang
- Cardiology department, First affiliated hospital of Sun Yat-Sen University.,NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University)
| | - Haojin Zhou
- Department of Statistical Science, School of Mathematics, Southern China Center for Statistical Science, Sun Yat-Sen University
| | - Zhenyu Xiong
- Cardiology department, First affiliated hospital of Sun Yat-Sen University.,NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University)
| | - Jiashu Zhao
- Department of Statistical Science, School of Mathematics, Southern China Center for Statistical Science, Sun Yat-Sen University
| | - Yiquan Huang
- Cardiology department, First affiliated hospital of Sun Yat-Sen University.,NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University)
| | - Menghui Liu
- Cardiology department, First affiliated hospital of Sun Yat-Sen University.,NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University)
| | - Yuehua Dong
- Department of Statistical Science, School of Mathematics, Southern China Center for Statistical Science, Sun Yat-Sen University
| | - Junjiong Zheng
- Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital
| | - Xiayao Diao
- Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital
| | - Jieyin Wu
- Department of Urology, the Third Affiliated Hospital of Sun Yat-Sen University
| | - Haide Qin
- Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital
| | - Yue Hu
- Department of Statistical Science, School of Mathematics, Southern China Center for Statistical Science, Sun Yat-Sen University
| | - Xueqin Wang
- Department of Statistical Science, School of Mathematics, Southern China Center for Statistical Science, Sun Yat-Sen University
| | - Xiaodong Zhuang
- Cardiology department, First affiliated hospital of Sun Yat-Sen University.,NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University)
| | - Xinxue Liao
- Cardiology department, First affiliated hospital of Sun Yat-Sen University.,NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University)
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Zhai Q, Wen J, Wang M, Zuo Y, Su X, Zhang Y, Gaisano H, He Y. Glomerular Hyperfiltration Interacts With Abnormal Metabolism to Enhance Arterial Stiffness in Middle-Aged and Elderly People. Front Med (Lausanne) 2021; 8:732413. [PMID: 34746175 PMCID: PMC8566717 DOI: 10.3389/fmed.2021.732413] [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: 06/29/2021] [Accepted: 09/24/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Glomerular hyperfiltration (GHF) is an early kidney injury. We investigated whether GHF is associated with arterial stiffness expressed by increase of brachial-ankle pulse wave velocity (baPWV) and pulse pressure (PP), and whether the coexistence of GHF and abnormal metabolism increases the risk of arterial stiffness. Methods: In this prospective cohort study, 2,133 non-chronic kidney disease (CKD) participants aged ≥40 years were followed for a mean period of 3.3 years. The extent of arterial stiffness was expressed by measures of baPWV and PP. GHF was defined as eGFR exceeding the age- and sex-specific 90th percentile. Multivariate logistic regression models were used to assess the association between GHF/abnormal metabolism and increased baPWV/PP. The interaction indexes of GHF and abnormal metabolism on arterial stiffness were calculated based on the OR in a multivariate logistic regression model. Results: GHF alone was not associated with increased baPWV or PP in all participants in this study. However, when GHF coexisted with abnormal metabolism, the risk of increased PP increased 3.23-fold [OR = 3.23(1.47-7.13)] compared with participants with normal filtration and normal metabolism, in which the interaction accounted for 55.1% of the total effect and 79.8% of the effect from GHF and abnormal metabolism. After subtracting the independent effects of GHF and abnormal metabolism, their combined effect still resulted in a 1.78-fold increase in PP. Conclusion: GHF could interact with abnormal metabolism to significantly enhance arterial stiffness. Since abnormal metabolism commonly exists in the general population, even slight changes in renal function should be distinguished to prevent arterial stiffness risk.
