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Bauer C, Sim M, Prince RL, Zhu K, Lim EM, Byrnes E, Pavlos N, Lim WH, Wong G, Lewis JR, Levinger I. Circulating lipocalin-2 and features of metabolic syndrome in community-dwelling older women: A cross-sectional study. Bone 2023; 176:116861. [PMID: 37524293 DOI: 10.1016/j.bone.2023.116861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/21/2023] [Accepted: 07/28/2023] [Indexed: 08/02/2023]
Abstract
Lipocalin-2 (LCN2) is released by several cell types including osteoblasts and adipocytes and has been suggested as a marker of renal dysfunction, metabolic syndrome (MetS) and type 2 diabetes (T2D). Whether LCN2 is linked to these diseases in older women remains unknown. This study investigated whether LCN2 is related to features of MetS and T2D in older women. This cross-sectional study included 705 non-diabetic women (mean age 75.1 ± 2.6 years) for MetS analysis and 76 women (mean age 75.4 ± 2.8 years) with T2D. Total circulating LCN2 levels were analysed using a two-step chemiluminescent microparticle monoclonal immunoassay. MetS was determined by a modified National Cholesterol Education Program Adult Treatment Panel III classification. Multivariable-adjusted logistic regression analysis was used to assess odds ratios between LCN2 quartiles and MetS. Women in the highest LCN2 quartile had approximately 3 times greater risk for MetS compared to women in the lowest quartile (OR 3.05; 95%CI 1.86-5.02). Women with T2D or MetS scores of ≥ 3 had higher LCN2 levels compared to women with a MetS score of 0 (p < 0.05). Higher LCN2 correlated with higher body mass index, fat mass, triglycerides and glycated haemoglobin and lower high-density lipoprotein cholesterol and estimated glomerular filtration rate (p < 0.05). Higher circulating levels of LCN2 are associated with worsened cardio-metabolic risk factors and increased odds of MetS and T2D in older women. Whether it can be used as a biomarker for identifying those at risk for MetS and T2D should be explored further.
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Affiliation(s)
- Carlie Bauer
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, Australia; Medical School, University of Western Australia, Perth, Australia
| | - Richard L Prince
- Medical School, University of Western Australia, Perth, Australia
| | - Kun Zhu
- Medical School, University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
| | - Ee M Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia; PathWest, QEII Medical Centre, Perth, Australia
| | | | - Nathan Pavlos
- School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Wai H Lim
- Medical School, University of Western Australia, Perth, Australia; Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, Australia; Medical School, University of Western Australia, Perth, Australia; Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Itamar Levinger
- Institute for Health and Sport, Victoria University, Melbourne, Australia; Australian Institute for Musculoskeletal Science, Victoria University, University of Melbourne, Western Health, St Albans, VIC, Australia.
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Zhu K, Hunter M, James A, Lim EM, Walsh JP. Relationships between longitudinal changes in body composition and bone mineral density in middle-to-older aged Australians. Osteoporos Int 2023; 34:1601-1611. [PMID: 37233793 PMCID: PMC10427547 DOI: 10.1007/s00198-023-06773-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/22/2023] [Indexed: 05/27/2023]
Abstract
There are limited longitudinal data regarding relationships between changes in body composition and bone mineral density (BMD). In 3671 participants aged 46-70 years at baseline, ∆lean mass was a stronger determinant than ∆fat mass of ∆BMD over 6 years. Maintained or increased lean mass may slow down age-related bone loss. PURPOSE There are limited longitudinal data regarding relationships between changes in body composition and bone mineral density (BMD) with ageing. We examined these in the Busselton Healthy Ageing Study. METHODS We studied 3671 participants (2019 females) aged 46-70 years at baseline with body composition and BMD assessments by dual-energy x-ray absorptiometry at baseline and after ~6 years. Relationships between changes in total body mass (∆TM), lean mass (∆LM) and fat mass (∆FM) with ∆BMD at total hip, femoral neck and lumbar spine were evaluated using restricted cubic spline modelling (accounting for baseline covariates) and mid-quartile least square means were compared. RESULTS ∆TM was positively associated with ∆BMD of total hip and femoral neck in both sexes, and spine in females; in females but not males, associations plateaued at ∆TM above ~5kg for all sites. In females, ∆LM was positively associated with ∆BMD of all three sites with plateauing of the relationship at ∆LM above ~1kg. Women in the highest quartile of ∆LM (Q4, mid-quartile value +1.6 kg) had 0.019-0.028 g/cm2 less reduction in BMD than those in the lowest quartile (Q1, -2.1 kg). In males, ∆LM was positively associated with ∆BMD of total hip and femoral neck; men in Q4 (+1.6 kg) had 0.015 and 0.011 g/cm2 less bone loss, respectively, compared with Q1 (-2.7 kg). ∆FM was positively associated with ∆BMD of total hip only in both sexes. CONCLUSION ∆LM is a stronger determinant than ∆FM of ∆BMD. Maintained or increased LM is associated with less age-related bone loss.
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Affiliation(s)
- K Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia.
