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Kim Y, Lee WK, Lee W. Prediction of low-density lipoprotein cholesterol levels using machine learning methods. Lab Med 2024; 55:471-484. [PMID: 38217551 DOI: 10.1093/labmed/lmad114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVE Low-density lipoprotein cholesterol (LDL-C) has been commonly calculated by equations, but their performance has not been entirely satisfactory. This study aimed to develop a more accurate LDL-C prediction model using machine learning methods. METHODS The study involved predicting directly measured LDL-C, using individual characteristics, lipid profiles, and other laboratory results as predictors. The models applied to predict LDL-C values were multiple regression, penalized regression, random forest, and XGBoost. Additionally, a novel 2-step prediction model was developed and introduced. The machine learning methods were evaluated against the Friedewald, Martin, and Sampson equations. RESULTS The Friedewald, Martin, and Sampson equations had root mean squared error (RMSE) values of 12.112, 8.084, and 8.492, respectively, whereas the 2-step prediction model showed the highest accuracy, with an RMSE of 7.015. The LDL-C levels were also classified as a categorical variable according to the diagnostic criteria of the dyslipidemia treatment guideline, and concordance rates were calculated between the predictive values obtained from each method and the directly measured ones. The 2-step prediction model had the highest concordance rate (85.1%). CONCLUSION The machine learning method can calculate LDL-C more accurately than existing equations. The proposed 2-step prediction model, in particular, outperformed the other machine learning methods.
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Affiliation(s)
- Yoori Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Won Kyung Lee
- Department of Prevention and Management, Inha University Hospital, School of Medicine, Inha University, Incheon, Republic of Korea
| | - Woojoo Lee
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
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Nong JC, You W, Wang YF, Xu Y, Xu T, Meng PN, Wu XQ, Wu ZM, Kong XH, Jia HB, Yin DL, Li L, Ye F. Dynamic natural components and morphological changes in nonculprit subclinical atherosclerosis in patients with acute coronary syndrome and mild chronic kidney disease at the 1-year follow-up and clinical significance at the 5-year follow-up. PLoS One 2024; 19:e0302547. [PMID: 38820294 PMCID: PMC11142449 DOI: 10.1371/journal.pone.0302547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/07/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION The natural outcome of coronary plaque in acute coronary syndrome (ACS) patients with chronic kidney disease (CKD) is unique, which can be analyzed quantitatively by optical flow ratio (OFR) software. METHODS A total of 184 ACS patients with at least one nonculprit subclinical atherosclerosis (NSA) detected by optical coherence tomography (OCT) at baseline and 1-year follow-up were divided into non-CKD group (n = 106, estimated glomerular filtration rate (eGFR)> 90 mL/(min×1.73 m2)) and mild CKD group (n = 78, 60≤eGFR<90 mL/(min×1.73 m2)). Changes of normalized total atheroma volume (TAVn) of NSA was the primary endpoint at the 1-year follow-up. RESULTS Patients with mild CKD showed more TAVn progression of NSA than non-CKD (p = 0.019) from baseline to the 1-year follow-up, which was mainly due to an increase in calcium TAVn (p<0.001). The morphological change in the maximal calcification thickness (p = 0.026) was higher and the change in the distance from the calcified surface to the contralateral coronary media membrane (ΔC-to-M) at the maximal cross-sectional calcium area was lower (p<0.001) in mild CKD group than in non-CKD group. Mild CKD had more NSA related MACEs at the 5-year follow-up than non-CKD (30.8% vs. 5.8%, p = 0.045). CONCLUSIONS Mild CKD patients had more plaque progression of NSA which showed the increase of calcium component with more protrusion into the lumen morphologically at the 1-year follow-up and a higher corresponding incidence of NSA-related MACEs at the 5-year follow-up. TRIAL REGISTRATION Clinical Trial registration ClinicalTrials.gov. NCT02140801. https://classic.clinicaltrials.gov/ct2/show/NCT02140801.
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Affiliation(s)
- Jia-cong Nong
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Wei You
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Yi-fei Wang
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Yi Xu
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Tian Xu
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Pei-na Meng
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Xiang-qi Wu
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Zhi-ming Wu
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Xiao-han Kong
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - Hai-bo Jia
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
| | - De-lu Yin
- Department of Cardiology, The First Hospital of Lianyungang Affiliated to Xuzhou Medical University, Haizhou District, Lianyungang, 222061, China
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Fei Ye
- Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, China
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Kounatidis D, Vallianou NG, Poulaki A, Evangelopoulos A, Panagopoulos F, Stratigou T, Geladari E, Karampela I, Dalamaga M. ApoB100 and Atherosclerosis: What's New in the 21st Century? Metabolites 2024; 14:123. [PMID: 38393015 PMCID: PMC10890411 DOI: 10.3390/metabo14020123] [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: 01/04/2024] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
ApoB is the main protein of triglyceride-rich lipoproteins and is further divided into ApoB48 in the intestine and ApoB100 in the liver. Very low-density lipoprotein (VLDL) is produced by the liver, contains ApoB100, and is metabolized into its remnants, intermediate-density lipoprotein (IDL) and low-density lipoprotein (LDL). ApoB100 has been suggested to play a crucial role in the formation of the atherogenic plaque. Apart from being a biomarker of atherosclerosis, ApoB100 seems to be implicated in the inflammatory process of atherosclerosis per se. In this review, we will focus on the structure, the metabolism, and the function of ApoB100, as well as its role as a predictor biomarker of cardiovascular risk. Moreover, we will elaborate upon the molecular mechanisms regarding the pathophysiology of atherosclerosis, and we will discuss the disorders associated with the APOB gene mutations, and the potential role of various drugs as therapeutic targets.
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Affiliation(s)
- Dimitris Kounatidis
- Second Department of Internal Medicine, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Natalia G Vallianou
- Department of Internal Medicine, Evangelismos General Hospital, 10676 Athens, Greece
| | - Aikaterini Poulaki
- Hematology Unit, Second Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Fotis Panagopoulos
- Department of Internal Medicine, Evangelismos General Hospital, 10676 Athens, Greece
| | - Theodora Stratigou
- Department of Endocrinology and Metabolism, Evangelismos General Hospital, 10676 Athens, Greece
| | - Eleni Geladari
- Department of Internal Medicine, Evangelismos General Hospital, 10676 Athens, Greece
| | - Irene Karampela
- Second Department of Critical Care, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Maria Dalamaga
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Beniwal A, Jain JC, Jain A. Lipids: A Major Culprit in Diabetic Nephropathy. Curr Diabetes Rev 2024; 20:60-69. [PMID: 38018185 DOI: 10.2174/0115733998259273231101052549] [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: 05/12/2023] [Revised: 08/13/2023] [Accepted: 09/28/2023] [Indexed: 11/30/2023]
Abstract
The pathophysiology of diabetic nephropathy (DN) is too complex and involves a variety of pathways and mediators. Hyperglycaemia and dyslipidemia are identified as major risk factors for diabetic nephropathy. Various studies revealed the fact that dyslipidemia is a major contributor to the process of diabetic nephropathy. Dyslipidemia refers to abnormal lipid levels. Lipids like LDL, free fatty acids, abnormal lipoproteins, ceramides, etc., are unsafe for kidneys. They target proximal tubular epithelial cells, podocytes, and tubulointerstitial tissues through biochemical changes, especially by enhancing the release of reactive oxygen species (ROS) and lipid peroxidation, endorsing tissue inflammation and mitochondrial damage, which give rise to nephropathy. Major lipid targets identified are SREBP1, LXR, FXR PPAR, CD-36, PKc, AGE/RAGE pathway, and ferroptosis. The drug acting on these targets has shown improvement in DN patients. Various preclinical and clinical studies support the fact that hyperlipidemic agents are promising targets for DN. Therefore, in conjunction with other standard therapies, drugs acting on dyslipidemia can be added as a part of the regimen in order to prevent the incidence of ESRD and CVD.
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Affiliation(s)
- Ankita Beniwal
- College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Jasmine Chaudhary Jain
- College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Akash Jain
- College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
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Kobayashi Y, Fujikawa T, Haruna A, Kawano R, Ozawa M, Haze T, Komiya S, Suzuki S, Ohki Y, Fujiwara A, Saka S, Hirawa N, Toya Y, Tamura K. Omega-3 Fatty Acids Reduce Remnant-like Lipoprotein Cholesterol and Improve the Ankle-Brachial Index of Hemodialysis Patients with Dyslipidemia: A Pilot Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:75. [PMID: 38256336 PMCID: PMC10818298 DOI: 10.3390/medicina60010075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Omega-3 fatty acids have potent lipid-lowering and antiplatelet effects; however, randomized controlled trials have yet to examine the effect of high-dose omega-3 fatty acid administration on peripheral artery disease (PAD) in hemodialysis patients with dyslipidemia. Therefore, this study aimed to evaluate the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on the ankle-brachial index (ABI) and remnant-like lipoprotein cholesterol (RLP-C) levels, which are indicators of PAD severity. Materials and Methods: Thirty-eight participants (mean age: 73.6 ± 12.7 years) were randomly assigned using stratified block randomization to either conventional therapy alone or conventional therapy supplemented with high-dose EPA/DHA (EPA: 1860 mg; DHA: 1500 mg) for a three-month intervention period. Patients in the conventional therapy alone group who opted to continue were provided with a low-dose EPA/DHA regimen (EPA: 930 mg; DHA: 750 mg) for an additional three months. The baseline and 3-month values for RLP-C, an atherogenic lipid parameter, and the ABI were recorded. Results: The results of the 3-month assessments revealed that the mean RLP-C changes were -3.25 ± 3.15 mg/dL and 0.44 ± 2.53 mg/dL in the EPA/DHA and control groups, respectively (p < 0.001), whereas the changes in the mean ABI values were 0.07 ± 0.11 and -0.02 ± 0.09 in the EPA/DHA and control groups, respectively (p = 0.007). In the EPA/DHA group, a significant negative correlation was found between the changes in RLP-C levels and the ABI (r = -0.475, p = 0.04). Additionally, the change in the RLP-C levels independently influenced the change in the ABI in the EPA/DHA group, even after adjusting for age, sex, and statin use (p = 0.042). Conclusions: Add-on EPA/DHA treatment improved the effectiveness of conventional therapy (such as statin treatment) for improving the ABI in hemodialysis patients with dyslipidemia by lowering RLP-C levels. Therefore, clinicians involved in dialysis should focus on RLP-C when considering residual cardiovascular disease risk in hemodialysis patients and should consider screening patients with elevated levels.
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Affiliation(s)
- Yusuke Kobayashi
- Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University, Yokohama 236-0004, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan (K.T.)
| | - Tetsuya Fujikawa
- Center for Health Service Sciences, Yokohama National University, Yokohama 240-8501, Japan
| | - Aiko Haruna
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan (K.T.)
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama 232-0024, Japan (N.H.)
| | - Rina Kawano
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan (K.T.)
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama 232-0024, Japan (N.H.)
| | - Moe Ozawa
- Department of Nephrology and Hypertension, Saiseikai Yokohamashi Nanbu Hospital, Yokohama 234-0054, Japan
| | - Tatsuya Haze
- Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University, Yokohama 236-0004, Japan
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama 232-0024, Japan (N.H.)
| | - Shiro Komiya
- Department of Nephrology and Hypertension, Saiseikai Yokohamashi Nanbu Hospital, Yokohama 234-0054, Japan
| | - Shota Suzuki
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama 232-0024, Japan (N.H.)
| | - Yuki Ohki
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama 232-0024, Japan (N.H.)
| | - Akira Fujiwara
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama 232-0024, Japan (N.H.)
| | - Sanae Saka
- Department of Nephrology and Hypertension, Saiseikai Yokohamashi Nanbu Hospital, Yokohama 234-0054, Japan
| | - Nobuhito Hirawa
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama 232-0024, Japan (N.H.)
| | - Yoshiyuki Toya
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan (K.T.)
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan (K.T.)
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Lipidic profiles of patients starting peritoneal dialysis suggest an increased cardiovascular risk beyond classical dyslipidemia biomarkers. Sci Rep 2022; 12:16394. [PMID: 36180468 PMCID: PMC9525574 DOI: 10.1038/s41598-022-20757-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 09/19/2022] [Indexed: 11/15/2022] Open
Abstract
Patients on peritoneal dialysis (PD) have an increased risk of cardiovascular disease (CVD) and an atherogenic lipid profile generated by exposure to high glucose dialysis solutions. In the general population, the reduction of classic lipids biomarkers is associated with improved clinical outcomes; however, the same results have not been seen in PD population, a lack of data this study aims to fulfill. Single-center prospective observational study of a cohort of CKD patients who started renal replacement therapy with continuous ambulatory peritoneal dialysis. The differences in the lipid profile and analytical variables before and 6 months after the start of peritoneal dialysis were analyzed. Samples were analyzed on an Ultra-Performance Liquid Chromatography system. Thirty-nine patients were enrolled in this study. Their mean age was 57.9 ± 16.3 years. A total of 157 endogenous lipid species of 11 lipid subclasses were identified. There were significant increases in total free fatty acids (p < 0.05), diacylglycerides (p < 0.01), triacylglycerides, (p < 0.01), phosphatidylcholines (p < 0.01), phosphatidylethanolamines (p < 0.01), ceramides (p < 0.01), sphingomyelins (p < 0.01), and cholesterol esters (p < 0.01) from baseline to 6 months. However, there were no differences in the classical lipid markers, neither lysophosphatidylcholines, monoacylglycerides, and sphingosine levels. 6 months after the start of the technique, PD patients present changes in the lipidomic profile beyond the classic markers of dyslipidemia.