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Affiliation(s)
- Qi Zhai
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jing Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Meiping Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xin Su
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,School of Public Health, Baotou Medical College, Baotou, China
| | - Yibo Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Herbert Gaisano
- Departments of Medicine and Physiology, University of Toronto, Toronto, ON, Canada
| | - Yan He
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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7
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Sequí-Domínguez I, Cavero-Redondo I, Álvarez-Bueno C, Saz-Lara A, Mesas AE, Martínez-Vizcaíno V. Association between arterial stiffness and the clustering of metabolic syndrome risk factors: a systematic review and meta-analysis. J Hypertens 2021; 39:1051-1059. [PMID: 33323912 DOI: 10.1097/hjh.0000000000002754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Metabolic syndrome (MetS) is a cluster of different cardiometabolic risk factors (CMRFs), and its different combinations with other CMRFs, such as arterial stiffness have been hypothesized to explain, at least partially, increased risk of cardiovascular disease. Thus, in this systematic review and meta-analysis, we aimed to synthesize the evidence regarding the association between the clustering of MetS-related CMRFs and arterial stiffness measured using pulse wave velocity (PWV). METHODS Original studies analysing the association between arterial stiffness, measured using PWV, and MetS were systematically searched. Pooled effect size estimates and their respective 95% confidence intervals (CI) were calculated using the DerSimonian and Laird method for two separate analyses: the diagnosis of MetS and PWV values and the number of CMRFs and PWV values. RESULTS Moderate effect size estimates were observed between MetS and PWV (0.68, 95% CI: 0.54-0.82) with a slightly higher effect size for the low-risk compared with the high-risk population group (0.75, 95% CI: 0.58-0.92; and 0.51, 95% CI: 0.32-0.82, respectively). A trend between the number of MetS-related CMRFs and PWV was found with the pooled effect size nearly doubling as the number of MetS-related CMRFs increased, 0.11 (95% CI: 0.04-0.17) for one MetS-related CMRF, 0.26 (95% CI: 0.13-0.4) for two, and 0.4 (95% CI: 0.2-0.6) for three or more. CONCLUSION These results demonstrated a clinically relevant association between MetS and PWV and an increasing trend in PWV values, such as a MetS-related CMRF increase. Although these results should be considered cautiously because of the considerable heterogeneity, our findings reinforce the rationale of MetS as an aggregation of risk factors with common causes, which could provide additional useful information to guide clinical management.
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Affiliation(s)
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Arthur E Mesas
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidade Estadual de Londrina, Department of Public Health, Paraná, Brazil
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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8
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Lambrinoudaki I, Kazani A, Armeni E, Rizos D, Augoulea A, Kaparos G, Alexandrou A, Georgiopoulos G, Kanakakis I, Stamatelopoulos K. The metabolic syndrome is associated with carotid atherosclerosis and arterial stiffness in asymptomatic, nondiabetic postmenopausal women. Gynecol Endocrinol 2018; 34:78-82. [PMID: 28675704 DOI: 10.1080/09513590.2017.1344208] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The menopause transition is associated with adverse changes in cardiometabolic risk factors. We aimed to examine the association of the metabolic syndrome (MS) and its features with indices of vascular structure and function in a population of asymptomatic postmenopausal women. A total of 473 informed-consenting, nondiabetic postmenopausal women were included in the study. The MS was defined according to the Joint Definition. We evaluated the association between the presence of MS and indices of vascular structure (carotid artery intima-media thickness (IMT); atherosclerotic plaques) and function (flow-mediated dilatation (FMD); pulse wave velocity (PWV)). The mean age of women was 56.4 ± 6.7 and the mean menopausal age was 7.91 ± 6.31. The MS was present in 17.3% of our population. Mean values of PWV increased linearly with the accumulation of features of the MS. IMT was higher in women with the MS compared to women without the MS (0.78 ± 0.12 mm vs. 0.74 ± 0.11, p = .003). Multivariate analysis showed that the presence of the MS was independently associated with common carotid artery IMT (b = 0.149, p = .001), PWV (b = 0.114, p = .012) as well as central systolic and diastolic blood pressure (b = 0.293, p < .001 and b = 0.163, p < .001 respectively). The presence of the MS is associated with subclinical atherosclerosis already in the first postmenopausal decade of this sample of asymptomatic, nondiabetic women. Additional evidence is required to support the causative effect of these associations.