- Medical School, University of Western Australia, Crawley, WA, Australia.
| | - M Hunter
- Busselton Population Medical Research Institute, Busselton, WA, Australia
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - A James
- Medical School, University of Western Australia, Crawley, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - E M Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia
| | - J P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
- Medical School, University of Western Australia, Crawley, WA, Australia
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Yeap BB, Dedic D, Budgeon CA, Murray K, Knuiman MW, Hunter M, Zhu K, Cooke BR, Lim EM, Mulrennan S, Walsh JP, Green DJ. U-shaped association of vigorous physical activity with risk of metabolic syndrome in men with low lean mass, and no interaction of physical activity and serum 25-hydroxyvitamin D with metabolic syndrome risk. Intern Med J 2021; 50:460-469. [PMID: 31161619 DOI: 10.1111/imj.14379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/16/2019] [Accepted: 05/29/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is uncertainty over how lean mass, physical activity (PA) and 25-hydroxyvitamin D (25-OH-D) status interact on metabolic syndrome (MetS) risk in adults. AIMS To test the hypothesis that these factors additively influence MetS risk. METHODS Four thousand eight hundred and fifty-eight adults (54.6% female) mean ± SD age 58.0 ± 5.8 years, body mass index 28.1 ± 4.8 kg/m2 , resident in Busselton, Western Australia. PA assessed by questionnaire (all/total and vigorous), lean mass using dual energy X-ray absorptiometry (% total body mass), serum 25-OH-D via immunoassay, analysed using multivariable logistic regression. RESULTS In men, lower total PA was associated with MetS (no vs >24 h/week odds ratio (OR) = 3.1; ≤8 vs >24 h/week OR = 1.8, both P < 0.001), as was lower lean mass (low vs high OR = 20.4; medium vs high OR = 7.4, both P < 0.001). Men with low lean mass exhibited a U-shaped relationship of vigorous PA with MetS risk (covariate-adjusted: 0 vs 4-8 h/week OR = 2.1, P = 0.037; >12 vs 4-8 h/week OR = 4.3, P = 0.002; interaction P = 0.039). In women, low PA (0 vs >24 h/week OR = 2.1, P = 0.003) and lean mass (low vs high OR = 13.1; medium vs high OR = 7.2, both P < 0.001) were associated with MetS risk. Low 25-OH-D status was associated with MetS in men (low vs high OR = 4.1; medium vs high OR = 2.3, both P < 0.001) and women (OR = 3.5 and 2.1 respectively, both P < 0.001) with no PA interaction. CONCLUSIONS Men and women with high lean mass have low risk of MetS regardless of PA. Low lean mass identifies men who may benefit most from increasing PA, with an optimal level associated with lowest risk. 25-OH-D and PA do not interact on MetS risk.
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Affiliation(s)
- Bu B Yeap
- Medical School, University of Western Australia, Perth, Western Australia, Australia.,Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Deila Dedic
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Charley A Budgeon
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Matthew W Knuiman
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Michael Hunter
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia.,Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
| | - Kun Zhu
- Medical School, University of Western Australia, Perth, Western Australia, Australia.,Department of Endocrinology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Brian R Cooke
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital and Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Ee M Lim
- Department of Endocrinology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital and Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Siobhain Mulrennan
- Medical School, University of Western Australia, Perth, Western Australia, Australia.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - John P Walsh
- Medical School, University of Western Australia, Perth, Western Australia, Australia.,Department of Endocrinology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Daniel J Green
- School of Exercise and Sport Science, University of Western Australia, Perth, Western Australia, Australia
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Zhu K, Hunter M, James A, Lim EM, Cooke BR, Walsh JP. Relationship between visceral adipose tissue and bone mineral density in Australian baby boomers. Osteoporos Int 2020; 31:2439-2448. [PMID: 32719992 DOI: 10.1007/s00198-020-05556-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/21/2020] [Indexed: 02/01/2023]
Abstract
UNLABELLED Adiposity has a complex relationship with bone health. In 4865 Australian baby boomers (2642 females) aged 45-70 years, we found that higher visceral adipose tissue mass is associated with reduced bone density adjusting for body mass and lifestyle factors, suggesting that excess visceral fat may be deleterious to bone. INTRODUCTION Increased body mass is associated with higher bone mineral density (BMD), but higher visceral adipose tissue (VAT) may have a negative impact on bone health. In the Busselton Healthy Ageing Study, we examined associations between VAT mass and BMD in 4865 participants (2642 females) aged 45-70 years. METHODS VAT mass and BMD of whole body, total hip, femoral neck and lumbar spine were measured using DXA. VAT mass was examined as a continuous variable and in quartiles using sex-specific cut-offs. RESULTS The mean age was 58.0 ± 5.8 years. Males had significantly higher BMI (28.3 ± 3.7 vs 27.5 ± 4.9 kg/m2) and VAT mass (1675 ± 878 vs 882 ± 600 g) than females (both P < 0.001). In males, after adjustment for age, body mass, height and lifestyle factors, VAT mass negatively associated with total body, total hip and femoral neck BMD (β = - 0.153 to - 0.293, all P < 0.001). Males in the highest quartile of VAT mass (> 2200 g) had significantly lower BMD at all three sites than those in lower quartiles, with estimated BMD differences of 2.3-5.7% (all P < 0.05). In females, VAT mass negatively associated with total body, femoral neck and lumbar spine BMD (β = - 0.067 to - 0.178, all P < 0.05) and those in the highest quartile (> 1250 g) had significantly lower total body BMD than other quartiles (by 1.7-3.7%, all P < 0.05). CONCLUSION In middle-aged Australians, after covariate adjustment, higher DXA-derived VAT mass is associated with reduced bone density, suggesting that excess visceral fat may be deleterious to bone, especially in males.