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Jiang XS, Cai MY, Li XJ, Zhong Q, Li ML, Xia YF, Shen Q, Du XG, Gan H. Activation of the Nrf2/ARE signaling pathway protects against palmitic acid-induced renal tubular epithelial cell injury by ameliorating mitochondrial reactive oxygen species-mediated mitochondrial dysfunction. Front Med (Lausanne) 2022; 9:939149. [PMID: 36177332 PMCID: PMC9513042 DOI: 10.3389/fmed.2022.939149] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic kidney disease (CKD) is often accompanied by dyslipidemia, and abnormal lipid metabolism in proximal tubule cells is considered closely related to the dysfunction of proximal tubule cells and eventually leads to accelerated kidney damage. Nuclear factor E2-related factor 2 (Nrf2), known as a redox-sensitive transcription factor, is responsible for regulating cellular redox homeostasis. However, the exact role of Nrf2 in dyslipidemia-induced dysfunction of proximal tubule cells is still not fully elucidated. In the present study, we showed that palmitic acid (PA) induced mitochondrial damage, excessive mitochondrial reactive oxygen species (ROS) (mtROS) generation, and cell injury in HK-2 cells. We further found that mtROS generation was involved in PA-induced mitochondrial dysfunction, cytoskeletal damage, and cell apoptosis in HK-2 cells. In addition, we demonstrated that the Nrf2/ARE signaling pathway was activated in PA-induced HK-2 cells and that silencing Nrf2 dramatically aggravated PA-induced mtROS production, mitochondrial damage, cytoskeletal damage and cell apoptosis in HK-2 cells. However, the mitochondrial antioxidant MitoTEMPOL effectively eliminated these negative effects of Nrf2 silencing in HK-2 cells under PA stimulation. Moreover, activation of the Nrf2/ARE signaling pathway with tBHQ attenuated renal injury, significantly reduced mtROS generation, and improved mitochondrial function in rats with HFD-induced obesity. Taken together, these results suggest that the Nrf2/ARE-mediated antioxidant response plays a protective role in hyperlipidemia-induced renal injury by ameliorating mtROS-mediated mitochondrial dysfunction and that enhancing Nrf2 antioxidant signaling provides a potential therapeutic strategy for kidney injury in CKD with hyperlipidemia.
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Affiliation(s)
- Xu-shun Jiang
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Meng-yao Cai
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xun-jia Li
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qing Zhong
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Man-li Li
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yun-feng Xia
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qing Shen
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-gang Du
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- The Chongqing Key Laboratory of Translational Medicine in Major Metabolic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Xiao-gang Du,
| | - Hua Gan
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Hua Gan,
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Poznyak AV, Sadykhov NK, Kartuesov AG, Borisov EE, Sukhorukov VN, Orekhov AN. Atherosclerosis Specific Features in Chronic Kidney Disease (CKD). Biomedicines 2022; 10:biomedicines10092094. [PMID: 36140195 PMCID: PMC9495595 DOI: 10.3390/biomedicines10092094] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022] Open
Abstract
Atherosclerosis is the major cause of cardiovascular disease, leading to a high mortality rate worldwide. Several risk factors are known to favor atherogenesis, among which are high blood pressure, smoking, diabetes mellitus, and others. Chronic kidney disease is another serious health problem associated with significant health care costs, morbidity, and mortality. Chronic kidney disease shares several risk factors with atherosclerosis and cardiovascular diseases, such as hypertension and diabetes mellitus. Additional risk factors for cardiovascular disease development should be considered in patients with chronic kidney disease. Interestingly, patients suffering from chronic kidney disease are more prone to cardiovascular problems than the general population. Moreover, chronic kidney disease is characterized by an increased atherosclerotic burden from the very early stages. The purpose of this review was to summarize data on atherosclerosis in chronic kidney disease, highlighting the specific features of the disease combination.
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Affiliation(s)
- Anastasia V. Poznyak
- Institute for Atherosclerosis Research, Osennyaya 4-1-207, 121609 Moscow, Russia
- Correspondence: (A.V.P.); (A.N.O.)
| | - Nikolay K. Sadykhov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 8 Baltiiskaya Street, 125315 Moscow, Russia
| | - Andrey G. Kartuesov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 8 Baltiiskaya Street, 125315 Moscow, Russia
| | - Evgeny E. Borisov
- Petrovsky National Research Centre of Surgery, Abrikosovsky Lane, 119991 Moscow, Russia
| | - Vasily N. Sukhorukov
- Institute for Atherosclerosis Research, Osennyaya 4-1-207, 121609 Moscow, Russia
- Petrovsky National Research Centre of Surgery, Abrikosovsky Lane, 119991 Moscow, Russia
| | - Alexander N. Orekhov
- Institute for Atherosclerosis Research, Osennyaya 4-1-207, 121609 Moscow, Russia
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 8 Baltiiskaya Street, 125315 Moscow, Russia
- Petrovsky National Research Centre of Surgery, Abrikosovsky Lane, 119991 Moscow, Russia
- Correspondence: (A.V.P.); (A.N.O.)
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Luo D, Luo Y, Zou Y, Xu Y, Fu B, Yang D, Yang J, Xu C, Ling S, Li S, Qi A. Non-high-density lipoprotein cholesterol may predict the cardio-cerebrovascular risk in patients on maintenance hemodialysis. Lipids Health Dis 2021; 20:159. [PMID: 34774042 PMCID: PMC8590291 DOI: 10.1186/s12944-021-01546-1] [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: 07/11/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
Background Non-high-density lipoprotein cholesterol (non-HDL-C) may be an independent risk factor for cardio-cerebrovascular disease (CVD); however, the cutoff level in patients on maintenance hemodialysis (MHD) is unknown. Methods This was a retrospective multicenter study of MHD patients treated at 10 dialysis centers in Guangdong Province from July 1, 2016, to April 1, 2017. Laboratory test data were collected and CVD complications and outcomes recorded. Results In total, 1288 eligible patients were included in this study; the non-HDL-C interquartile range was 2.76 (2.24–3.45) mmol/L. Over a median follow-up time of 24 months, 141 patients developed CVD. The non-HDL-C level was a principal risk factor for such events (P < 0.05; 95% confidence interval 0.800–0.842). The maximum Youden index was 0.549 and the best cutoff > 3.39 mmol/L. Conclusion Higher baseline non-HDL-C levels may increase the CVD risk in MHD patients. Thus, non-HDL-C effectively predicts CVD.
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Affiliation(s)
- Denggui Luo
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Yueming Luo
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Yanhong Zou
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Yuanzhao Xu
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Bo Fu
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Dong Yang
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Jun Yang
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Cai Xu
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Shuyi Ling
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Shunmin Li
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
| | - Airong Qi
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
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Hirano T, Satoh N, Kodera R, Hirashima T, Suzuki N, Aoki E, Oshima T, Hosoya M, Fujita M, Hayashi T, Ito Y. Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross-sectional study from a regional diabetes cohort. J Diabetes Investig 2021; 13:657-667. [PMID: 34665936 PMCID: PMC9017612 DOI: 10.1111/jdi.13697] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/17/2021] [Accepted: 10/17/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS/INTRODUCTION Diabetic kidney disease (DKD) exacerbates dyslipidemia and increases the incidence of atherosclerotic cardiovascular disease. DKD is a concept that includes typical diabetic nephropathy and an atypical phenotype without proteinuria. We investigated dyslipidemia in different DKD phenotypes that have not been fully studied. MATERIALS AND METHODS Fasting plasma was obtained from 1,073 diabetes patients enrolled in the regional diabetes cohort (ViNA cohort). Non-proteinuric and proteinuric DKD were defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 in the absence or presence of urinary albumin-to-creatinine ratio >300 mg/g. Novel lipid risk factors, low-density lipoprotein (LDL) triglyceride (TG) and small dense LDL cholesterol were measured using our established homologous assay. RESULTS The proportion of atherosclerotic cardiovascular disease patients was higher in non-proteinuric DKD and even higher in proteinuric DKD than in non-DKD. Increased estimated glomerular filtration rate grade and albuminuric stage were independently correlated with higher TG, TG-rich lipoprotein cholesterol and apolipoprotein CIII. Therefore, proteinuric DKD had the highest of these levels. Small dense LDL cholesterol and LDL-TG were higher in the proteinuria without renal dysfunction group in the lipid-lowering drug-free subset. Lipoprotein(a) was higher in DKD regardless of proteinuria. CONCLUSIONS Proteinuria was associated with an atherogenic subspecies of LDL, whereas renal dysfunction was associated with increased lipoprotein(a). Proteinuria and renal dysfunction independently exacerbated TG-rich lipoprotein-related dyslipidemia. This is in good agreement with the results of large-scale clinical studies in which proteinuria and renal dysfunction synergistically increased the risk of atherosclerotic cardiovascular disease in populations with diabetes.
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Affiliation(s)
- Tsutomu Hirano
- Diabetes Center, Ebina General Hospital, Ebina City, Japan
| | - Noriyuki Satoh
- Vaccine & Diagnostics R&D Department, Denka Co., Ltd, Gosen, Japan
| | - Rieko Kodera
- Diabetes Center, Ebina General Hospital, Ebina City, Japan
| | | | - Natsuko Suzuki
- Diabetes Center, Ebina General Hospital, Ebina City, Japan
| | - Ema Aoki
- Diabetes Center, Ebina General Hospital, Ebina City, Japan
| | - Taito Oshima
- Diabetes Center, Ebina General Hospital, Ebina City, Japan
| | - Mitsuru Hosoya
- Diabetes Center, Ebina General Hospital, Ebina City, Japan
| | | | | | - Yasuki Ito
- Vaccine & Diagnostics R&D Department, Denka Co., Ltd, Gosen, Japan
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11
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Izar MC. Can we improve accuracy in LDL-cholesterol estimation in chronic kidney disease? Eur J Prev Cardiol 2021; 28:1409-1410. [PMID: 33624056 DOI: 10.1093/eurjpc/zwaa048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Maria Cristina Izar
- Lipids, Atherosclerosis and Vascular Biology Section, Cardiology Division, Department of Medicine, Universidade Federal de Sao Paulo, Rua Loefgren, 1350-Vila Clementino, Sao Paulo, SP 04040-001, Brazil
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12
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Pribylova NN, Yakovleva MV, Pribylov CA, Barbashina TA, Gavriljuk EV, Mal GS, Pribylov VS. [Vasoprotective effects hypotensive therapy in patients with coronary heart disease combined with chronic kidney disease stage 2-3 after coronary stenting]. ACTA ACUST UNITED AC 2021; 61:14-22. [PMID: 34549689 DOI: 10.18087/cardio.2021.8.n1525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/25/2021] [Accepted: 03/09/2021] [Indexed: 11/18/2022]
Abstract
Aim To study the condition of coronary vasculature by data of coronarography (CG) in patients with chronic ischemic heart disease (IHD) and arterial hypertension (AH) associated with stage 2-4 chronic kidney disease (CKD) and to evaluate the effect of a 12-week complex treatment with perindopril or with a combination of perindopril/amlodipine on changes in vascular wall stiffness, endothelial function, and structure and function parameters in this patient category after coronary stenting.Material and methodsr This study included 87 patients with chronic IHD and AH associated with stage 2-3 CKD for whom CG was performed due to ineffectiveness of the antianginal therapy. The patients were divided into three subgroups: subgroup 1 included 28 patients who received a conservative treatment with perindopril 10 mg/day; subgroup 2 consisted of 25 patients who underwent coronary stenting and were prescribed perindopril; subgroup 3 consisted of 34 patients who underwent stenting and were prescribed the perindopril/amlodipine combination. The reference group included 47 patients with IHD and AH with preserved kidney function. Anatomic and functional parameters of the heart, arterial stiffness, pulse wave velocity, cardio-ankle vascular index, augmentation index, central aortic systolic and pulse pressure, endothelium-dependent vasodilation, plasma concentration of endothelin-1 (ET-1), and plasma concentration of nitric oxide metabolites were evaluated at baseline and after 12 weeks of treatment.Results In patients with IHD, AH, and stage 2-3 CKD, arterial stiffness was more pronounced than in patients with preserved kidney function. Concentrations of ET-1 were significantly higher and levels of nitric oxide were lower in CKD. Supplementing the complex therapy with perindopril resulted in a considerable hypotensive effect in all subgroups, improvement of the kidney function, and positive dynamics of arterial stiffness and endothelial function. Changes in these parameters were more pronounced in patients after coronary stenting than in patients receiving only a conservative treatment. The use of perindopril/amlodipine following stenting exerted the most significant angioprotective and cardioprotective effect.Conclusion Patients with IHD and AH in combination with early CKD have pronounced impairment of the condition of arterial blood vessels and the heart. Addition of perindopril to the treatment not only exerted a hypotensive effect but also beneficially influenced mechanisms of progression of this combined pathology.