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Affiliation(s)
- Irene Lambrinoudaki
- a 2nd Department of Obstetrics and Gynecology , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Aikaterini Kazani
- b Department of Therapeutics , University of Athens, Alexandra Hospital , Athens , Greece
| | - Eleni Armeni
- a 2nd Department of Obstetrics and Gynecology , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Demetrios Rizos
- c Hormonal and Biochemical Laboratory , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Areti Augoulea
- a 2nd Department of Obstetrics and Gynecology , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Georgios Kaparos
- c Hormonal and Biochemical Laboratory , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Andreas Alexandrou
- d 1st Department of Surgery , National and Kapodestrian University of Athens, Medical School, Laiko General Hospital , Athens , Greece
| | - Georgios Georgiopoulos
- b Department of Therapeutics , University of Athens, Alexandra Hospital , Athens , Greece
| | | | - Kimon Stamatelopoulos
- b Department of Therapeutics , University of Athens, Alexandra Hospital , Athens , Greece
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9
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Chen MC, Hsu BG, Lee CJ, Yang CF, Wang JH. High serum adipocyte fatty acid binding protein level as a potential biomarker of aortic arterial stiffness in hypertensive patients with metabolic syndrome. Clin Chim Acta 2017; 473:166-172. [PMID: 28860092 DOI: 10.1016/j.cca.2017.08.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/02/2017] [Accepted: 08/27/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The adipocyte-fatty-acid-binding protein (A-FABP) has been implicated in arterial stiffness, metabolic syndrome (MetS), and cardiovascular disease. We aimed to determine the relationship among serum A-FABP concentration, cardiometabolic risk factors, and central arterial stiffness in a hypertensive population. METHODS Fasting blood samples and baseline characteristics were obtained from 110 hypertensive patients. Serum A-FABP concentrations were determined by enzyme immunoassay kit. High arterial stiffness was defined as carotid-femoral pulse wave velocity values >10m/s via the SphygmoCor system. RESULTS Patients with MetS and high arterial stiffness accounted for 67.3% and 42.7% of the study population, respectively. Serum A-FABP was positively associated with MetS and high arterial stiffness (P=0.006 and P<0.001, respectively). Multivariable stepwise linear regression analysis of the significant variables of arterial stiffness revealed that logarithmically transformed A-FABP (log-A-FABP, β=0.278, P=0.002) was positively correlated arterial stiffness in hypertensive patients. Subgroup analysis revealed that log-A-FABP (β=0.327, P=0.003), age (β=0229, P=0.032), and triglyceride (β=0.307, P=0.004) were significantly positively correlated with arterial stiffness in hypertensive patients with MetS. CONCLUSIONS Elevated A-FABP concentration could be a predictor for MetS and arterial stiffness in hypertensive patients.
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Affiliation(s)
- Ming-Chun Chen
- Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Bang-Gee Hsu
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chung-Jen Lee
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Chiu-Fen Yang
- Division of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Ji-Hung Wang
- School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
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10
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Tsai SS, Lin YS, Hwang JS, Chu PH. Vital roles of age and metabolic syndrome-associated risk factors in sex-specific arterial stiffness across nearly lifelong ages: Possible implication of menopause and andropause. Atherosclerosis 2017; 258:26-33. [PMID: 28182996 DOI: 10.1016/j.atherosclerosis.2017.01.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 01/13/2017] [Accepted: 01/19/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Postmenopausal status is correlated with increased metabolic syndrome (MetS) and cardiovascular risks. However, the vital roles of age and MetS-associated risk factors in sex-specific arterial stiffness remain unclear. METHODS In this population-based cross-sectional study of the general population, we enrolled in our Health Examination Program 9812 adult participants who were measured for brachial-ankle pulse wave velocity (baPWV) to assess arterial stiffness. Piecewise linear regression models were used to survey pre-defined ages associated with menopause and andropause in relation to arterial stiffness. Multivariate linear regression analyses were used to evaluate independent determinants. RESULTS Across gender, stepwise increases in baPWV corresponded to increased MetS-associated risk scores (MetSRS) and aging (all p for trend < 0.001), while a turning point was found at 50 years of age (50age). The incremental ratios of baPWV presented inverse U curves with aging, whereas the highest R2 values and incremental ratios of baPWV were found at 50age across gender. Comparing men with women, a 1.4-fold higher incremental ratio of baPWV was observed before 50age, compared to a 1.3-fold after 50age, respectively. MetS risk group and over 50age were associated with stepwise increased baPWV across gender (both p for trend < 0.001). Before 50age, the determinants did not include hs-CRP for women compared with men, while MetSRS was lost as a determinant across gender. In contrast with men, in women after 50age, HDL-C was an additional determinant and triglyceride was not, while MetSRS remained a determinant across gender. CONCLUSIONS Arterial stiffness increased with aging across nearly lifelong ages more in women than in men. While menopause and andropause may both play a role, 50age was the most critical factor across gender. The sex-specific differences in determinants of arterial stiffness may remind us of sex-specific targets for further interventional studies associated with arterial stiffness.