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Affiliation(s)
- K Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, 6009, Australia.
- Medical School, University of Western Australia, Crawley, Western Australia, Australia.
| | - M Hunter
- Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia
| | - A James
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - E M Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, 6009, Australia
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - B R Cooke
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - J P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, 6009, Australia
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
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Rueter K, Black LJ, Jones A, Bulsara M, Clarke MW, Gamez C, Lim EM, Palmer DJ, Prescott SL, Siafarikas A. Analytical Bias in the Measurement of Plasma 25-Hydroxyvitamin D Concentrations in Infants. Int J Environ Res Public Health 2020; 17:ijerph17020412. [PMID: 31936279 PMCID: PMC7014414 DOI: 10.3390/ijerph17020412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/30/2019] [Accepted: 12/30/2019] [Indexed: 01/16/2023]
Abstract
Hypovitaminosis D is prevalent worldwide; however, analytical bias in the measurement of circulating 25-hydroxyvitamin D (25(OH)D) concentrations may affect clinical treatment decisions and research. We performed parallel plasma 25(OH)D analyses using the Abbott Architect i2000 chemiluminescent immunoassay (CIA) and liquid chromatography–tandem mass spectrometry (LC–MS/MS) for paired samples from the same infants at 3 (n = 69), 6 (n = 79) and 12 months (n = 73) of age. To test agreement, we used Lin’s concordance correlation coefficient and corresponding 95% confidence interval, Bland–Altman’s limits of agreement, and Bradley–Blackwood (BB) test. Agreement was high at 3 months (coefficient between difference and mean −0.076; BB F = 0.825; p = 0.440), good at 12 months (−0.25; BB F = 2.41; p = 0.097) but missing at 6 months of age (−0.39; BB F = 12.30; p < 0.001). Overall, 18 infants had disparate results based on the cut-off point for vitamin D deficiency (25(OH)D < 50 nmol/L), particularly at three months, with seven (10%) infants deficient according to CIA but not LC–MS/MS, and four (6%) deficient by LC–MS/MS but not CIA. To our knowledge, this is the first study to show that the reported 25(OH)D concentration may be influenced by both age and assay type. Physicians and researchers should be aware of these pitfalls when measuring circulating 25(OH)D concentrations in infants and when developing treatment plans based on measured vitamin D status.
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Affiliation(s)
- Kristina Rueter
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Perth Children’s Hospital, Department of Paediatric Immunology, Perth 6009, Australia
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), West New York, NJ 07093, USA
- Correspondence:
| | - Lucinda J. Black
- School of Public Health, Curtin University, Perth 6102, Australia;
| | - Anderson Jones
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Max Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle 6160, Australia;
| | - Michael W. Clarke
- Metabolomics Australia, Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth 6009, Australia;
| | - Cristina Gamez
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
| | - Ee M. Lim
- Sir Charles Gairdner Hospital, Department of Endocrinology, Perth 6009, Australia;
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands 6009, Australia
| | - Debra J. Palmer
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Susan L. Prescott
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Perth Children’s Hospital, Department of Paediatric Immunology, Perth 6009, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Aris Siafarikas
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Institute for Health Research, University of Notre Dame, Fremantle 6160, Australia;
- Perth Children’s Hospital, Department of Paediatric Endocrinology and Diabetes, Perth 6009, Australia
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Lewis JR, Brennan-Speranza TC, Levinger I, Byrnes E, Lim EM, Blekkenhorst LC, Sim M, Hodgson JM, Zhu K, Lim WH, Adams LA, Prince RL. Effects of calcium supplementation on circulating osteocalcin and glycated haemoglobin in older women. Osteoporos Int 2019; 30:2065-2072. [PMID: 31342138 DOI: 10.1007/s00198-019-05087-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/09/2019] [Indexed: 01/18/2023]
Abstract
UNLABELLED One year of calcium supplementation in older women led to modest reductions in total osteocalcin and undercarboxylated osteocalcin (ucOC), with no changes in muscle or fat mass, or glycated haemoglobin. Future studies should explore whether treatments with more profound effects of suppressing ucOC may lead to impaired glycaemic control. INTRODUCTION Total osteocalcin (TOC) is a marker of bone turnover, while its undercarboxylated form has beneficial effects on glucose metabolism in mice. This post hoc analysis of a randomised double-blind, placebo-controlled trial examined whether 1 year of calcium supplementation affected circulating TOC, undercarboxylated osteocalcin (ucOC) or glycated haemoglobin (HbA1c) in 1368 older community-dwelling women (mean age 75.2 ± 2.7 years). METHODS Women enrolled in the Calcium Intake Fracture Outcome Study trial (1998-2003) were supplemented with 1.2 g/d of elemental calcium (in the form of calcium carbonate) or placebo. Circulating TOC, ucOC and HbA1c was measured at 1 year (1999). RESULTS After 1 year of calcium supplementation, TOC and ucOC levels were 17% and 22% lower compared with placebo (mean 22.7 ± 9.1 vs. 27.3 ± 10.9 μg/L and 11.1 ± 4.9 vs. 13.0 ± 5.7 μg/L, both P < 0.001). Carboxylated osteocalcin/ucOC was 6% lower after calcium supplementation (P < 0.05). Despite this, no differences in HbA1c were observed (calcium, 5.2 ± 0.6 vs. placebo, 5.3 ± 0.8%; P = 0.08). Calcium supplementation did not affect BMI, whole body lean or fat mass. In exploratory analyses, total calcium (dietary and supplemental) was inversely related to TOC and ucOC, indicating calcium intake is an important dietary determinant of osteocalcin levels. CONCLUSION One year of calcium supplementation in older women led to modest reductions in TOC and ucOC, with no changes in muscle or fat mass, or HbA1c. Future studies should explore whether treatments with more profound effects of suppressing ucOC may lead to impaired glycaemic control.