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Affiliation(s)
| | | | | | | | | | - G S Mal
- Kursk State Medical University, Kursk
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13
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Moisi MI, Bungau SG, Vesa CM, Diaconu CC, Behl T, Stoicescu M, Toma MM, Bustea C, Sava C, Popescu MI. Framing Cause-Effect Relationship of Acute Coronary Syndrome in Patients with Chronic Kidney Disease. Diagnostics (Basel) 2021; 11:diagnostics11081518. [PMID: 34441451 PMCID: PMC8391570 DOI: 10.3390/diagnostics11081518] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 02/06/2023] Open
Abstract
The main causes of death in patients with chronic kidney disease (CKD) are of cardiovascular nature. The interaction between traditional cardiovascular risk factors (CVRF) and non-traditional risk factors (RF) triggers various complex pathophysiological mechanisms that will lead to accelerated atherosclerosis in the context of decreased renal function. In terms of mortality, CKD should be considered equivalent to ischemic coronary artery disease (CAD) and properly monitored. Vascular calcification, endothelial dysfunction, oxidative stress, anemia, and inflammatory syndrome represents the main uremic RF triggered by accumulation of the uremic toxins in CKD subjects. Proteinuria that appears due to kidney function decline may initiate an inflammatory status and alteration of the coagulation—fibrinolysis systems, favorizing acute coronary syndromes (ACS) occurrence. All these factors represent potential targets for future therapy that may improve CKD patient’s survival and prevention of CV events. Once installed, the CAD in CKD population is associated with negative outcome and increased mortality rate, that is the reason why discovering the complex pathophysiological connections between the two conditions and a proper control of the uremic RF are crucial and may represent the solutions for influencing the prognostic. Exclusion of CKD subjects from the important trials dealing with ACS and improper use of the therapeutical options because of the declined kidney functioned are issues that need to be surpassed. New ongoing trials with CKD subjects and platelets reactivity studies offers new perspectives for a better clinical approach and the expected results will clarify many aspects.
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Affiliation(s)
- Mădălina Ioana Moisi
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.I.M.); (C.B.)
| | - Simona Gabriela Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania
- Correspondence: (S.B.); (C.M.V)
| | - Cosmin Mihai Vesa
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.I.M.); (C.B.)
- Correspondence: (S.B.); (C.M.V)
| | - Camelia Cristina Diaconu
- Department 5, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Tapan Behl
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Punjab 140401, India;
| | - Manuela Stoicescu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.S.); (C.S.); (M.I.P.)
| | - Mirela Mărioara Toma
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania
| | - Cristiana Bustea
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.I.M.); (C.B.)
| | - Cristian Sava
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.S.); (C.S.); (M.I.P.)
| | - Mircea Ioachim Popescu
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.S.); (C.S.); (M.I.P.)
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14
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Barbagallo CM, Cefalù AB, Giammanco A, Noto D, Caldarella R, Ciaccio M, Averna MR, Nardi E. Lipoprotein Abnormalities in Chronic Kidney Disease and Renal Transplantation. Life (Basel) 2021; 11:life11040315. [PMID: 33916487 PMCID: PMC8067409 DOI: 10.3390/life11040315] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 12/15/2022] Open
Abstract
Chronic kidney disease (CKD) is one of the most important risk factors for cardiovascular disease (CVD). Despite the kidney having no direct implications for lipoproteins metabolism, advanced CKD dyslipidemia is usually present in patients with CKD, and the frequent lipid and lipoprotein alterations occurring in these patients play a role of primary importance in the development of CVD. Although hypertriglyceridemia is the main disorder, a number of lipoprotein abnormalities occur in these patients. Different enzymes pathways and proteins involved in lipoprotein metabolism are impaired in CKD. In addition, treatment of uremia may modify the expression of lipoprotein pattern as well as determine acute changes. In renal transplantation recipients, the main lipid alteration is hypercholesterolemia, while hypertriglyceridemia is less pronounced. In this review we have analyzed lipid and lipoprotein disturbances in CKD and also their relationship with progression of renal disease. Hypolipidemic treatments may also change the natural history of CVD in CKD patients and may represent important strategies in the management of CKD patients.
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Affiliation(s)
- Carlo Maria Barbagallo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties—University of Palermo, Via del Vespro, 127, 90127 Palermo, Italy; (C.M.B.); (A.B.C.); (A.G.); (D.N.); (R.C.); (M.R.A.)
| | - Angelo Baldassare Cefalù
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties—University of Palermo, Via del Vespro, 127, 90127 Palermo, Italy; (C.M.B.); (A.B.C.); (A.G.); (D.N.); (R.C.); (M.R.A.)
| | - Antonina Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties—University of Palermo, Via del Vespro, 127, 90127 Palermo, Italy; (C.M.B.); (A.B.C.); (A.G.); (D.N.); (R.C.); (M.R.A.)
| | - Davide Noto
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties—University of Palermo, Via del Vespro, 127, 90127 Palermo, Italy; (C.M.B.); (A.B.C.); (A.G.); (D.N.); (R.C.); (M.R.A.)
| | - Rosalia Caldarella
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties—University of Palermo, Via del Vespro, 127, 90127 Palermo, Italy; (C.M.B.); (A.B.C.); (A.G.); (D.N.); (R.C.); (M.R.A.)
| | - Marcello Ciaccio
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), Section of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, 90127 Palermo, Italy;
| | - Maurizio Rocco Averna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties—University of Palermo, Via del Vespro, 127, 90127 Palermo, Italy; (C.M.B.); (A.B.C.); (A.G.); (D.N.); (R.C.); (M.R.A.)
| | - Emilio Nardi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties—University of Palermo, Via del Vespro, 127, 90127 Palermo, Italy; (C.M.B.); (A.B.C.); (A.G.); (D.N.); (R.C.); (M.R.A.)
- Correspondence: ; Tel.: +39-916-554-316
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15
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Bagherniya M, Soleimani D, Rouhani MH, Askari G, Sathyapalan T, Sahebkar A. The Use of Curcumin for the Treatment of Renal Disorders: A Systematic Review of Randomized Controlled Trials. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1291:327-343. [PMID: 34331699 DOI: 10.1007/978-3-030-56153-6_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Chronic kidney disease (CKD) is one of the significant causes of morbidity and mortality worldwide, which could develop and progress to end-stage renal disease. Increased inflammation and reduced antioxidant capacity commonly occur in CKD and hemodialysis patients. Curcumin is a natural bioactive compound with antioxidant and anti-inflammatory properties. This systematic review was undertaken with the main aim of assessing the effects of curcumin/turmeric supplementation on renal diseases based on clinical trials. A comprehensive search was performed in PubMed/MEDLINE, Scopus, ISI Web of Science, and Google Scholar from inception up to April 6, 2020 to identify clinical trials assessing the effects of curcumin or turmeric alone, or in combination with other herbs or nutrients on renal diseases. Twelve studies met the eligibility criteria. These randomized controlled trials (RCTs) comprised 631 patients with either chronic kidney diseases (CKD), hemodialysis, diabetic proteinuria and nephropathy, and lupus nephritis. Curcumin/turmeric supplementation had favorable effects on renal diseases, particularly in terms of inflammation and oxidative stress. However, with the exception for proteinuria, their impact on clinical parameters, such as blood urea nitrogen, creatinine, glomerular filtration rate (GFR), and serum albumin, was weak and not significant. No serious adverse effects were reported following curcumin/turmeric supplementation. Within the limitations of this review, it can be concluded that curcumin/turmeric supplementation might have some beneficial effects on inflammatory and oxidative stress parameters of patients but no considerable positive impact on clinical outcomes of kidney diseases, apart from proteinuria.
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Affiliation(s)
- Mohammad Bagherniya
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Soleimani
- School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hossein Rouhani
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Thozhukat Sathyapalan
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Halal Research Center of IRI, FDA, Tehran, Iran.
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.
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16
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Mathew AV, Zeng L, Atkins KB, Sadri KN, Byun J, Fujiwara H, Reddy P, Pennathur S. Deletion of bone marrow myeloperoxidase attenuates chronic kidney disease accelerated atherosclerosis. J Biol Chem 2021; 296:100120. [PMID: 33234591 PMCID: PMC7948401 DOI: 10.1074/jbc.ra120.014095] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/28/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
Increased myeloperoxidase (MPO) expression and activity are associated with atherosclerotic disease in patients with chronic kidney disease (CKD). However, the causal relationship between MPO and the development and progression of atherosclerosis in patients with CKD is unknown. Eight-week-old male low-density-lipoprotein-receptor-deficient mice were subjected to 5/6 nephrectomy, irradiated, and transplanted with bone marrow from MPO-deficient mice to induce bone marrow MPO deletion (CKD-bMPOKO) or bone marrow from WT mice as a control to maintain preserved bone marrow MPO(CKD-bMPOWT). The mice were maintained on a high-fat/high-cholesterol diet for 16 weeks. As anticipated, both groups of mice exhibited all features of moderate CKD, including elevated plasma creatinine, lower hematocrit, and increased intact parathyroid hormone but did not demonstrate any differences between the groups. Irradiation and bone marrow transplantation did not further affect body weight, blood pressure, creatinine, or hematocrit in either group. The absence of MPO expression in the bone marrow and atherosclerotic lesions of the aorta in the CKD-bMPOKO mice was confirmed by immunoblot and immunohistochemistry, respectively. Decreased MPO activity was substantiated by the absence of 3-chlorotyrosine, a specific by-product of MPO, in aortic atherosclerotic lesions as determined by both immunohistochemistry and highly sensitive LC-MS. Quantification of the aortic lesional area stained with oil red O revealed that CKD-bMPOKO mice had significantly decreased aortic plaque area as compared with CKD-bMPOWT mice. This study demonstrates the reduction of atherosclerosis in CKD mice with the deletion of MPO in bone marrow cells, strongly implicating bone-marrow-derived MPO in the pathogenesis of CKD atherosclerosis.
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Affiliation(s)
- Anna V Mathew
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
| | - Lixia Zeng
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Kevin B Atkins
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Kiana N Sadri
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jaeman Byun
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Hideaki Fujiwara
- Division of Hematology-Oncology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Pavan Reddy
- Division of Hematology-Oncology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Subramaniam Pennathur
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA; Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA.
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17
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Wang L, Xiang F, Ji J, Ding X, Shen B, Chen J, Chen Y, Xue N, Zhang L, Jiang X, Cao X. Indoxyl sulfate and high-density lipoprotein cholesterol in early stages of chronic kidney disease. Ren Fail 2020; 42:1157-1163. [PMID: 33191829 PMCID: PMC7671672 DOI: 10.1080/0886022x.2020.1845731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background High IS level has been demonstrated to be associated with vascular calcification and lymphocyte functional disorders, which are both risk factors of CVD. Low HDL-c level is a risk factor of CVD in CKD patients. This study was designed to explore the potential relationship between IS and HDL-c levels in early stages of CKD population. Methods Patients of CKD stage 1-3 were enrolled in this cross-sectional study. Correlations between HDL-c and IS levels were investigated among various clinicopathological variables through independent samples t test and multivariate logistic regression. Results A total of 205 CKD patients (96 men) aged 43.27 ± 13.80 years old were included in this research. There were 96 patients (46 men) in CKD stage1 and 109 (50 men) in CKD stage 2 or stage 3. IS levels were significantly higher in CKD 2 + 3 group (1.50 ± 1.74 μg/ml vs. 0.94 ± 0.66 μg/ml, p = 0.007), while HDL-c levels were lower (1.19 ± 0.39 mmol/L vs. 1.33 ± 0.45 mmol/L, p = 0.017) compared to CKD 1 group. Among all the patients, a negative correlation was observed between IS and HDL-c levels (r = −0.244, p = 0.001). IS level was an independent risk factor for low HDL-c (<1.04 mmol/L) incidence even after controlling for potential confounders including concomitant disease, age, sex, blood pressure, BMI and laboratory biochemical test including eGFR (OR = 1.63, 95% CI: 1.11–2.39, p = 0.013). IS and HDL-c were both risk factors for predicting CKD stage 3. Conclusions In early CKD stages, low HDL-c level is associated with increased IS levels, which may be an important contributor in the development of dyslipidemia in CKD patients.
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Affiliation(s)
- Li Wang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Fangfang Xiang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Jun Ji
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Bo Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yunqin Chen
- Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ning Xue
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Lin Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaotian Jiang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xuesen Cao
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
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18
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Xiang XY, Liu T, Wu Y, Jiang XS, He JL, Chen XM, Du XG. Berberine alleviates palmitic acid‑induced podocyte apoptosis by reducing reactive oxygen species‑mediated endoplasmic reticulum stress. Mol Med Rep 2020; 23:3. [PMID: 33179098 PMCID: PMC7673344 DOI: 10.3892/mmr.2020.11641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/22/2020] [Indexed: 02/06/2023] Open
Abstract
Lipid accumulation in podocytes can lead to the destruction of cellular morphology, in addition to cell dysfunction and apoptosis, which is a key factor in the progression of chronic kidney disease (CKD). Berberine (BBR) is an isoquinoline alkaloid extracted from medicinal plants such as Coptis chinensis, which has been reported to have a lipid-lowering effect and prevent CKD progression. Therefore, the present study aimed to investigate the effect of BBR on palmitic acid (PA)-induced podocyte apoptosis and its specific mechanism using an in vitro model. Cell death was measured using the Cell Counting Kit-8 colorimetric assay. Cell apoptotic rate was assessed by flow cytometry. The expression of endoplasmic reticulum (ER) stress- and apoptosis-related proteins was detected by western blotting or immunofluorescence. Reactive oxygen species (ROS) were evaluated by 2′,7′-dichlorofluorescein diacetate fluorescence staining. The results of the present study revealed that BBR treatment decreased PA-induced podocyte apoptosis. In addition, 4-phenylbutyric acid significantly reduced PA-induced cell apoptosis and the expression of ER stress-related proteins, which indicated that ER stress was involved in PA-induced podocyte apoptosis. In addition, N-acetylcysteine inhibited PA-induced excessive ROS production, ER stress and cell apoptosis of podocytes. BBR also significantly reduced PA-induced ROS production and ER stress in podocytes. These results suggested that PA mediated podocyte apoptosis through enhancing ER stress and the production of ROS. In conclusion, BBR may protect against PA-induced podocyte apoptosis, and suppression of ROS-dependent ER stress may be the key mechanism underlying the protective effects of BBR.