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Affiliation(s)
- Sung-Sheng Tsai
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Yu-Sheng Lin
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Healthcare Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Jaw-Shan Hwang
- Healthcare Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Heart Failure Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Pao-Hsien Chu
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Healthcare Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Heart Failure Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
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11
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Yoon H, Choi SW, Park J, Ryu SY, Han MA, Kim GS, Kim SG, Oh HJ, Choi CW. The Relationship Between the Metabolic Syndrome and Systolic Inter-Arm Systolic Blood Pressure Difference in Korean Adults. Metab Syndr Relat Disord 2015; 13:329-35. [DOI: 10.1089/met.2015.0031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hyun Yoon
- Department of Biomedical Laboratory Science, Hanlyo University, Jeollanamdo, South Korea
| | - Seong Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, South Korea
| | - Jong Park
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, South Korea
| | - So Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, South Korea
| | - Mi Ah Han
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, South Korea
| | - Gwang Seok Kim
- Emergency Medical Technology, Chungbuk Health and Science University, Chungcheongbukdo, South Korea
| | - Sung Gil Kim
- Department of Radiological Science, Hanlyo University, Jeollanamdo, South Korea
| | - Hye Jong Oh
- Department of Biomedical Laboratory Science, Hanlyo University, Jeollanamdo, South Korea
| | - Cheol Won Choi
- Department of Biomedical Laboratory Science, Hanlyo University, Jeollanamdo, South Korea
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12
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Tsai SS, Lin YS, Lin CP, Hwang JS, Wu LS, Chu PH. Metabolic Syndrome-Associated Risk Factors and High-Sensitivity C-Reactive Protein Independently Predict Arterial stiffness in 9903 Subjects With and Without Chronic Kidney Disease. Medicine (Baltimore) 2015; 94:e1419. [PMID: 26356694 PMCID: PMC4616642 DOI: 10.1097/md.0000000000001419] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Metabolic syndrome (MS), high-sensitivity C-reactive protein (hs-CRP), and chronic kidney disease (CKD) are related to cardiovascular diseases. Although MS is common in CKD subjects, the contribution of MS-associated risk factors and hs-CRP to arterial stiffness in CKD has not been well studied.In this cross-sectional cohort study, we enrolled 9903 subjects who underwent brachial-ankle pulse wave velocity (baPWV) measurements from our database of Health Care Center. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m. Comparing those grouped with and without CKD, multivariate linear regression analyses were used.Overall, baPWV was found to have an inverse relationship with eGFR (P for trend <0.001), which increased progressively with the presence of CKD, increasing number of MS-associated risk factors and hs-CRP (P for trend <0.001). In the non-CKD group, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, triglyceride, high-density lipoprotein cholesterol, and hs-CRP independently predicted baPWV, whereas in CKD, eGFR, age, gender, body mass index, SBP, DBP, and fasting glucose remained predictors.The number of MS-associated risk factors and hs-CRP remains a determinant of arterial stiffness in both CKD and non-CKD groups. The decline of renal function contributes to arterial stiffness only in CKD but not in non-CKD. Our findings suggest that for CKD subjects, renal function, BP, and glycemic control are potential targets for further interventional studies of arterial stiffness.