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Affiliation(s)
- J R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
- Medical School, University of Western Australia, Perth, Australia.
- Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
| | - T C Brennan-Speranza
- Department of Physiology, Bosch Institute for Medical Research, University of Sydney, Sydney, Australia
| | - I Levinger
- Institute of Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - E Byrnes
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - E M Lim
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
| | - L C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - M Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - J M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - K Zhu
- Medical School, University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
| | - W H Lim
- Medical School, University of Western Australia, Perth, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - L A Adams
- Medical School, University of Western Australia, Perth, Australia
- Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - R L Prince
- Medical School, University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
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Tacey A, Parker L, Yeap BB, Joseph J, Lim EM, Garnham A, Hare DL, Brennan-Speranza T, Levinger I. Single-dose prednisolone alters endocrine and haematologic responses and exercise performance in men. Endocr Connect 2019; 8:111-119. [PMID: 30673629 PMCID: PMC6373622 DOI: 10.1530/ec-18-0473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/23/2019] [Indexed: 12/11/2022]
Abstract
The aim of this study was to investigate the effect of a single dose of prednisolone on (A) high-intensity interval cycling performance and (B) post-exercise metabolic, hormonal and haematological responses. Nine young men participated in this double-blind, randomised, cross-over study. The participants completed exercise sessions (4 × 4 min cycling bouts at 90-95% of peak heart rate), 12 h after ingesting prednisolone (20 mg) or placebo. Work load was adjusted to maintain the same relative heart rate between the sessions. Exercise performance was measured as total work performed. Blood samples were taken at rest, immediately post exercise and up to 3 h post exercise. Prednisolone ingestion decreased total work performed by 5% (P < 0.05). Baseline blood glucose was elevated following prednisolone compared to placebo (P < 0.001). Three hours post exercise, blood glucose in the prednisolone trial was reduced to a level equivalent to the baseline concentration in the placebo trial (P > 0.05). Prednisolone suppressed the increase in blood lactate immediately post exercise (P < 0.05). Total white blood cell count was elevated at all time-points with prednisolone (P < 0.01). Androgens and sex hormone-binding globulin were elevated immediately after exercise, irrespective of prednisolone or placebo. In contrast, prednisolone significantly reduced the ratio of testosterone/luteinizing hormone (P < 0.01). Acute prednisolone treatment impairs high-intensity interval cycling performance and alters metabolic and haematological parameters in healthy young men. Exercise may be an effective tool to minimise the effect of prednisolone on blood glucose levels.