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Affiliation(s)
- Xing-Yang Xiang
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
| | - Ting Liu
- Department of Nephrology, Chengdu Fifth People's Hospital, Chengdu, Sichuan 611130, P.R. China
| | - Yue Wu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
| | - Xu-Shun Jiang
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
| | - Jun-Ling He
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Xue-Mei Chen
- Emergency Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
| | - Xiao-Gang Du
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
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Raikou VD, Kyriaki D, Gavriil S. Triglycerides to High-Density Lipoprotein Cholesterol Ratio Predicts Chronic Renal Disease in Patients without Diabetes Mellitus (STELLA Study). J Cardiovasc Dev Dis 2020; 7:jcdd7030028. [PMID: 32752179 PMCID: PMC7570173 DOI: 10.3390/jcdd7030028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/11/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been included in the potential indices for atherosclerosis in chronic kidney disease (CKD). In this study, we addressed the role of the TG/HDL-C ratio on CKD prediction defined by both classified estimated glomerular filtration rate (eGFR) and classified urinary albumin-to-creatinine ratio (UACR) in non-diabetic participants. METHODS One hundred and eighty-three subjects with a mean age 67.3 ± 15.6 years old were included. Our participants were classified in both eGFR and UACR categories according to the Kidney Disease Improving Global Outcomes 2012 criteria. Estimated pulse wave velocity (ePWV) was calculated using an equation from age and mean blood pressure. The TG/HDL-C ratio was calculated. X2 tests and adjusted models were applied using confounders. RESULTS The TG/HDL-C ratio was inversely associated with eGFR and positively with both UACR and ePWV. We divided our patients in two groups according to the found ROC curve of the TG/HDL-C ratio cut-off point, either with an eGFR of less or more than 60 mL/min/1.73 m2. X2 tests showed significant association between the high TG/HDL-C ratio and classified eGFR, and classified UACR and hypertension (x2 = 24.5, p = 0.001, x2 = 12.5, p = 0.002 and x2 = 12.6, p = 0.001, respectively). The adjusted model showed the high TG/HDL-C ratio to be an independent predictor for both a low eGFR and UACR (OR = 1.5, 1.2-1.9 and OR = 1.22, 1.02-1.47, respectively) in combination with old age and hypertension. CONCLUSION The TG/HDL-C ratio was revealed to be a potential predictor for both a low eGFR and micro/macroalbuminuria in non-diabetic patients. The arterial stiffening was included in the main underlying pathophysiological mechanisms.
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Affiliation(s)
- Vaia D. Raikou
- . Department of Nephrology, Doctors’ Hospital, 26 Kefallinias, Athens 11257, Greece
- Correspondence: ; Tel.: +30-21-0821-2000; Fax: +30-21-0821-8228
| | - Despina Kyriaki
- Department of Nuclear Medicine, General Hospital “LAΪKO”, Athens 11527, Greece;
| | - Sotiris Gavriil
- Department of of Bariatric Surgery, Doctors’ Hospital, 26 Kefallinias, Athens 11257, Greece;
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Yokote K, Niwa K, Hakoda T, Oh F, Kajimoto Y, Fukui T, Kim H, Noda Y, Lundström T, Yajima T. Short-Term Efficacy (at 12 Weeks) and Long-Term Safety (up to 52 Weeks) of Omega-3 Free Fatty Acids (AZD0585) for the Treatment of Japanese Patients With Dyslipidemia - A Randomized, Double-Blind, Placebo-Controlled, Phase III Study. Circ J 2020; 84:994-1003. [PMID: 32281579 DOI: 10.1253/circj.cj-19-0358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study is the first to evaluate the short-term efficacy and long-term safety of AZD0585, a mixture of omega-3 free fatty acids, in Japanese patients with dyslipidemia.Methods and Results:In this randomized double-blind placebo-controlled Phase III study, 383 patients were randomized to 2 g AZD0585, 4 g AZD0585, or placebo once daily for 52 weeks. Eligible patients had low-density lipoprotein cholesterol (LDL-C) levels controlled regardless of statin use, and triglyceride levels between 150 and 499 mg/dL. The least-squares (LS) mean percentage changes in triglyceride concentrations from baseline to the 12-week endpoint (mean of measurements at Weeks 10 and 12) in the 2 and 4 g AZD0585 and placebo groups were -15.57%, -21.75%, and 11.15% respectively (P<0.0001 for both AZD0585 doses vs. placebo). No clinically significant changes from baseline to the 12-week endpoint in total cholesterol, LDL-C, and LDL-C/apolipoprotein (Apo) B were found with AZD0585. High-density lipoprotein cholesterol (HDL-C) was slightly increased and very low-density lipoprotein cholesterol, non-HDL-C, ApoC-II, and ApoC-III were decreased with AZD0585 compared with placebo at the 12-week endpoint. Lipid profiles up to Week 52 were consistent with those up to the 12-week endpoint. No clinically important safety concerns were raised. CONCLUSIONS AZD0585 significantly decreased serum triglyceride levels compared with placebo at the 12-week endpoint and was generally safe and well tolerated in Japanese patients with dyslipidemia.
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Affiliation(s)
- Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital
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21
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Interrelation Between Disorder of Melatonin-forming Function of Epiphysis and Dyslipidemia in Patients with Chronic Kidney Disease of 5 Stage Treated by Hemodialysis. Fam Med 2020. [DOI: 10.30841/2307-5112.1-2.2020.204575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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22
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Fawzy MS, Abu AlSel BT, Al Ageeli E, Al-Qahtani SA, Abdel-Daim MM, Toraih EA. Long non-coding RNA MALAT1 and microRNA-499a expression profiles in diabetic ESRD patients undergoing dialysis: a preliminary cross-sectional analysis. Arch Physiol Biochem 2020; 126:172-182. [PMID: 30270667 DOI: 10.1080/13813455.2018.1499119] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background: Circulating non-coding RNAs (ncRNAs) have been implicated in health and disease. This study aimed to evaluate the serum expression profile of microRNA-499a (miR-499a) and its selected bioinformatically predicted partner long-ncRNA MALAT1 (metastasis-associated lung adenocarcinoma transcript 1) in diabetes-related end-stage renal disease (ESRD) patients and to correlate the expressions with the patients' clinicolaboratory data.Subjects and methods: Real-time quantitative polymerase chain reaction was applied in diabetics with and without ESRD (n = 90 for each).Results: Serum MALAT1 expression levels were increased in the ESRD group relative to diabetics without ESRD with median (quartile) values of 10.5 (1.41-126.7) (p < .001). However, miR-499a levels were decreased in more than half of ESRD patients with a median of 0.96 (0.13-3.14). Both MALAT1 and miR-499a expression levels were inversely correlated in the ESRD patient-group.Conclusions: MALAT1 up-regulation and miR-499 down-regulation might be involved in diabetic nephropathy-related ESRD pathogenesis. Functional validation studies are warranted to confirm the MALAT1/miR-499a partnership.
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MESH Headings
- Adult
- Aged
- Base Pairing
- Base Sequence
- Cross-Sectional Studies
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/therapy
- Diabetic Nephropathies/diagnosis
- Diabetic Nephropathies/etiology
- Diabetic Nephropathies/genetics
- Diabetic Nephropathies/therapy
- Disease Progression
- Female
- Gene Expression Regulation
- Humans
- Kidney Failure, Chronic/diagnosis
- Kidney Failure, Chronic/etiology
- Kidney Failure, Chronic/genetics
- Kidney Failure, Chronic/therapy
- Male
- MicroRNAs/blood
- MicroRNAs/genetics
- Middle Aged
- RNA, Long Noncoding/blood
- RNA, Long Noncoding/genetics
- Renal Dialysis
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Affiliation(s)
- Manal S Fawzy
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Baraah T Abu AlSel
- Department of Microbiology, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
| | - Essam Al Ageeli
- Department of Clinical Biochemistry (Medical Genetics), Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Saeed Awad Al-Qahtani
- Department of Physiology, Faculty of Medicine, Taibah University, Almadinah Almunawwarah, Saudi Arabia
| | - Mohamed M Abdel-Daim
- Department of Pharmacology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Eman A Toraih
- Department of Histology and Cell Biology (Genetics Unit), Faculty of Medicine, Suez Canal University, Ismailia, Egypt
- Center of Excellence of Molecular and Cellular Medicine, Suez Canal University, Ismailia, Egypt
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Ademowo OS, Sharma P, Cockwell P, Reis A, Chapple IL, Griffiths HR, Dias IHK. Distribution of plasma oxidised phosphatidylcholines in chronic kidney disease and periodontitis as a co-morbidity. Free Radic Biol Med 2020; 146:130-138. [PMID: 31644951 DOI: 10.1016/j.freeradbiomed.2019.10.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/08/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
Abstract
Individuals with chronic kidney disease (CKD) and periodontitis as a co-morbidity have a higher mortality rate than individuals with CKD and no periodontitis. The inflammatory burden associated with both diseases contributes to an increased risk of cardiovascular and all-cause mortality. We previously demonstrated that periodontitis is associated with increasing circulating markers of inflammation and oxidative stress. We propose that inflammatory oxidised phosphocholines may contribute to the increased risk of cardiovascular disease in patients with CKD. However, the analysis of oxidised phospholipids has been limited by a lack of authentic standards for absolute quantification. Here, we have developed a comprehensive quantification liquid chromatography-mass spectrometry-based multiple reaction monitoring method for oxidised phospholipids (including some without available authentic species) that enables us to simultaneously measure twelve oxidised phosphatidylcholine species with high levels of sensitivity and specificity. The standard curves for commercial standards 1-palmitoyl-2-glutaroyl-sn-glycero-3-phosphatidylcholine (PGPC); 1-palmitoyl-2-(9'-oxo-nonanoyl)-sn-glycero-3-phosphatidylcholine (PONPC), 1-palmitoyl-2-azelaoyl-sn-glycero-3-phosphatidylcholine (PAzPC) and 1-palmitoyl-2-(5'-oxo-valeroyl)-sn-glycero-3-phosphatidylcholine (POVPC), were linear with a correlation coefficient greater than 0.99 for all analytes. The method is reproducible, with intra- and inter-day precision <15%, and accuracy within ±5% of nominal values for all analytes. This method has been successfully applied to investigate oxidised phosphatidylcholine in plasma from CKD patients with and without chronic periodontitis and the data that was obtained has been compared to plasma from healthy controls. Comparative analysis demonstrates altered chain fragmented phosphatidylcholine profiles in the plasma samples of patients with CKD and periodontitis as a co-morbidity compared to healthy controls.
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Affiliation(s)
| | - Praveen Sharma
- Periodontal Research Group, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, England, UK
| | - Paul Cockwell
- Renal Medicine, University Hospital Birmingham Foundation Trust, Birmingham, England, UK
| | - Ana Reis
- LAQV/REQUIMTE, Department of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, 4169-007, Porto, Portugal
| | - Iain L Chapple
- Periodontal Research Group, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, England, UK
| | - Helen R Griffiths
- Faculty of Health and Medical Sciences, University of Surrey, Priestley Road, Guildford, GU2 7YH, UK; Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, B4 7ET, UK
| | - Irundika H K Dias
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, B4 7ET, UK.
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Liu H, Li Y, Lin N, Dong X, Li W, Deng Y, Ma L. Interleukin-1β Promotes Ox-LDL Uptake by Human Glomerular Mesangial Cells via LOX-1. Int J Med Sci 2020; 17:1056-1061. [PMID: 32410835 PMCID: PMC7211151 DOI: 10.7150/ijms.43981] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/30/2020] [Indexed: 01/26/2023] Open
Abstract
The aim of this study was to determine whether interleukin-1β (IL-1β) promotes oxidised low-density lipoprotein (Ox-LDL) uptake by human glomerular mesangial cells (HMCs) and its effect on the expression of lectin-like Ox-LDL receptor 1 (LOX-1) and to identify pathways through which IL-1β affects lipid uptake. Confocal laser scanning microscopy and flow cytometry were used to observe the effect of IL-1β on lipid uptake by HMCs and the pathway by which IL-1β may mediate lipid uptake. Real-time polymerase chain reaction (PCR) and western blotting were used to evaluate the effect of IL-1β on LOX-1 expression. Confocal laser scanning microscopy and flow cytometry revealed that IL-1β promoted uptake of fluorescent Dil-labelled Ox-LDL(Dil-Ox-LDL) by HMCs and the enhanced uptake of Dil-Ox-LDL was partially inhibited by an anti-LOX-1 antibody evaluated by flow cytometry. Further, IL-1β promoted LOX-1 mRNA and protein expression of HMCs in a dose- and time-dependent manner. Thus, Ox-LDL is ingested by HMCs under basic conditions. Inflammatory cytokine IL-1β promotes Ox-LDL uptake by HMCs. Furthermore, IL-1β promotes the mRNA and protein expression of LOX-1, a specific receptor of Ox-LDL, suggesting that the enhancement of Ox-LDL uptake may be mediated by LOX-1 pathway. Anti-LOX-1 therapy may be a promising option for treatment of glomerulosclerosis.