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Affiliation(s)
- Sung-Sheng Tsai
- From the Division of Endocrinology and Metabolism (S-ST, J-SH), Department of Cardiology (Y-SL, C-PL, L-SW, P-HC), Healthcare Center (Y-SL, J-SH, P-HC), and Heart Failure Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan (P-HC)
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13
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Elewa U, Fernandez-Fernandez B, Alegre R, Sanchez-Niño MD, Mahillo-Fernández I, Perez-Gomez MV, El-Fishawy H, Belal D, Ortiz A. Modifiable risk factors for increased arterial stiffness in outpatient nephrology. PLoS One 2015; 10:e0123903. [PMID: 25880081 PMCID: PMC4400164 DOI: 10.1371/journal.pone.0123903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 02/25/2015] [Indexed: 11/19/2022] Open
Abstract
Arterial stiffness, as measured by pulse wave velocity (PWV), is an independent predictor of cardiovascular events and mortality. Arterial stiffness increases with age. However, modifiable risk factors such as smoking, BP and salt intake also impact on PWV. The finding of modifiable risk factors may lead to the identification of treatable factors, and, thus, is of interest to practicing nephrologist. We have now studied the prevalence and correlates of arterial stiffness, assessed by PWV, in 191 patients from nephrology outpatient clinics in order to identify modifiable risk factors for arterial stiffness that may in the future guide therapeutic decision-making. PWV was above normal levels for age in 85/191 (44.5%) patients. Multivariate analysis showed that advanced age, systolic BP, diabetes mellitus, serum uric acid and calcium polystyrene sulfonate therapy or calcium-containing medication were independent predictors of PWV. A new parameter, Delta above upper limit of normal PWV (Delta PWV) was defined to decrease the weight of age on PWV values. Delta PWV was calculated as (measured PWV) - (upper limit of the age-adjusted PWV values for the general population). Mean±SD Delta PWV was 0.76±1.60 m/sec. In multivariate analysis, systolic blood pressure, active smoking and calcium polystyrene sulfonate therapy remained independent predictors of higher delta PWV, while age, urinary potassium and beta blocker therapy were independent predictors of lower delta PWV. In conclusion, arterial stiffness was frequent in nephrology outpatients. Systolic blood pressure, smoking, serum uric acid, calcium-containing medications, potassium metabolism and non-use of beta blockers are modifiable factors associated with increased arterial stiffness in Nephrology outpatients.
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Affiliation(s)
- Usama Elewa
- IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain
- REDINREN, Madrid, Spain
- Kasr El-Aini University Hospitals, Cairo University, Cairo, Egypt
| | - Beatriz Fernandez-Fernandez
- IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain
- REDINREN, Madrid, Spain
| | - Raquel Alegre
- IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain
- REDINREN, Madrid, Spain
| | | | | | - Maria Vanessa Perez-Gomez
- IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain
- REDINREN, Madrid, Spain
| | | | - Dawlat Belal
- Kasr El-Aini University Hospitals, Cairo University, Cairo, Egypt
| | - Alberto Ortiz
- IIS-Fundación Jiménez Díaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Fundación Renal Iñigo Alvarez de Toledo-IRSIN, Madrid, Spain
- REDINREN, Madrid, Spain
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14
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Dhaun N, Yuzugulen J, Kimmitt RA, Wood EG, Chariyavilaskul P, MacIntyre IM, Goddard J, Webb DJ, Corder R. Plasma pro-endothelin-1 peptide concentrations rise in chronic kidney disease and following selective endothelin A receptor antagonism. J Am Heart Assoc 2015; 4:e001624. [PMID: 25801761 PMCID: PMC4392442 DOI: 10.1161/jaha.114.001624] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Endothelin 1 (ET‐1) contributes to chronic kidney disease (CKD) development and progression, and endothelin receptor antagonists are being investigated as a novel therapy for CKD. The proET‐1 peptides, endothelin‐like domain peptide (ELDP) and C‐terminal pro‐ET‐1 (CT‐proET‐1), are both potential biomarkers of CKD and response to therapy with endothelin antagonists. Methods and Results We assessed plasma and urine ELDP and plasma CT‐proET‐1 in CKD patients with minimal comorbidity. Next, in a randomized double‐blind crossover study of 27 subjects with proteinuric CKD, we examined the effects of 6 weeks of treatment with placebo, sitaxentan (endothelin A antagonist), and nifedipine on these peptides alongside the primary end points of proteinuria, blood pressure, and arterial stiffness. Plasma ELDP and CT‐proET‐1 increased with CKD stage (both P<0.0001), correlating inversely with estimated glomerular filtration rate (both P<0.0001). Following intervention, placebo and nifedipine did not affect plasma and urine ELDP or plasma CT‐proET‐1. Sitaxentan increased both plasma ELDP and CT‐proET‐1 (baseline versus week 6±SEM: ELDP, 11.8±0.5 versus 13.4±0.6 fmol/mL; CT‐proET‐1, 20.5±1.2 versus 23.3±1.5 fmol/mL; both P<0.0001). Plasma ET‐1 was unaffected by any treatment. Following sitaxentan, plasma ELDP and CT‐proET‐1 correlated negatively with 24‐hour urinary sodium excretion. Conclusions ELDP and CT‐proET‐1 increase in CKD and thus are potentially useful biomarkers of renal injury. Increases in response to endothelin A antagonism may reflect EDN1 upregulation, which may partly explain fluid retention with these agents. Clinical Trial Registration URL: www.clinicalTrials.gov Unique identifier: NCT00810732
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Affiliation(s)
- Neeraj Dhaun
- BHF Centre of Research Excellence, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK (N.D., R.A.K., P.C., I.M.M.I., D.J.W.) Department of Renal Medicine, Royal Infirmary of Edinburgh, UK (N.D., J.G.)