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Affiliation(s)
- Alexander Tacey
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Department of Medicine-Western Health, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lewan Parker
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, and Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - John Joseph
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Ee M Lim
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Andrew Garnham
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
| | - David L Hare
- University of Melbourne and the Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - Tara Brennan-Speranza
- Department of Physiology and Bosch Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Department of Medicine-Western Health, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- Correspondence should be addressed to I Levinger:
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Rueter K, Black L, Bulsara M, Clark M, Gamez C, Lim EM, Jones A, Palmer DJ, Prescott SL, Siafarikas A. P74: CHEMILUMINESCENT IMMUNOASSAY (CIA) AND LIQUID CHROMATOGRAPHY-TANDEM MASS SPECTOMETRY ASSAY (LC/MS-MS) METHODOLOGY FOR THE DETERMINATION OF VITAMIN D STATUS IN INFANTS AT HIGH RISK FOR DEVELOPING ALLERGIC DISEASES: IS THERE ANY ANALYTICAL BIAS? Intern Med J 2017. [DOI: 10.1111/imj.74_13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K Rueter
- School of Paediatrics and Child Health; University of Western Australia; Australia
- Princess Margaret Hospital for Children; Perth Australia
- Telethon Kids Institute; University of Western Australia; Australia
| | - L Black
- Curtin University; Perth Australia
| | - M Bulsara
- Institute of Health Research; University of Notre Dame; Fremantle Australia
| | - M Clark
- Centre for Metabolomics; University of Western Australia; Australia
| | - C Gamez
- Telethon Kids Institute; University of Western Australia; Australia
| | - EM Lim
- Endocrinology Department, Sir Charles Gardiner Hospital; Perth Australia
| | - A Jones
- School of Paediatrics and Child Health; University of Western Australia; Australia
- Telethon Kids Institute; University of Western Australia; Australia
| | - DJ Palmer
- School of Paediatrics and Child Health; University of Western Australia; Australia
- Telethon Kids Institute; University of Western Australia; Australia
| | - SL Prescott
- School of Paediatrics and Child Health; University of Western Australia; Australia
- Princess Margaret Hospital for Children; Perth Australia
- Telethon Kids Institute; University of Western Australia; Australia
| | - A Siafarikas
- School of Paediatrics and Child Health; University of Western Australia; Australia
- Princess Margaret Hospital for Children; Perth Australia
- Telethon Kids Institute; University of Western Australia; Australia
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Lewis JR, Lim WH, Wong G, Abbs S, Zhu K, Lim EM, Thompson PL, Prince RL. Association Between High-Sensitivity Cardiac Troponin I and Cardiac Events in Elderly Women. J Am Heart Assoc 2017; 6:JAHA.116.004174. [PMID: 28757482 PMCID: PMC5586400 DOI: 10.1161/jaha.116.004174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Elderly women are at high risk of coronary heart disease (CHD) and heart failure. High‐sensitivity assays allow detection of cardiac troponin I (hsTnI) well below diagnostic cutoffs for acute coronary syndrome. We investigated the association between these levels with future cardiac events in community‐based ambulant white women aged over 70 years initially recruited for a 5‐year randomized, controlled trial of calcium supplements. Methods and Results This was a prospective study of 1081 elderly women without clinical CHD at baseline (1998) or hsTnI above the diagnostic cutoffs for acute coronary syndrome with 14.5‐year follow‐up hospitalization and mortality (events). Two hundred forty‐three (22%) women had CHD events, 163 (15%) myocardial infarction or CHD death (hard CHD), and 109 (10%) heart failure. In 99.6% of available serum samples, hsTnI was above the level of detection (median, 4.5 ng/L; interquartile range, 3.6–5.8). After adjusting for Framingham risk factors, each SD natural log‐transformed hsTnI increase was associated with an increased hazard for CHD (hazard ratio, 1.34; 95% CI, 1.18–1.53; P<0.001) hard CHD (hazard ratio, 1.51; 95% CI, 1.29–1.76; P<0.001), and heart failure (hazard ratio, 1.65; 95% CI, 1.36–1.99; P<0.001). Step‐wise increases in relative hazards were observed with increasing quartiles of hsTnI (P for trend, <0.001), whereas the addition of hsTnI to conventional risk factors modestly improved discrimination indices: Harrell's c‐statistic, net reclassification, and integrated discrimination (P<0.05). Conclusions Cardiac troponin I is independently associated with future cardiac events in elderly women without apparent clinical manifestations. The addition of cardiac troponin I to conventional risk factors may modestly improve risk prediction in this setting.
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Affiliation(s)
- Joshua R Lewis
- Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Australia .,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia.,Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Australia
| | - Wai H Lim
- Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Australia.,Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Australia
| | - Samuel Abbs
- PathWest, Sir Charles Gairdner Hospital, Perth, Australia
| | - Kun Zhu
- Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
| | - Ee M Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia.,PathWest, Sir Charles Gairdner Hospital, Perth, Australia
| | - Peter L Thompson
- Department of Cardiology, Sir Charles Gairdner Hospital, Perth, Australia
| | - Richard L Prince
- Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
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10
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Abstract
OBJECTIVES The health benefits of 'drinking at least 8 glasses of water a day" in healthy individuals are largely unproven. We aimed to examine the relationship between total fluid and the sources of fluid consumption, risk of rapid renal decline, cardiovascular disease (CVD) mortality and all-cause mortality in elderly women. DESIGN, SETTING AND PARTICIPANTS We conducted a longitudinal analysis of a population-based cohort study of 1055 women aged ≥70 years residing in Australia. MAIN OUTCOME MEASURES The associations between total daily fluid intake (defined as total volume of beverage excluding alcohol and milk) and the types of fluid (water, black tea, coffee, milk and other fluids) measured as cups per day and rapid renal decline, CVD and all-cause mortality were assessed using adjusted logistic and Cox regression analyses. RESULTS Over a follow-up period of 10 years, 70 (6.6%) experienced rapid renal decline and 362 (34.4%) died, of which 142 (13.5%) deaths were attributed to CVD. The median (IQR) intake of total fluid was 10.4 (8.5-12.5) cups per day, with water (median (IQR) 4 (2-6) cups per day) and black tea (median (IQR) 3 (1-4) cups per day) being the most frequent type of fluid consumed. Every cup per day higher intake of black tea was associated with adjusted HRs of 0.90 (95% CI 0.81 to 0.99) and 0.92 (95% CI 0.86 to 0.98) for CVD mortality and all-cause mortality, respectively. There were no associations between black tea intake and rapid renal decline, or between the quantity or type of other fluids, including water intake, and any clinical outcomes. CONCLUSIONS Habitual higher intake of black tea may potentially improve long-term health outcomes, independent of treating traditional CVD risk factors, but validation of our study findings is essential.