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Affiliation(s)
- Hua Liu
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Yinping Li
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Na Lin
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xingtong Dong
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Wen Li
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Yinghui Deng
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Soohoo M, Moradi H, Obi Y, Kovesdy CP, Kalantar-Zadeh K, Streja E. Serum triglycerides and mortality risk across stages of chronic kidney disease in 2 million U.S. veterans. J Clin Lipidol 2019; 13:744-753.e15. [DOI: 10.1016/j.jacl.2019.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/01/2019] [Accepted: 08/04/2019] [Indexed: 11/24/2022]
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Valdivielso JM, Rodríguez-Puyol D, Pascual J, Barrios C, Bermúdez-López M, Sánchez-Niño MD, Pérez-Fernández M, Ortiz A. Atherosclerosis in Chronic Kidney Disease: More, Less, or Just Different? Arterioscler Thromb Vasc Biol 2019; 39:1938-1966. [PMID: 31412740 DOI: 10.1161/atvbaha.119.312705] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Patients with chronic kidney disease (CKD) are at an increased risk of premature mortality, mainly from cardiovascular causes. The association between CKD on hemodialysis and accelerated atherosclerosis was described >40 years ago. However, more recently, it has been suggested that the increase in atherosclerosis risk is actually observed in early CKD stages, remaining stable thereafter. In this regard, interventions targeting the pathogenesis of atherosclerosis, such as statins, successful in the general population, have failed to benefit patients with very advanced CKD. This raises the issue of the relative contribution of atherosclerosis versus other forms of cardiovascular injury such as arteriosclerosis or myocardial injury to the increased cardiovascular risk in CKD. In this review, the pathophysiogical contributors to atherosclerosis in CKD that are shared with the general population, or specific to CKD, are discussed. The NEFRONA study (Observatorio Nacional de Atherosclerosis en NEFrologia) prospectively assessed the prevalence and progression of subclinical atherosclerosis (plaque in vascular ultrasound), confirming an increased prevalence of atherosclerosis in patients with moderate CKD. However, the adjusted odds ratio for subclinical atherosclerosis increased with CKD stage, suggesting a contribution of CKD itself to subclinical atherosclerosis. Progression of atherosclerosis was closely related to CKD progression as well as to the baseline presence of atheroma plaque, and to higher phosphate, uric acid, and ferritin and lower 25(OH) vitamin D levels. These insights may help design future clinical trials of stratified personalized medicine targeting atherosclerosis in patients with CKD. Future primary prevention trials should enroll patients with evidence of subclinical atherosclerosis and should provide a comprehensive control of all known risk factors in addition to testing any additional intervention or placebo.
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Affiliation(s)
- José M Valdivielso
- From the Vascular & Renal Translational Research Group and UDETMA, IRBLleida. Spanish Research Network for Renal Diseases (RedInRen. ISCIII), Lleida, Spain (J.M.V., M.B.-L.)
| | - Diego Rodríguez-Puyol
- Nephrology Unit, Fundación para la investigación del Hospital Universitario Príncipe de Asturias, RedInRen, Alcalá de Henares, Madrid, Spain (D.R.-P.)
| | - Julio Pascual
- Department of Nephrology, Institute Mar for Medical Research, Hospital del Mar, RedInRen, Barcelona, Spain (J.P., C.B.)
| | - Clara Barrios
- Department of Nephrology, Institute Mar for Medical Research, Hospital del Mar, RedInRen, Barcelona, Spain (J.P., C.B.)
| | - Marcelino Bermúdez-López
- From the Vascular & Renal Translational Research Group and UDETMA, IRBLleida. Spanish Research Network for Renal Diseases (RedInRen. ISCIII), Lleida, Spain (J.M.V., M.B.-L.)
| | - Maria Dolores Sánchez-Niño
- IIS-Fundacion Jimenez Diaz, School of Medicine, University Autonoma of Madrid, FRIAT and RedInRen, Madrid, Spain (M.D.S.-N., A.O.)
| | | | - Alberto Ortiz
- IIS-Fundacion Jimenez Diaz, School of Medicine, University Autonoma of Madrid, FRIAT and RedInRen, Madrid, Spain (M.D.S.-N., A.O.)
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Fenofibrate attenuates cardiac and renal alterations in young salt-loaded spontaneously hypertensive stroke-prone rats through mitochondrial protection. J Hypertens 2019; 36:1129-1146. [PMID: 29278547 DOI: 10.1097/hjh.0000000000001651] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The simultaneous presence of cardiac and renal diseases is a pathological condition that leads to increased morbidity and mortality. Several lines of evidence have suggested that lipid dysmetabolism and mitochondrial dysfunction are pathways involved in the pathological processes affecting the heart and kidney. In the salt-loaded spontaneously hypertensive stroke-prone rat (SHRSP), a model of cardiac hypertrophy and nephropathy that shows mitochondrial alterations in the myocardium, we evaluated the cardiorenal effects of fenofibrate, a peroxisome proliferator-activated receptor alpha (PPARα) agonist that acts by modulating mitochondrial and peroxisomal fatty acid oxidation. METHODS Male SHRSPs aged 6-7 weeks were divided in three groups: standard diet (n = 6), Japanese diet with vehicle (n = 6), and Japanese diet with fenofibrate 150 mg/kg/day (n = 6) for 5 weeks. Cardiac and renal functions were assessed in vivo by MRI, ultrasonography, and biochemical assays. Mitochondria were investigated by transmission electron microscopy, succinate dehydrogenase (SDH) activity, and gene expression analysis. RESULTS Fenofibrate attenuated cardiac hypertrophy, as evidenced by histological and MRI analyses, and protected the kidneys, preventing morphological alterations, changes in arterial blood flow velocity, and increases in 24-h proteinuria. Cardiorenal inflammation, oxidative stress, and cellular senescence were also inhibited by fenofibrate. In salt-loaded SHRSPs, we observed severe morphological mitochondrial alterations, reduced SDH activity, and down-regulation of genes regulating mitochondrial fatty-acid oxidation (i.e. PPARα, SIRT3, and Acadm). These changes were counteracted by fenofibrate. In vitro, a direct protective effect of fenofibrate on mitochondrial membrane potential was observed in albumin-stimulated NRK-52E renal tubular epithelial cells. CONCLUSION The results suggest that the cardiorenal protective effects of fenofibrate in young male salt-loaded SHRSPs are explained by its capacity to preserve mitochondrial function.
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Bajaj A, Xie D, Cedillo-Couvert E, Charleston J, Chen J, Deo R, Feldman HI, Go AS, He J, Horwitz E, Kallem R, Rahman M, Weir MR, Anderson AH, Rader DJ. Lipids, Apolipoproteins, and Risk of Atherosclerotic Cardiovascular Disease in Persons With CKD. Am J Kidney Dis 2019; 73:827-836. [PMID: 30686529 PMCID: PMC6615056 DOI: 10.1053/j.ajkd.2018.11.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 11/26/2018] [Indexed: 01/06/2023]
Abstract
RATIONALE & OBJECTIVE A large residual risk for atherosclerotic cardiovascular disease (ASCVD) remains in the setting of chronic kidney disease (CKD) despite treatment with statins. We sought to evaluate the associations of lipid and apolipoprotein levels with risk for ASCVD in individuals with CKD. STUDY DESIGN Prospective cohort study. SETTINGS & PARTICIPANTS Adults aged 21 to 74 years with non-dialysis-dependent CKD at baseline enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study in 7 clinical study centers in the United States. PREDICTOR Baseline total cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), very low-density lipoprotein cholesterol (VLDL-C), triglycerides, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo-B), HDL-C, and apolipoprotein AI (Apo-AI) values stratified into tertiles. OUTCOME A composite ASCVD event of myocardial infarction or ischemic stroke. ANALYTIC APPROACH Multivariable Cox proportional hazards regression to estimate the risk for ASCVD for each tertile of lipoprotein predictor. RESULTS Among 3,811 CRIC participants (mean age, 57.7 years; 41.8% white), there were 451 ASCVD events during a median follow-up of 7.9 years. There was increased ASCVD risk among participants with VLDL-C levels in the highest tertile (HR, 1.28; 95% CI, 1.01-1.64), Apo-B levels in the middle tertile (HR, 1.30; 95% CI, 1.03-1.64), HDL-C levels in the middle and lowest tertiles (HRs of 1.40 [95% CI, 1.08-1.83] and 1.77 [95% CI, 1.35-2.33], respectively), and Apo-AI levels in the middle and lowest tertiles (HRs of 1.77 [95% CI, 1.02-1.74] and 1.77 [95% CI, 1.36-2.32], respectively). LDL-C level was not significantly associated with the ASCVD outcome in this population (HR, 1.00 [95% CI, 0.77-1.30] for the highest tertile). LIMITATIONS Associations based on observational data do not permit inferences about causal associations. CONCLUSIONS Higher VLDL-C and Apo-B levels, as well as lower HDL-C and Apo-AI levels, are associated with increased risk for ASCVD. These findings support future investigations into pharmacologic targeting of lipoproteins beyond LDL-C, such as triglyceride-rich lipoproteins, to reduce residual risk for ASCVD among individuals with CKD.
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Affiliation(s)
- Archna Bajaj
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
| | - Dawei Xie
- Department of Biostatistics and Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Esteban Cedillo-Couvert
- Division of Nephrology, Department of Medicine, University of Illinois College of Medicine at Chicago, Chicago, IL
| | - Jeanne Charleston
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jing Chen
- Division of Nephrology and Hypertension, Department of Medicine, Tulane University School of Medicine, New Orleans, LA
| | - Rajat Deo
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Harold I Feldman
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Biostatistics and Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Alan S Go
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Edward Horwitz
- Division of Nephrology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
| | - Radhakrishna Kallem
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Mahboob Rahman
- Division of Nephrology and Hypertension, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, OH
| | - Matthew R Weir
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Amanda H Anderson
- Department of Biostatistics and Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Daniel J Rader
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; The Penn Cardiovascular Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Institute for Translational Medicine and Therapeutics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Takahashi G, Honda H, Takahashi K, Ikeda M, Hosaka N, Ogata H, Koiwa F, Shishido K, Shibata T. Truncal Adiposity Influences High-Density Lipoprotein Cholesterol Levels and Cardiovascular Events in Hemodialysis Patients. J Ren Nutr 2018; 29:235-242. [PMID: 30322786 DOI: 10.1053/j.jrn.2018.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/16/2018] [Accepted: 08/21/2018] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Adiposity influences lipid metabolism and atherosclerotic cardiovascular disease (CVD) in the general population. The aim of the present study was to assess the association between fat mass (FM) and lipid metabolism and CVD events among patients on hemodialysis (HD). METHODS This prospective observational study examined 240 patients on prevalent HD. Blood samples were obtained before dialysis at baseline to measure lipids, high-sensitivity C-reactive protein (hs-CRP), interleukin-6, and adiponectin. Lipids and hs-CRP were measured every 3 months for 12 months. FM was estimated by dual energy x-ray absorptiometric scan at baseline and 12 months later. Patients were then prospectively followed up for 36 months after the 1-year measurement period, and composite CVD events were estimated. RESULTS Truncal FM was positively correlated with body mass index, hs-CRP, interleukin-6, total cholesterol, low-density lipoprotein-C, triglyceride, and negatively correlated with high-density lipoprotein (HDL)-C and adiponectin at baseline. HDL-C levels were repeatedly decreased, and triglyceride and non-HDL-C were serially increased in the patient group with truncal FM > 7,000 g at both baseline and 12 months (large truncal FM group) compared with the other groups. Cox proportional hazards models adjusted for confounders showed composite CVD events occurred significantly in patients with large truncal FM and continuous low HDL-C levels. CONCLUSIONS Truncal adiposity influences lipid metabolism in patients on HD, and the prevalence of CVD events may be increased in those patients with high fat and lipid abnormalities, especially continuously low HDL-C levels.
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Affiliation(s)
- Go Takahashi
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Hirokazu Honda
- Division of Nephrology, Department of Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan.
| | | | - Misa Ikeda
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Nozomu Hosaka
- Division of Nephrology, Department of Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Hiroaki Ogata
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Fumihiko Koiwa
- Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Kanji Shishido
- Department of Dialysis, Kawasaki Clinic, Kawasaki, Japan
| | - Takanori Shibata
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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Kozak A, Formanowicz D, Formanowicz P. Structural analysis of a Petri net model of oxidative stress in atherosclerosis. IET Syst Biol 2018; 12:108-117. [PMID: 29745904 PMCID: PMC8687318 DOI: 10.1049/iet-syb.2017.0015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 12/23/2017] [Accepted: 01/14/2018] [Indexed: 11/22/2023] Open
Abstract
Atherosclerosis is a complex process of gathering sub-endothelial plaques decreasing lumen of the blood vessels. This disorder affects people of all ages, but its progression is asymptomatic for many years. It is regulated by many typical and atypical factors including the immune system response, a chronic kidney disease, a diet rich in lipids, a local inflammatory process and a local oxidative stress that is here one of the key factors. In this study, a Petri net model of atherosclerosis regulation is presented. This model includes also some information about stoichiometric relationships between its components and covers all mentioned factors. For the model, a structural analysis based on invariants was made and biological conclusions are presented. Since the model contains inhibitor arcs, a heuristic method for analysis of such cases is presented. This method can be used to extend the concept of feasible t-invariants.