| | - Jale Yuzugulen
- William Harvey Research Institute, Barts & the London School of Medicine, Queen Mary University of London, UK (J.Y., E.G.W., R.C.)
| | - Robert A Kimmitt
- BHF Centre of Research Excellence, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK (N.D., R.A.K., P.C., I.M.M.I., D.J.W.)
| | - Elizabeth G Wood
- William Harvey Research Institute, Barts & the London School of Medicine, Queen Mary University of London, UK (J.Y., E.G.W., R.C.)
| | - Pajaree Chariyavilaskul
- BHF Centre of Research Excellence, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK (N.D., R.A.K., P.C., I.M.M.I., D.J.W.)
| | - Iain M MacIntyre
- BHF Centre of Research Excellence, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK (N.D., R.A.K., P.C., I.M.M.I., D.J.W.)
| | - Jane Goddard
- Department of Renal Medicine, Royal Infirmary of Edinburgh, UK (N.D., J.G.)
| | - David J Webb
- BHF Centre of Research Excellence, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK (N.D., R.A.K., P.C., I.M.M.I., D.J.W.)
| | - Roger Corder
- William Harvey Research Institute, Barts & the London School of Medicine, Queen Mary University of London, UK (J.Y., E.G.W., R.C.)
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15
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Schlieper G, Hess K, Floege J, Marx N. The vulnerable patient with chronic kidney disease. Nephrol Dial Transplant 2015; 31:382-90. [DOI: 10.1093/ndt/gfv041] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 01/25/2015] [Indexed: 11/14/2022] Open
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16
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The effect of known cardiovascular risk factors on carotid-femoral pulse wave velocity in school-aged children: a population based twin study. J Dev Orig Health Dis 2015; 5:307-13. [PMID: 24965137 DOI: 10.1017/s2040174414000282] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Childhood cardiovascular risk factors affect vascular function long before overt cardiovascular disease. Twin studies provide a unique opportunity to examine the influence of shared genetic and environmental influences on childhood cardiovascular function. We examined the relationship between birth parameters, markers of adiposity, insulin resistance, lipid profile and blood pressure and carotid-femoral pulse wave velocity (PWV), a validated non-invasive measure of arterial stiffness in a healthy cohort of school-aged twin children. PWV was performed on a population-based birth cohort of 147 twin pairs aged 7-11 years. Fasting blood samples, blood pressure and adiposity measures were collected concurrently. Mixed linear regression models were used to account for twin clustering, within- and between-twin pair associations. There were positive associations between both markers of higher adiposity, insulin resistance, elevated triglycerides and PWV, which remained significant after accounting for twin birth-set clustering. There was a positive association between both diastolic and mean arterial blood pressure and PWV in within-pair analysis in dizygotic, but not monozygotic twins, indicating genetic differences evident in dizygotic not monozygotic twins may affect these associations. Increased blood pressure, triglycerides and other metabolic markers are associated with increased PWV in school-aged twins. These results support both the genetic and environmental contribution to higher PWV, as a marker of arterial stiffness, and reiterate the importance of preventing metabolic syndrome from childhood.