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Affiliation(s)
- Wai H Lim
- Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Western Australia, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead, Sydney, New South Wales, Australia
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Joshua R Lewis
- Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Western Australia, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Charmaine E Lok
- Department of Medicine, University of Toronto;Division of Nephrology, Toronto General Hospital, Toronto, Ontario, Canada
| | - Kevan R Polkinghorne
- Department of Nephrology, Monash Medical Centre, Clayton, Melbourne, Australia
- Department of Medicine, Monash University, Clayton, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahan, Melbourne, Australia
| | - Jonathan Hodgson
- Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Ee M Lim
- PathWest, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Richard L Prince
- Sir Charles Gairdner Hospital Unit, University of Western Australia School of Medicine and Pharmacology, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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11
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Zhu K, Hunter M, James A, Lim EM, Cooke BR, Walsh JP. Discordance between fat mass index and body mass index is associated with reduced bone mineral density in women but not in men: the Busselton Healthy Ageing Study. Osteoporos Int 2017; 28:259-268. [PMID: 27468902 DOI: 10.1007/s00198-016-3710-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/14/2016] [Indexed: 01/31/2023]
Abstract
UNLABELLED The obesity-BMD relationship is complex. In 3045 middle-aged adults, we found that in women (but not men) with discordant fat mass index (FMI)/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone. INTRODUCTION The relationship between obesity and BMD is complex. FMI (fat mass (kg) / height (m)2) is a more accurate measure of fatness than BMI, and depending on body composition, some individuals have discordant BMI/FMI categories. We examined associations between FMI, BMI and BMD in participants in the Busselton Healthy Ageing Study. METHODS Body composition and BMD of the hip, spine and total body were measured using DXA in 3045 participants (1644 females) aged 45-67 years. Using standard BMI/FMI categories, the participants were classified as underweight/fat deficit, normal, overweight/excess fat, obese I and obese II-III. RESULTS BMI and FMI categories were concordant in 77.3 % of females and 71.2 % of males. There were 12.9 % females and 13.2 % males in a higher FMI than BMI category (high body fat for BMI), whereas 9.8 % females and 15.6 % males were in a lower category (low body fat for BMI). Females with high body fat for BMI had significantly lower covariate-adjusted BMD at the femoral neck, total hip and total body (differences of 3.8, 5.1 and 2.6 %, respectively, all P < 0.05) than females with low body fat for BMI and lower total body BMD than women with concordant FMI/BMI (by 1.4 %, P = 0.04). In males, BMD did not differ significantly between those who were concordant or discordant for FMI/BMI categories. CONCLUSION In women (but not men) with discordant FMI/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone.
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Affiliation(s)
- K Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia.
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
| | - M Hunter
- Busselton Population Medical Research Institute, Busselton, WA, Australia
- School of Population Health, University of Western Australia, Crawley, WA, Australia
| | - A James
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - E M Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia
| | - B R Cooke
- Department of Clinical Biochemistry, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - J P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
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12
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Rueter K, Jones A, Siafarikas A, Lim EM, Prescott SL, Palmer DJ. ASCIA-P55: THE INFLUENCE OF VITAMIN D AND UV-LIGHT EXPOSURE ON THE DEVELOPING IMMUNE PHENOTYPE IN INFANCY. Intern Med J 2016. [DOI: 10.1111/imj.55_13197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kristina Rueter
- School of Paediatrics and Child Health; University of Western Australia
- Princess Margaret Hospital for Children; Perth Australia
- Telethon Kids Institute; University of Western Australia
| | - Anderson Jones
- School of Paediatrics and Child Health; University of Western Australia
- Telethon Kids Institute; University of Western Australia
| | - Aris Siafarikas
- School of Paediatrics and Child Health; University of Western Australia
- Princess Margaret Hospital for Children; Perth Australia
| | - Ee M Lim
- Endocrinology Department; Sir Charles Gardner Hospital; Perth Australia
| | - Susan L. Prescott
- School of Paediatrics and Child Health; University of Western Australia
- Princess Margaret Hospital for Children; Perth Australia
- Telethon Kids Institute; University of Western Australia
| | - Debra J. Palmer
- School of Paediatrics and Child Health; University of Western Australia
- Telethon Kids Institute; University of Western Australia
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13