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Affiliation(s)
- Adam Kozak
- Institute of Computing Science, Poznan University of Technology, Poznań, Poland
| | - Dorota Formanowicz
- Department of Clinical Biochemistry and Laboratory Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Piotr Formanowicz
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Poznań, Poland.
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Ruderman I, Holt SG, Hewitson TD, Smith ER, Toussaint ND. Current and potential therapeutic strategies for the management of vascular calcification in patients with chronic kidney disease including those on dialysis. Semin Dial 2018; 31:487-499. [PMID: 29733462 DOI: 10.1111/sdi.12710] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Patients with CKD have accelerated vascular stiffening contributing significantly to excess cardiovascular morbidity and mortality. Much of the arterial stiffening is thought to involve vascular calcification (VC), but the pathogenesis of this phenomenon is complex, resulting from a disruption of the balance between promoters and inhibitors of calcification in a uremic milieu, along with derangements in calcium and phosphate metabolic pathways. Management of traditional cardiovascular risk factors to reduce VC may be influential but has not been shown to significantly improve mortality. Control of mineral metabolism may potentially reduce the burden of VC, although using conventional approaches of restricting dietary phosphate, administering phosphate binders, and use of active vitamin D and calcimimetics, remains controversial because recommended biochemical targets are hard to achieve and clinical relevance hard to define. Increasing time on dialysis is perhaps another therapy with potential effectiveness in this area. Despite current treatments, cardiovascular morbidity and mortality remain high in this group. Novel therapies for addressing VC include magnesium and vitamin K supplementation, which are currently being investigated in large randomized control trials. Other therapeutic targets include crystallization inhibitors, ligand trap for activin receptors and BMP-7. This review summarizes current treatment strategies and therapeutic targets for the future management of VC in patients with CKD.
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Affiliation(s)
- Irene Ruderman
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Vic., Australia.,Department of Medicine (RMH), The University of Melbourne, Melbourne, Vic., Australia
| | - Stephen G Holt
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Vic., Australia.,Department of Medicine (RMH), The University of Melbourne, Melbourne, Vic., Australia
| | - Tim D Hewitson
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Vic., Australia.,Department of Medicine (RMH), The University of Melbourne, Melbourne, Vic., Australia
| | - Edward R Smith
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Vic., Australia.,Department of Medicine (RMH), The University of Melbourne, Melbourne, Vic., Australia
| | - Nigel D Toussaint
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Vic., Australia.,Department of Medicine (RMH), The University of Melbourne, Melbourne, Vic., Australia
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Sun J, Chen X, Liu T, Jiang X, Wu Y, Yang S, Hua W, Li Z, Huang H, Ruan X, Du X. Berberine Protects Against Palmitate-Induced Apoptosis in Tubular Epithelial Cells by Promoting Fatty Acid Oxidation. Med Sci Monit 2018. [PMID: 29528039 PMCID: PMC5859669 DOI: 10.12659/msm.908927] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Increased lipid accumulation in renal tubular epithelial cells (TECs) contributes to their injury and dysfunction and progression of tubulointerstitial fibrosis. Berberine (BBR), a natural plant alkaloid isolated from traditional medicine herbs, is effective in lowing serum lipid, and has a protective effect on chronic kidney disease (CKD) with dyslipidemia, including diabetic nephropathy. The aim of this study was to investigate the effect of BBR on palmitate (PA)-induced lipid accumulation and apoptosis in TECs. MATERIAL AND METHODS Human kidney proximal tubular epithelial cell line (HK-2) cells were treated with PA, BBR, and/or palmitoyltransferase 1A (CPT1A) inhibitor Etomoxir. Intracellular lipid content was assessed by Oil Red O and Nile Red staining. Cell apoptosis rate was evaluated by flow cytometry assay. The expression of apoptosis-related protein cleaved-caspase3 and fatty acid oxidation (FAO)-regulating proteins, including CPT1A, peroxisome proliferator-activated receptor α (PPARα), and PPARγ co-activator-1α (PGC1α), was measured by Western blot analysis and immunofluorescence. RESULTS In the present study, PA treatment increased intracellular lipid deposition accompanied by elevated apoptosis in TECs compared with control group, whereas the protein expression of CPT1A, PPARα, and PGC1α, did not correspondingly increase in TECs. BBR significantly up-regulated the protein expression of CPT1A, PPARα, and PGC1α in TECs treated with or without PA, and reversed PA-induced intracellular lipid accumulation and apoptosis. Moreover, the CPT1A inhibitor Etomoxir counteracted the protective effect of BBR in TECs. CONCLUSIONS These in vitro findings suggest that PA can induce intracellular lipid accumulation and apoptosis in TECs, and the mechanism may be associated with inducing defective FAO, whereas BBR can protect TECs against PA-induced intracellular lipid accumulation and apoptosis by promoting FAO.
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Affiliation(s)
- Jiye Sun
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Xuemei Chen
- Department of Emergency, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Ting Liu
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Xushun Jiang
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Yue Wu
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Shan Yang
- Department of Emergency, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Wei Hua
- Department of Nephrology, Occupational Disease Prevention and Control Hospital of Chongqing, Chongqing, China (mainland)
| | - Zhengdong Li
- Department of Nephrology, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, China (mainland)
| | - Huizhe Huang
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Xiongzhong Ruan
- Centre for Nephrology, Royal Free and University College Medical School, University College London, Royal Free Campus, London, United Kingdom.,Centre for Lipid Research, Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, China (mainland)
| | - Xiaogang Du
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).,The Chongqing Key Laboratory of Translational Medicine in Major Metabolic Diseases, Chongqing, China (mainland)
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Deng Y, Lin N, Wu L, Jia Q, Liu H. Expression of LOX-1 in human mesangial cells is increased by Ox-LDL and IL-1β treatment. Exp Ther Med 2017; 14:3632-3636. [PMID: 29042958 PMCID: PMC5639305 DOI: 10.3892/etm.2017.4950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 03/31/2017] [Indexed: 12/20/2022] Open
Abstract
The present study aimed to determine whether the expression of lectin-like oxidized LDL receptor 1 (LOX-1) could be induced by oxidized low-density lipoprotein (Ox-LDL) and interleukin 1β (IL-1β) in human mesangial cells (HMCs). Oil Red O staining was used to observe the uptake of Ox-LDL by HMCs stimulated with IL-1β, and reverse transcription-quantitative polymerase chain reaction analysis and western blotting were used to examine the expression of LOX-1 in HMC following Ox-LDL and IL-1β treatment. Uptake of Ox-LDL by HMCs was upregulated upon stimulation with IL-1β. Furthermore, Ox-LDL (10–40 µg/ml) treatment induced LOX-1 mRNA and protein expression in a dose-dependent manner. In addition, when HMCs were treated with IL-1β and Ox-LDL, the expression of LOX-1 was enhanced further. These results indicated that inhibiting LOX-1 expression or inhibiting the Ox-LDL/LOX-1 signaling axis may be a potential novel method for treating renal disease.
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Affiliation(s)
- Yinghui Deng
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P.R. China
| | - Na Lin
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P.R. China
| | - Leiyun Wu
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P.R. China
| | - Qaing Jia
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P.R. China
| | - Hua Liu
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P.R. China
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Lu K, Liang CL, Li PC, Liliang PC, Huang CY, Lee YC, Wang KW, Yang SN, Sun YT, Wang HK. Risk factors for myocardial dysfunction after traumatic brain injury: A one-year follow-up study. Injury 2017; 48:1794-1800. [PMID: 28701282 DOI: 10.1016/j.injury.2017.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/16/2017] [Accepted: 07/03/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Traumatic brain injury has been associated with an increased risk of myocardial dysfunction. Common abnormalities accompanying this pathology include electrocardiographic abnormalities, elevated creatine kinase levels, arrhythmias, and pathologic changes of the myocardium. The aim of this study was to determine if TBI patients have a higher risk of myocardial dysfunction than the general population and to identify the risk factors of myocardial dysfunction in TBI patients. PATIENTS AND METHODS The study sample was drawn from Taiwan's National Health Insurance Research Database of reimbursement claims, and comprised 26,860 patients who visited ambulatory care centers or were hospitalized with a diagnosis of TBI. The comparison group consisted of 134,300 randomly selected individuals. The stratified Fine and Gray regression was performed to evaluate independent risk factors for myocardial dysfunction in all patients and to identify risk factors in TBI patients. RESULTS During a 1-year follow-up period, 664 patients with TBI and 1494 controls developed myocardial dysfunction. TBI was independently associated with increased risk of myocardial dysfunction. Diabetes, hypertension, peptic ulcer disease, chronic liver disease and chronic renal disease were risk factors of myocardial dysfunction in TBI patients. CONCLUSIONS Individuals with TBI are at greater risk of developing myocardial dysfunction after adjustments for possible confounding factors. Early monitor should be initiated to decrease disability and dependence in patients with TBI.
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Affiliation(s)
- Kang Lu
- Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - Cheng-Loong Liang
- Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - Ping-Chia Li
- School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - Po-Chou Liliang
- Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Yuan Huang
- Neurosurgical Service, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yi-Che Lee
- Department of Nephrology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Kuo-Wei Wang
- Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - San-Nan Yang
- School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - Yuan-Ting Sun
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hao-Kuang Wang
- Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan.
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Honda H, Hirano T, Ueda M, Kojima S, Mashiba S, Hayase Y, Michihata T, Shishido K, Takahashi K, Hosaka N, Ikeda M, Sanada D, Shibata T. Associations among apolipoproteins, oxidized high-density lipoprotein and cardiovascular events in patients on hemodialysis. PLoS One 2017; 12:e0177980. [PMID: 28542510 PMCID: PMC5436869 DOI: 10.1371/journal.pone.0177980] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 05/05/2017] [Indexed: 11/18/2022] Open
Abstract
Apolipoproteins are associated with survival among patients on hemodialysis (HD), but these associations might be influenced by dysfunctional (oxidized) high-density lipoprotein (HDL). We assessed associations among apolipoproteins and oxidized HDL, mortality and cardiovascular disease (CVD) events in patients on HD. This prospective observational study examined 412 patients on prevalent HD. Blood samples were obtained before dialysis at baseline to measure lipids, apolipoproteins, oxidized LDL, oxidized HDL, high-sensitivity C-reactive protein (hs-CRP) and interleukin (IL)-6 at baseline, and HDL-C and hs-CRP were measured 12 months later. Patients were then prospectively followed-up (mean, 40 months) and all-cause mortality and composite CVD events were analyzed. Associations between variables at baseline and clinical outcome were assessed by Cox proportional hazards modeling (n = 412) and Cox hazards modeling with a time-varying covariate with HDL-C and hs-CRP (n = 369). Quartiles of apolipoproteins and oxidized HDL were not associated with all-cause mortality. However, Cox proportional hazards models with quartiles of each variable adjusted for confounders and hs-CRP or IL-6 identified apolipoprotein (apo)B-to-apoA-I ratio (apoB/apoA-I) and oxidized HDL, but not apoA-I or apoA-II, as independent risk factors for composite CVD events. These associations were confirmed by Cox proportional hazards modeling with time-varying covariates for hs-CRP. ApoB/apoA-I was independently associated with composite CVD events in 1-standard deviation (SD) increase-of-variables models adjusted for the confounders, oxidized HDL and hs-CRP. However, these associations disappeared from the model adjusted with IL-6 instead of hs-CRP, and oxidized HDL and IL-6 were independently associated with composite CVD events. Findings resembled those from Cox proportional hazards modeling using time-varying covariates with HDL-C adjusted with IL-6. In conclusion, both oxidized HDL and apoB/apoA-I might be associated with CVD events in patients on prevalent HD, while associations of apoB/apoA-I with CVD events differed between models of apoB/apoA-I quartiles and 1-SD increases, and were influenced by IL-6.
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Affiliation(s)
- Hirokazu Honda
- Division of Nephrology, Department of Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- * E-mail:
| | - Tsutomu Hirano
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | | | | | | | | | | | - Kanji Shishido
- Department of Dialysis, Kawasaki Clinic, Kawasaki, Japan
| | - Keiko Takahashi
- Division of Dialysis, Kitami Higashiyama Clinic, Tokyo, Japan
| | - Nozomu Hosaka
- Division of Nephrology, Department of Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Misa Ikeda
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Daisuke Sanada
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takanori Shibata
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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Vikulova OK, Zheleznyakova AV, Lebedeva NO, Nikitin AG, Nosikov VV, Shestakova MV. Genetic factors in the development of chronic kidney disease in patients with diabetes mellitus. RUSS J GENET+ 2017. [DOI: 10.1134/s1022795417030140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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38
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Christoffersen C, Bartels ED, Aarup A, Nielsen LB, Pedersen TX. ApoB and apoM - New aspects of lipoprotein biology in uremia-induced atherosclerosis. Eur J Pharmacol 2017; 816:154-160. [PMID: 28351665 DOI: 10.1016/j.ejphar.2017.03.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/09/2017] [Accepted: 03/23/2017] [Indexed: 12/27/2022]
Abstract
Chronic kidney disease affects as much as 13% of the population, and is associated with a markedly increased risk of developing cardiovascular disease. One of the underlying reasons is accelerated development of atherosclerosis. This can be ascribed both to increased occurrence of traditional cardiovascular risk factors, and to risk factors that may be unique to patients with chronic kidney disease. The latter is reflected in the observation that the current treatment modalities, mainly directed against traditional risk factors, are insufficient to prevent cardiovascular disease in the patient with chronic kidney disease. This review discusses mechanisms accelerating uremic atherosclerosis with a specific focus on the putative roles of apolipoprotein(apo)s B and M that may be particularly important in patients with chronic kidney disease.