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Dudinskaya EN, Tkacheva ON, Shestakova MV, Brailova NV, Strazhesko ID, Akasheva DU, Isaykina OY, Pokrovskaya MS, Sharashkina NV, Boytsov SA. Telomere length and vascular wall in patients with Type 2 Diabetes Mellitus. DIABETES MELLITUS 2014. [DOI: 10.14341/dm2014331-38] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aim. To study the relationship between changes in the artery structure and function and peripheral lymphocyte telomere length in patients with type 2 diabetes mellitus (DM2). Materials and methods. A total of 50 patients with T2DM and without clinical manifestations of cardiovascular disease (CVD) were included in the study; the control group consisted of 49 people. The following tests were conducted for all study participants: carbohydrate metabolism evaluation, carotid artery duplex scan to measure intima?media complex thickness (IMT) and to determine the presence of atherosclerotic plaques, carotid?femoral pulse wave velocity (PWV) measurement and lymphocyte telomere length measurement. Results. The vascular changes were more pronounced in patients with T2DM than in controls. The telomeres were shorter in patients with T2DM than in those without diabetes (9.53?0.1 vs 9.86?0.1, p=0.033). The participants were divided according to the telomere length. Among patients with T2DM, there were significant differences in the condition of the vascular wall [PWV: 10.58?0.1 m/s in patients with ?long? telomeres and 15.08?1.3 m/s in patients with ?short? telomeres; IMT: 0.80?0.09 mm in patients with ?long? telomeres and 0.87?0.05 mm in patients with ?short? telomeres (p=0.024)]. There were no significant differences in the arterial structure between the patient and control groups with ?long? telomeres [PWV: 10.58?0.1 m/s vs 10.5?0.5 m/s (p=0.913); IMT: 0.080?0.09 mm vs 0.73?0.03 mm (p=0.12). However, there were significant differences in the vascular wall condition between the patient and control groups with ?short? telomeres [PWV: 15.08?1.3 m/s vs, 10.7?0.5 m/s (p=0.015); IMT: 0.87?0.1 vs 0.78?0.1 (p=0.03)]. Conclusions. The signs of vascular ageing were more pronounced in patients with T2DM than in controls. However, despite diabetes, vascular changes were minimal in patients with ?long? lymphocyte telomeres, comparable with the state of the vascular walls in healthy individuals. Thus, enhanced lymphocyte telomere length may have a protective effect on the vascular wall and may prevent damage from carbohydrate metabolism disorders.
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18
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Yamada S, Oshima M, Watanabe Y, Miyake H. Arterial location-specific calcification at the carotid artery and aortic arch for chronic kidney disease, diabetes mellitus, hypertension, and dyslipidemia. Calcif Tissue Int 2014; 95:267-74. [PMID: 25017195 DOI: 10.1007/s00223-014-9891-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/26/2014] [Indexed: 11/30/2022]
Abstract
Several risk factors for arterial calcification have been reported but controversial. The aim of this study was to clarify the interactions among chronic kidney disease (CKD), diabetes mellitus (DM), hypertension, and dyslipidemia in altering the risk of arterial calcification in the three different arterial locations and the intramural location at the internal carotid artery (ICA) origins. Calcified burdens at the ICA origins, the aortic arch, and its orifices were evaluated in a retrospective fashion by using computed tomography angiography in 397 patients. The multivariate analyses were adjusted for age, gender, CKD, DM, hypertension, dyslipidemia, and current smoking status. Additionally, subgroup analyses in each variable were conducted. Our multivariate logistic regression analyses revealed that CKD was significantly associated with the outside-wall calcification at the ICA origins, whereas DM was only associated with the inside-ICA-wall calcification. Additionally, we found that DM increased the association between CKD and arterial calcification at the aortic arch and its orifices, and the outside-wall at the ICA origins. Hypertension was significantly associated with the calcification at the orifices of the aortic arch branches synergistically with CKD. Dyslipidemia did not have any significant association with calcification in any of the three vascular beds. CKD had the highest prevalence risk of calcification in common with the three different vascular beds. CKD in combination with DM, as well as hypertension in combination with CKD, were key relationships affecting the risk of arterial calcification, especially at the aortic arch and its orifices.