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Lewis JR, Schousboe JT, Lim WH, Wong G, Zhu K, Lim EM, Wilson KE, Thompson PL, Kiel DP, Prince RL. Abdominal Aortic Calcification Identified on Lateral Spine Images From Bone Densitometers Are a Marker of Generalized Atherosclerosis in Elderly Women. Arterioscler Thromb Vasc Biol 2015; 36:166-173. [PMID: 26603153 DOI: 10.1161/atvbaha.115.306383] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 11/15/2015] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Dual-energy x-ray absorptiometry is a low-cost, minimal radiation technique used to improve fracture prediction. Dual-energy x-ray absorptiometry machines can also capture single-energy lateral spine images, and abdominal aortic calcification (AAC) is commonly seen on these images. APPROACH AND RESULTS We investigated whether dual-energy x-ray absorptiometry-derived measures of AAC were related to an established test of generalized atherosclerosis in 892 elderly white women aged >70 years with images captured during bone density testing in 1998/1999 and B-mode carotid ultrasound in 2001. AAC scores were calculated using a validated 24-point scale into low (AAC24 score, 0 or 1), moderate (AAC24 scores, 2-5), and severe AAC (AAC24 scores, >5) seen in 45%, 36%, and 19%, respectively. AAC24 scores were correlated with mean and maximum common carotid artery intimal medial thickness (rs=0.12, P<0.001 and rs=0.14, P<0.001). Compared with individuals with low AAC, those with moderate or severe calcification were more likely to have carotid atherosclerotic plaque (adjusted prevalence ratio (PR), 1.35; 95% confidence interval, 1.14-1.61; P<0.001 and prevalence ratio, 1.94; 95% confidence interval, 1.65-2.32; P<0.001, respectively) and moderate carotid stenosis (adjusted prevalence ratio, 2.22; 95% confidence interval, 1.39-3.54; P=0.001 and adjusted prevalence ratio, 4.82; 95% confidence interval, 3.09-7.050; P<0.001, respectively). The addition of AAC24 scores to traditional risk factors improved identification of women with carotid atherosclerosis as quantified by C-statistic (+0.075, P<0.001), net reclassification (0.249, P<0.001), and integrated discrimination (0.065, P<0.001). CONCLUSIONS AAC identified on images from a dual-energy x-ray absorptiometry machine were strongly related to carotid ultrasound measures of atherosclerosis. This low-cost, minimal radiation technique used widely for osteoporosis screening is a promising marker of generalized extracoronary atherosclerosis.
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Affiliation(s)
- Joshua R Lewis
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia.,Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - John T Schousboe
- Park Nicollet Osteoporosis Center and Institute for Research and Education, Minneapolis, MN, USA and Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - Wai H Lim
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia.,Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Kun Zhu
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
| | - Ee M Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia.,PathWest, Sir Charles Gairdner Hospital, Perth, Australia
| | | | - Peter L Thompson
- Department of Cardiology, Sir Charles Gairdner Hospital, Perth, Australia
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Richard L Prince
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
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14
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Lim WH, Wong G, Lim EM, Byrnes E, Zhu K, Devine A, Pavlos NJ, Prince RL, Lewis JR. Circulating Lipocalin 2 Levels Predict Fracture-Related Hospitalizations in Elderly Women: A Prospective Cohort Study. J Bone Miner Res 2015; 30:2078-85. [PMID: 25939604 DOI: 10.1002/jbmr.2546] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/22/2015] [Accepted: 04/29/2015] [Indexed: 01/17/2023]
Abstract
Lipocalin 2 (LCN2) or neutrophil gelatinase-associated lipocalin (NGAL) is expressed in a wide range of cells and pathological states. Mounting evidence suggests lipocalin 2 may be an important regulator of bone homeostasis. Recently it has been suggested LCN2 is a novel mechanoresponsive gene central to the pathological response to low mechanical force. We undertook a prospective study of 1009 elderly women over 70 years of age to study the association between circulating LCN2 and potential associated variables, including estimated glomerular filtration rate, physical activity, and baseline measures of hip bone density and heel bone quality. Osteoporotic fractures requiring hospitalizations were identified from the Western Australian Data Linkage System. Over 14.5 years, 272 (27%) of women sustained an osteoporotic fracture-related hospitalization; of these, 101 were hip fractures. Circulating LCN2 levels were correlated with body mass index and estimated glomerular filtration rate (r = 0.249, p < 0.001 and r = -0.481, p < 0.001, respectively) that modified the association with hip and heel bone measures. Per standard deviation increase in LCN2, there was a 30% multivariable-adjusted increase in the risk of any osteoporotic fracture (hazard ratio [HR] = 1.30, 95% confidence interval [CI] 1.13-1.50, p < 0.001). In participants with elevated LCN2 levels above the median (76.6 ng/mL), there was an 80% to 81% increase in the risk of any osteoporotic or hip fracture (HR = 1.81, 95% CI 1.38-2.36, p < 0.001 and HR = 1.80, 95% CI 1.16-2.78, p = 0.008, respectively). These associations remained significant after adjustment for total hip bone mineral density (p < 0.05). In conclusion, we have demonstrated that circulating LCN2 levels predict future risk of osteoporotic fractures requiring hospitalization. Measurement of LCN2 levels may improve fracture prediction in addition to current fracture risk factors in the elderly, particularly in those with impaired renal function.