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Affiliation(s)
- Christina Christoffersen
- Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Oe, Denmark; Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Emil D Bartels
- Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Oe, Denmark.
| | - Annemarie Aarup
- Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Lars B Nielsen
- Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Oe, Denmark; Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Tanja X Pedersen
- Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
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Lent EM, Crouse LC, Eck WS. Acute and subacute oral toxicity of periodate salts in rats. Regul Toxicol Pharmacol 2017; 83:23-37. [DOI: 10.1016/j.yrtph.2016.11.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 11/07/2016] [Accepted: 11/08/2016] [Indexed: 01/09/2023]
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Florens N, Calzada C, Lyasko E, Juillard L, Soulage CO. Modified Lipids and Lipoproteins in Chronic Kidney Disease: A New Class of Uremic Toxins. Toxins (Basel) 2016; 8:E376. [PMID: 27999257 PMCID: PMC5198570 DOI: 10.3390/toxins8120376] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 02/07/2023] Open
Abstract
Chronic kidney disease (CKD) is associated with an enhanced oxidative stress and deep modifications in lipid and lipoprotein metabolism. First, many oxidized lipids accumulate in CKD and were shown to exert toxic effects on cells and tissues. These lipids are known to interfere with many cell functions and to be pro-apoptotic and pro-inflammatory, especially in the cardiovascular system. Some, like F2-isoprostanes, are directly correlated with CKD progression. Their accumulation, added to their noxious effects, rendered their nomination as uremic toxins credible. Similarly, lipoproteins are deeply altered by CKD modifications, either in their metabolism or composition. These impairments lead to impaired effects of HDL on their normal effectors and may strongly participate in accelerated atherosclerosis and failure of statins in end-stage renal disease patients. This review describes the impact of oxidized lipids and other modifications in the natural history of CKD and its complications. Moreover, this review focuses on the modifications of lipoproteins and their impact on the emergence of cardiovascular diseases in CKD as well as the appropriateness of considering them as actual mediators of uremic toxicity.
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Affiliation(s)
- Nans Florens
- CarMeN, INSERM U1060, INRA U1397, INSA de Lyon, Université Claude Bernard Lyon 1, University of Lyon, F-69621 Villeurbanne, France.
- Hospices Civils de Lyon, Department of Nephrology, Hôpital E. Herriot, F-69003 Lyon, France.
| | - Catherine Calzada
- CarMeN, INSERM U1060, INRA U1397, INSA de Lyon, Université Claude Bernard Lyon 1, University of Lyon, F-69621 Villeurbanne, France.
| | - Egor Lyasko
- CarMeN, INSERM U1060, INRA U1397, INSA de Lyon, Université Claude Bernard Lyon 1, University of Lyon, F-69621 Villeurbanne, France.
| | - Laurent Juillard
- CarMeN, INSERM U1060, INRA U1397, INSA de Lyon, Université Claude Bernard Lyon 1, University of Lyon, F-69621 Villeurbanne, France.
- Hospices Civils de Lyon, Department of Nephrology, Hôpital E. Herriot, F-69003 Lyon, France.
| | - Christophe O Soulage
- CarMeN, INSERM U1060, INRA U1397, INSA de Lyon, Université Claude Bernard Lyon 1, University of Lyon, F-69621 Villeurbanne, France.
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Agrawal N, Freitas Corradi P, Gumaste N, Goldberg IJ. Triglyceride Treatment in the Age of Cholesterol Reduction. Prog Cardiovasc Dis 2016; 59:107-118. [PMID: 27544319 PMCID: PMC5364728 DOI: 10.1016/j.pcad.2016.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 08/15/2016] [Indexed: 01/28/2023]
Abstract
Cholesterol reduction has markedly reduced major cardiovascular disease (CVD) events and shown regression of atherosclerosis in some studies. However, CVD has for decades also been associated with increased levels of circulating triglyceride (TG)-rich lipoproteins. Whether this is due to a direct toxic effect of these lipoproteins on arteries or whether this is merely an association is unresolved. More recent genetic analyses have linked genes that modulate TG metabolism with CVD. Moreover, analyses of subgroups of hypertriglyceridemic (HTG) subjects in clinical trials using fibric acid drugs have been interpreted as evidence that TG reduction reduces CVD events. This review will focus on how HTG might cause CVD, whether TG reduction makes a difference, what pathophysiological defects cause HTG, and what options are available for treatment.
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Affiliation(s)
- Nidhi Agrawal
- Division of Endocrinology, Diabetes and Metabolism, New York University School of Medicine, New York, NY
| | - Patricia Freitas Corradi
- Division of Endocrinology, Diabetes and Metabolism, New York University School of Medicine, New York, NY
| | - Namrata Gumaste
- Division of Endocrinology, Diabetes and Metabolism, New York University School of Medicine, New York, NY
| | - Ira J Goldberg
- Division of Endocrinology, Diabetes and Metabolism, New York University School of Medicine, New York, NY.
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Chen YH, Lin WW, Liu CS, Hsu LS, Lin YM, Su SL. Caveolin-1 Expression Ameliorates Nephrotic Damage in a Rabbit Model of Cholesterol-Induced Hypercholesterolemia. PLoS One 2016; 11:e0154210. [PMID: 27124120 PMCID: PMC4849769 DOI: 10.1371/journal.pone.0154210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 04/10/2016] [Indexed: 01/14/2023] Open
Abstract
Caveolin-1 (CAV-1) participates in regulating vesicular transport, signal transduction, tumor progression, and cholesterol homeostasis. In the present study, we tested the hypothesis that CAV-1 improves dyslipidemia, inhibits cyclophilin A (CypA)- mediated ROS production, prevents mitochondrial compensatory action and attenuates oxidative stress responses in cholesterol-induced hypercholesterolemia. To determine the role of CAV-1 in mediating oxidative and antioxidative as well as cholesterol homeostasis, hypercholesterolemic rabbits were intravenously administered antenapedia-CAV-1 (AP-CAV-1) peptide for 2 wk. AP-CAV-1 enhanced CAV-1 expression by ˃15%, inhibited CypA expression by ˃50% (P < 0.05) and significantly improved dyslipidemia, thus reducing neutral lipid peroxidation. Moreover, CAV-1 attenuated hypercholesterolemia-induced changes in mitochondrial morphology and biogenesis and preserved mitochondrial respiratory function. In addition, CAV-1 protected against hypercholesterol-induced oxidative stress responses by reducing the degree of oxidative damage and enhancing the expression of antioxidant enzymes. CAV-1 treatment significantly suppressed apoptotic cell death, as evidenced by the reduction in the number of terminal deoxynucleotidyl transferase dUTP nick end-labeling-positive cells. We concluded that CAV-1 plays a critical role in inhibiting CypA-mediated ROS production, improving dyslipidemia, maintaining mitochondrial function, and suppressing oxidative stress responses that are vital for cell survival in hypercholesterol-affected renal organs.
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Affiliation(s)
- Ya-Hui Chen
- Vascular and Genomic Center, Changhua Christian Hospital, Changhua, Taiwan
- Institute of Biochemistry and Biotechnology, Chung Shan Medical University, Taichung, Taiwan
| | - Wei-Wen Lin
- Department of Internal Medicine, Division of Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chin-San Liu
- Vascular and Genomic Center, Changhua Christian Hospital, Changhua, Taiwan
- Graduate Institute of Integrative Medicine, China Medical University, Taichung, Taiwan
| | - Li-Sung Hsu
- Institute of Biochemistry and Biotechnology, Chung Shan Medical University, Taichung, Taiwan
| | - Yueh-Min Lin
- Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan
- Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Shih-Li Su
- Vascular and Genomic Center, Changhua Christian Hospital, Changhua, Taiwan
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Changhua Christian Hospital, Changhua, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- * E-mail:
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Kisic B, Miric D, Dragojevic I, Rasic J, Popovic L. Role of Myeloperoxidase in Patients with Chronic Kidney Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:1069743. [PMID: 27127544 PMCID: PMC4834151 DOI: 10.1155/2016/1069743] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 03/14/2016] [Indexed: 01/26/2023]
Abstract
Chronic kidney disease (CKD) is a worldwide public health problem. Patients with CKD have a number of disorders in the organism, and the presence of oxidative stress and systemic inflammation in these patients is the subject of numerous studies. Chronic inflammation joined with oxidative stress contributes to the development of numerous complications: accelerated atherosclerosis process and cardiovascular disease, emergence of Type 2 diabetes mellitus, development of malnutrition, anaemia, hyperparathyroidism, and so forth, affecting the prognosis and quality of life of patients with CKD. In this review we presented the potential role of the myeloperoxidase enzyme in the production of reactive/chlorinating intermediates and their role in oxidative damage to biomolecules in the body of patients with chronic kidney disease and end-stage renal disease. In addition, we discussed the role of modified lipoprotein particles under the influence of prooxidant MPO intermediates in the development of endothelial changes and cardiovascular complications in renal failure.
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Affiliation(s)
- Bojana Kisic
- Institute of Biochemistry, Medical Faculty Pristina, Kosovska Mitrovica 38220, Serbia
| | - Dijana Miric
- Institute of Biochemistry, Medical Faculty Pristina, Kosovska Mitrovica 38220, Serbia
| | - Ilija Dragojevic
- Institute of Biochemistry, Medical Faculty Pristina, Kosovska Mitrovica 38220, Serbia
| | - Julijana Rasic
- Institute of Pharmacology, Medical Faculty Pristina, Kosovska Mitrovica 38220, Serbia
| | - Ljiljana Popovic
- Institute of Pathophysiology, Medical Faculty Pristina, Kosovska Mitrovica 38220, Serbia
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López-Olmos V, Carreón-Torres E, Luna-Luna M, Flores-Castillo C, Martínez-Ramírez M, Bautista-Pérez R, Franco M, Sandoval-Zárate J, Roldán FJ, Aranda-Fraustro A, Soria-Castro E, Muñoz-Vega M, Fragoso JM, Vargas-Alarcón G, Pérez-Méndez O. Increased HDL Size and Enhanced Apo A-I Catabolic Rates Are Associated With Doxorubicin-Induced Proteinuria in New Zealand White Rabbits. Lipids 2016; 51:311-20. [PMID: 26781765 DOI: 10.1007/s11745-016-4120-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 12/24/2015] [Indexed: 11/24/2022]
Abstract
The catabolism and structure of high-density lipoproteins (HDL) may be the determining factor of their atheroprotective properties. To better understand the role of the kidney in HDL catabolism, here we characterized HDL subclasses and the catabolic rates of apo A-I in a rabbit model of proteinuria. Proteinuria was induced by intravenous administration of doxorubicin in New Zealand white rabbits (n = 10). HDL size and HDL subclass lipids were assessed by electrophoresis of the isolated lipoproteins. The catabolic rate of HDL-apo A-I was evaluated by exogenous radiolabelling with iodine-131. Doxorubicin induced significant proteinuria after 4 weeks (4.47 ± 0.55 vs. 0.30 ± 0.02 g/L of protein in urine, P < 0.001) associated with increased uremia, creatininemia, and cardiotoxicity. Large HDL2b augmented significantly during proteinuria, whereas small HDL3b and HDL3c decreased compared to basal conditions. HDL2b, HDL2a, and HDL3a subclasses were enriched with triacylglycerols in proteinuric animals as determined by the triacylglycerol-to-phospholipid ratio; the cholesterol content in HDL subclasses remained unchanged. The fractional catabolic rate (FCR) of [(131)I]-apo A-I in the proteinuric rabbits was faster (FCR = 0.036 h(-1)) compared to control rabbits group (FCR = 0.026 h(-1), P < 0.05). Apo E increased and apo A-I decreased in HDL, whereas PON-1 activity increased in proteinuric rabbits. Proteinuria was associated with an increased number of large HDL2b particles and a decreased number of small HDL3b and 3c. Proteinuria was also connected to an alteration in HDL subclass lipids, apolipoprotein content of HDL, high paraoxonase-1 activity, and a rise in the fractional catabolic rate of the [(131)I]-apo A-I.