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Affiliation(s)
- Shigeki Yamada
- Department of Neurosurgery & Stroke Center, Rakuwakai Otowa Hospital, Otowachinji-cho 2, Yamashina-ku, Kyoto, 607-8602, Japan,
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Koumaras C, Katsiki N, Athyros VG, Karagiannis A. Metabolic syndrome and arterial stiffness: the past, the present and the future. J Cardiovasc Med (Hagerstown) 2014; 14:687-9. [PMID: 24335882 DOI: 10.2459/jcm.0b013e3283657c96] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Charalambos Koumaras
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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Kim CS, Kim HY, Kang YU, Choi JS, Bae EH, Ma SK, Kim SW. Association of Pulse Wave Velocity and Pulse Pressure With Decline in Kidney Function. J Clin Hypertens (Greenwich) 2014; 16:372-7. [DOI: 10.1111/jch.12302] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 01/24/2014] [Accepted: 02/02/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Chang Seong Kim
- Department of Internal Medicine; Chonnam National University Medical School; Gwangju Korea
| | - Ha Yeon Kim
- Department of Internal Medicine; Chonnam National University Medical School; Gwangju Korea
| | - Yong Un Kang
- Department of Internal Medicine; Chonnam National University Medical School; Gwangju Korea
| | - Joon Seok Choi
- Department of Internal Medicine; Chonnam National University Medical School; Gwangju Korea
| | - Eun Hui Bae
- Department of Internal Medicine; Chonnam National University Medical School; Gwangju Korea
| | - Seong Kwon Ma
- Department of Internal Medicine; Chonnam National University Medical School; Gwangju Korea
| | - Soo Wan Kim
- Department of Internal Medicine; Chonnam National University Medical School; Gwangju Korea
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McIntyre NJ, Fluck RJ, McIntyre CW, Fakis A, Taal MW. Determinants of arterial stiffness in chronic kidney disease stage 3. PLoS One 2013; 8:e55444. [PMID: 23383192 PMCID: PMC3559556 DOI: 10.1371/journal.pone.0055444] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 12/30/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early chronic kidney disease (CKD) is associated with increased cardiovascular (CV) risk but underlying mechanisms remain uncertain. Arterial stiffness (AS) is associated with increased CV risk in advanced CKD, but it is unclear whether AS is relevant to CV disease (CVD) in early CKD. STUDY DESIGN Cross-sectional. SETTING AND PARTICIPANTS 1717 patients with previous estimated glomerular filtration rate (eGFR) 59-30 mL/min/1.73 m(2); mean age 73±9y, were recruited from 32 general practices in primary care. OUTCOMES Increased arterial stiffness. MEASUREMENTS Medical history was obtained and participants underwent clinical assessment, urine and serum biochemistry testing. Carotid to femoral pulse wave velocity (PWV) was determined as a measure of AS, using a Vicorder™ device. RESULTS Univariate analysis revealed significant correlations between PWV and risk factors for CVD including age (r = 0.456; p<0.001), mean arterial pressure (MAP) (r = 0.228; p<0.001), body mass index (r = -0.122; p<0.001), log urinary albumin to creatinine ratio (r = 0.124; p<0.001), Waist to Hip ratio (r = 0.124, p<0.001), eGFR (r = -0.074; p = 0.002), log high sensitivity c-reactive protein (r = 0.066; p = 0.006), HDL (r = -0.062; p = 0.01) and total cholesterol (r = -0.057; p = 0.02). PWV was higher in males (9.6 m/sec vs.10.3 m/sec; p<0.001), diabetics (9.8 m/sec vs. 10.3 m/sec; p<0.001), and those with previous CV events (CVE) (9.8 m/s vs. 10.3 m/sec; p<0.001). Multivariable analysis identified age, MAP and diabetes as strongest independent determinants of higher PWV (adjusted R² = 0.29). An interactive term indicated that PWV increased to a greater extent with age in males versus females. Albuminuria was a weaker determinant of PWV and eGFR did not enter the model. LIMITATIONS Data derived from one study visit, with absence of normal controls. CONCLUSION In this cohort, age and traditional CV risk factors were the strongest determinants of AS. Albuminuria was a relatively weak determinant of AS and eGFR was not an independent determinant. Long-term follow-up will investigate AS as an independent risk factor for CVE in this cohort.
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Affiliation(s)
- Natasha J. McIntyre
- Department of Renal Medicine, Royal Derby Hospital, Derbyshire, United Kingdom
| | - Richard J. Fluck
- Department of Renal Medicine, Royal Derby Hospital, Derbyshire, United Kingdom
| | - Christopher W. McIntyre
- Department of Renal Medicine, Royal Derby Hospital, Derbyshire, United Kingdom
- Department of Vascular Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Apostolos Fakis
- Department of Renal Medicine, Royal Derby Hospital, Derbyshire, United Kingdom
| | - Maarten W. Taal
- Department of Renal Medicine, Royal Derby Hospital, Derbyshire, United Kingdom
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