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Affiliation(s)
- Victoria López-Olmos
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico
| | - Elizabeth Carreón-Torres
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico.,Atherosclerosis Study Group, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico
| | - María Luna-Luna
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico
| | - Cristobal Flores-Castillo
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico
| | - Miriam Martínez-Ramírez
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico
| | - Rocío Bautista-Pérez
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico.,Atherosclerosis Study Group, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico
| | - Martha Franco
- Atherosclerosis Study Group, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico.,Nephrology Department, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico
| | - Julio Sandoval-Zárate
- Atherosclerosis Study Group, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico.,Cardiopulmonary Department, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico
| | - Francisco-Javier Roldán
- Outpatient Care Department, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico
| | - Alberto Aranda-Fraustro
- Pathology Department, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico
| | - Elizabeth Soria-Castro
- Pathology Department, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico
| | - Mónica Muñoz-Vega
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico
| | - José-Manuel Fragoso
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico.,Atherosclerosis Study Group, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico
| | - Gilberto Vargas-Alarcón
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico.,Atherosclerosis Study Group, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico
| | - Oscar Pérez-Méndez
- Molecular Biology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Section XVI, 14080, México D.F., Mexico. .,Atherosclerosis Study Group, Instituto Nacional de Cardiología "Ignacio Chávez", México D.F., Mexico.
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Hu ZB, Chen Y, Gong YX, Gao M, Zhang Y, Wang GH, Tang RN, Liu H, Liu BC, Ma KL. Activation of the CXCL16/CXCR6 Pathway by Inflammation Contributes to Atherosclerosis in Patients with End-stage Renal Disease. Int J Med Sci 2016; 13:858-867. [PMID: 27877078 PMCID: PMC5118757 DOI: 10.7150/ijms.16724] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/13/2016] [Indexed: 12/19/2022] Open
Abstract
Background: Chronic inflammation plays a critical role in the progression of atherosclerosis (AS). This study aimed to determine the effects of the CXC chemokine ligand 16 (CXCL16)/CXC chemokine receptor 6 (CXCR6) pathway on cholesterol accumulation in the radial arteries of end-stage renal disease (ESRD) patients with concomitant microinflammation and to further investigate the potential effects of the purinergic receptor P2X ligand-gated ion channel 7 (P2X7R). Methods: Forty-three ESRD patients were divided into the control group (n=17) and the inflamed group (n=26) based on plasma C-reactive protein (CRP) levels. Biochemical indexes and lipid profiles of the patients were determined. Surgically removed tissues from the radial arteries of patients receiving arteriovenostomy were used for preliminary evaluation of AS. Haematoxylin-eosin (HE) and Filipin staining were performed to assess foam cell formation. CXCL16/CXCR6 pathway-related protein expression, P2X7R protein expression and the expression of monocyte chemotactic protein-1 (MCP-1), tumour necrosis factor-α (TNF-α), and CD68 were detected by immunohistochemical and immunofluorescence staining. Results: Inflammation increased both MCP-1 and TNF-α expression and macrophage infiltration in radial arteries. Additionally, foam cell formation significantly increased in the radial arteries of the inflamed group compared to that of the controls. Further analysis showed that protein expression of CXCL16, CXCR6, disintegrin and metalloproteinase-10 (ADAM10) in the radial arteries of the inflamed group was significantly increased. Furthermore, CXCL16 expression was positively correlated with P2X7R expression in the radial arteries of ESRD patients. Conclusions: Inflammation contributed to foam cell formation in the radial arteries of ESRD patients via activation of the CXCL16/CXCR6 pathway, which may be regulated by P2X7R.
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Affiliation(s)
- Ze Bo Hu
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Yan Chen
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China;; Department of Nephrology, Taizhou First People's Hospital, Taizhou, 225300, China
| | - Yu Xiang Gong
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Min Gao
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Yang Zhang
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Gui Hua Wang
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Ri Ning Tang
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Hong Liu
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Bi Cheng Liu
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Kun Ling Ma
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
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Honda H, Hirano T, Ueda M, Kojima S, Mashiba S, Hayase Y, Michihata T, Shibata T. High-Density Lipoprotein Subfractions and Their Oxidized Subfraction Particles in Patients with Chronic Kidney Disease. J Atheroscler Thromb 2015; 23:81-94. [PMID: 26289085 DOI: 10.5551/jat.30015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Chronic kidney disease (CKD) may lead to reduced concentrations of high-density lipoprotein (HDL) and its subfractions (HDL2 and HDL3), and damage them via inflammation and oxidative stress. The present study aimed to determine the contribution of such changes to cardiovascular disease (CVD) in patients with CKD. METHODS The levels of total cholesterol, low-density lipoprotein cholesterol, HDL-C, HDL2, HDL3, apolipoproteins, malondialdehyde-modified LDL (MDA-LDL), oxidized (ox) HDL, oxHDL2, and oxHDL3 were measured in blood samples from patients with CKD (stages 2-5, n=86) who were not on dialysis and from patients undergoing hemodialysis (CKD stage 5D, n=25). The patients were followed up for 28±9 months after baseline examinations and CVD events were recorded. RESULT The levels of HDL3 and ApoA1 in HDL3 fraction decreased according to CKD severity, whereas those of HDL2 and ApoA1 in HDL2 fraction did not differ. The levels of oxHDL were similar across CKD stages. The levels of oxHDL3 and MDA-LDL were decreased, whereas those of oxHDL2 increased according to CKD severity. Multivariate analyses using the Cox proportional hazards model selected high levels of oxHDL and its subfractions, and those adjusted with HDL-C and HDL subfractions or ApoA1 in HDL fractions respectively, compared with HDL-C and HDL subfractions or ApoA1 in HDL fractions alone as independent risk factors for CVD events. CONCLUSION The levels of HDL subfractions and their oxidized subfraction particles differed among patients with CKD. The increasing levels of oxHDL subfractions might cause a high frequency of CVD events in such patients.
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Affiliation(s)
- Hirokazu Honda
- Division of Nephrology, Department of Medicine, Showa University Koto Toyosu Hospital
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Lin J, Khetarpal SA, Terembula K, Reilly MP, Wilson FP. Relation of atherogenic lipoproteins with estimated glomerular filtration rate decline: a longitudinal study. BMC Nephrol 2015; 16:130. [PMID: 26238454 PMCID: PMC4545861 DOI: 10.1186/s12882-015-0122-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 07/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with dyslipidemia, but the role of atherogenic lipid fractions in CKD progression remains unclear. Here we assess whether baseline plasma levels of lipoprotein(a) [Lp(a)] and apolipoprotein C-III (apoC-III), causal cardiovascular (CV) risk factors being studied as therapeutic targets, are associated with decreasing estimated glomerular filtration rate (eGFR) over time. METHODS In the Penn Diabetes Heart Study (PDHS), a single-center observational cohort of type 2 diabetes patients without clinical CV disease or pre-existing CKD, we performed linear mixed effects modeling with incremental multivariable analysis to evaluate the effects of baseline plasma Lp(a) and apoC-III on the slope of eGFR over time for subjects with longitudinal data (N = 400). RESULTS Each two-fold higher plasma Lp(a) level was associated with an additional decline in eGFR by 0.50 mL/min/year in the fully adjusted model (p < 0.001). Baseline Lp(a) levels greater than the atherogenic cut-point of 30 mg/dL were associated with a decline in eGFR by 2.75 mL/min/year compared to 1.01 mL/min/year in subjects with baseline Lp(a) less than 30 mg/dL (p < 0.001). Although each two-fold higher apoC-III level was also associated with statistically significant decline in eGFR over time, as expected the association was attenuated after adjusting for baseline triglycerides, the key lipid intermediary regulated by apoC-III in circulation. CONCLUSIONS Elevated baseline plasma Lp(a) levels are associated with a decrease in eGFR over time independent of race, lipid medication use, and albuminuria, whereas elevated baseline apoC-III levels are associated with eGFR decline in a triglyceride-dependent fashion.
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Affiliation(s)
- Jennie Lin
- Renal Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, 1 Founders, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Sumeet A Khetarpal
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
| | - Karen Terembula
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
| | - Muredach P Reilly
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
| | - F Perry Wilson
- Section of Nephrology, Department of Medicine, Yale School of Medicine, Program of Applied Translational Research, Yale University, New Haven, USA.
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Hov GG, Aasarød KI, Sagen E, Åsberg A. Arginine, dimethylated arginine and homoarginine in relation to cardiovascular risk in patients with moderate chronic kidney disease. Clin Biochem 2015; 48:646-51. [DOI: 10.1016/j.clinbiochem.2015.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 10/23/2022]
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Penno G, Solini A, Zoppini G, Fondelli C, Trevisan R, Vedovato M, Gruden G, Lamacchia O, Pontiroli AE, Arosio M, Orsi E, Pugliese G. Hypertriglyceridemia Is Independently Associated with Renal, but Not Retinal Complications in Subjects with Type 2 Diabetes: A Cross-Sectional Analysis of the Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicenter Study. PLoS One 2015; 10:e0125512. [PMID: 25942403 PMCID: PMC4420503 DOI: 10.1371/journal.pone.0125512] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 02/19/2015] [Indexed: 11/30/2022] Open
Abstract
Objective Atherogenic dyslipidemia seems to play a major role in microvascular complications and in residual microvascular risk after statin therapy, which reduces triglycerides up to 40%. We assessed whether raised TG levels are associated with an increased burden from microvascular complications in patients with type 2 diabetes. Methods Subjects from the Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicentre Study (n=15,773) were divided in 4 groups depending on whether they had plasma triglycerides below (NTG, 67.8%) or above (HTG, 32.2%) 1.7 mmol/L and were (42.4%) or not on (57.6%) statin therapy. Estimated GFR (eGFR) was calculated from serum creatinine, albuminuria was measured by immunonephelometry or immunoturbidimetry, and retinopathy was evaluated by fundus examination. Results HTG subjects, either with or without statin, had higher prevalence of albuminuria, reduced eGFR and chronic kidney disease (CKD), especially the albuminuric forms, but not of retinopathy, than NTG subjects. In contrast, cardiovascular disease and advanced DR were more prevalent in subjects on statin than in those not, independently of triglyceride levels. Logistic regression analysis confirmed that HTG, without or with statin, was independently associated with micro and macroalbuminuria, mildly to severely reduced eGFR, and all CKD phenotypes, but not with retinopathy. The adjusted odd ratios for CKD increased linearly for every 0.26 mmol/L increase (approximately one decile) in triglyceride levels. The increase was higher with increasing severity of albuminuria, eGFR loss and CKD phenotype as well as in subjects receiving than in those not receiving statin treatment. Conclusions Triglycerides are associated with CKD, but not retinopathy in subjects with type 2 diabetes, independently of statin treatment. These data point to a possible role of hypertriglyceridemia in the development of CKD, though it remains to be demonstrated that diabetic individuals might benefit from triglyceride reduction with statins and eventually with combination therapy with fibrates. Trial Registration www.ClinicalTrials.gov NCT00715481
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Affiliation(s)
- Giuseppe Penno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Anna Solini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giacomo Zoppini
- Division of Endocrinology and Metabolic Diseases, University of Verona, Verona, Italy
| | | | - Roberto Trevisan
- Endocrinology and Diabetes Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Monica Vedovato
- Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy
| | - Gabriella Gruden
- Department of Internal Medicine, University of Turin, Turin, Italy
| | - Olga Lamacchia
- Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Antonio E. Pontiroli
- Department of Medicine, Surgery and Odontoiatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | - Maura Arosio
- Endocrinology Unit, San Giuseppe Hospital, University of Milan, Milan, Italy
| | - Emanuela Orsi
- Diabetes Unit, IRCCS “Cà Granda—Ospedale Maggiore Policlinico” Foundation, Milan, Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, “La Sapienza” University, Rome, Italy
- * E-mail:
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Shimizu R, Torii H, Yasuda D, Hiraoka Y, Kitada N, Hashida T, Yoshimoto A, Kita T, Kume N. Serum Lipid Goal Attainment in Chronic Kidney Disease (CKD) Patients under the Japan Atherosclerosis Society (JAS) 2012 Guidelines. J Atheroscler Thromb 2015; 22:949-57. [PMID: 25843151 DOI: 10.5551/jat.29165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM According to the Japan Atherosclerosis Society 2012 guidelines (JAS2012-GL), chronic kidney disease (CKD) has newly been added to the high-risk group in terms of atherosclerotic cardiovascular diseases. We therefore explored the lipid target level achievement rates under the JAS2012-GL in real-world clinical practice. METHODS We retrospectively reviewed the medical charts of patients who were hospitalized at the Nephrology Department at Kobe City Medical Center General Hospital in the period from April 1, 2012 to May 31, 2013 and explored the serum lipid target level achievement rates. Patients without lipid data or those undergoing regular dialysis because of chronic renal failure were excluded. In this study, the CKD group (CKD-G) did not include CKD patients under secondary prevention for coronary heart disease (CHD) or diabetes mellitus (DM). RESULTS The CKD-G included 146 (81.1%) of the 180 enrolled patients. According to the JAS2012-GL, 100% of the CKD-G patients were categorized into the high-risk group, although only 12.1% of the CKD-G subjects were at high risk according to the JAS2007-GL. Under the JAS2012-GL, the LDL cholesterol (LDL-C) and non-HDL cholesterol (non-HDL-C) target level achievement rates for CKD-G were 71.4% and 68.1%, respectively. According to the JAS2007-GL, these rates were 81.3% and 79.1%, respectively, and, under both guidelines, these rates were 71.7% and 72.1% for primary prevention DM and 66.7% and 66.7% for CHD, respectively. CONCLUSIONS After the revision of the JAS-GL in 2012, the LDL-C and non-HDL-C target level achievement rates for CKD-G were reduced by approximately 10%; however, they remained similar to those for DM and higher than those for CHD.
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Affiliation(s)
- Rumiko Shimizu
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University
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