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Affiliation(s)
- Wai H Lim
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia.,Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Ee M Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia.,PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Elizabeth Byrnes
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Kun Zhu
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia.,PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Amanda Devine
- School of Exercise and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Nathan J Pavlos
- School of Surgery, Centre for Orthopaedic Research, University of Western Australia, Perth, Australia
| | - Richard L Prince
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia.,PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Joshua R Lewis
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia.,PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
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Lim WH, Lewis JR, Wong G, Teo R, Lim EM, Byrnes E, Prince RL. Plasma neutrophil gelatinase-associated lipocalin and kidney function decline and kidney disease-related clinical events in older women. Am J Nephrol 2015; 41:156-64. [PMID: 25824561 DOI: 10.1159/000380831] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/25/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND It is still unclear whether serum neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of renal tubular injury, is a prognostic marker for the progression of chronic kidney disease (CKD) in the general population. METHODS A prospective-cohort study of 1,245 women aged ≥70 from the general population. Associations between plasma NGAL and change in 5-year estimated glomerular filtration rate (eGFR), rapid renal decline and 10-year risk of acute or chronic renal disease-related hospitalisations and/or mortality were examined. RESULTS Compared to women with above-median plasma NGAL of 76.5 ng/l, women with below-median plasma NGAL had a 9.3% reduction in eGFR over a 5-year period. Among women with above-median plasma NGAL, there was over a 1.7-fold increased risk of rapid renal decline (eGFR decline of >3 ml/min/year) (adjusted odds ratio 1.76, 95% CI 1.003, 3.102, p = 0.049). Compared to women with baseline eGFR of <60 ml/min/1.73 m(2), women with above-median plasma NGAL experienced over a 2.5-fold increased risk of renal disease events at 10 years (hazard ratio 2.55, 95% CI 1.13, 5.78, p = 0.025) after adjustment of age, hypertension and diabetes. Addition of plasma NGAL in participants with eGFR of <60 ml/min/1.73 m(2) significantly improved the accuracy in predicting the 10-year risk of renal disease events (adjusted area-under-curve receiver operator characteristics without and with NGAL 0.64 and 0.71, respectively; p = 0.027) and reclassified 13% of women who experienced renal disease events into the higher risk categories (p = 0.03). CONCLUSION Plasma NGAL is of modest clinical utility in predicting the renal function decline and risk of renal disease-related clinical events, particularly those with mild to moderate CKD.
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Affiliation(s)
- Wai H Lim
- University of Western Australia School of Medicine and Pharmacology, Perth, Australia
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16
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Lim WH, Lewis JR, Wong G, Turner RM, Lim EM, Thompson PL, Prince RL. Comparison of estimated glomerular filtration rate by the chronic kidney disease epidemiology collaboration (CKD-EPI) equations with and without Cystatin C for predicting clinical outcomes in elderly women. PLoS One 2014; 9:e106734. [PMID: 25265151 PMCID: PMC4180254 DOI: 10.1371/journal.pone.0106734] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 08/05/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Reduced estimated glomerular filtration rate (eGFR) using the cystatin-C derived equations might be a better predictor of cardiovascular disease (CVD) mortality compared with the creatinine-derived equations, but this association remains unclear in elderly individuals. AIM The aims of this study were to compare the predictive values of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)-creatinine, CKD-EPI-cystatin C and CKD-EPI-creatinine-cystatin C eGFR equations for all-cause mortality and CVD events (hospitalizations±mortality). METHODS Prospective cohort study of 1165 elderly women aged>70 years. Associations between eGFR and outcomes were examined using Cox regression analysis. Test accuracy of eGFR equations for predicting outcomes was examined using Receiver Operating Characteristic (ROC) analysis and net reclassification improvement (NRI). RESULTS Risk of all-cause mortality for every incremental reduction in eGFR determined using CKD-EPI-creatinine, CKD-EPI-cystatin C and the CKD-EPI-creatinine-cystatic C equations was similar. Areas under the ROC curves of CKD-EPI-creatinine, CKD-EPI-cystatin C and CKD-EPI-creatinine-cystatin C equations for all-cause mortality were 0.604 (95%CI 0.561-0.647), 0.606 (95%CI 0.563-0.649; p = 0.963) and 0.606 (95%CI 0.563-0.649; p = 0.894) respectively. For all-cause mortality, there was no improvement in the reclassification of eGFR categories using the CKD-EPI-cystatin C (NRI -4.1%; p = 0.401) and CKD-EPI-creatinine-cystatin C (NRI -1.2%; p = 0.748) compared with CKD-EPI-creatinine equation. Similar findings were observed for CVD events. CONCLUSION eGFR derived from CKD-EPI cystatin C and CKD-EPI creatinine-cystatin C equations did not improve the accuracy or predictive ability for clinical events compared to CKD-EPI-creatinine equation in this cohort of elderly women.
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Affiliation(s)
- Wai H. Lim
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
- * E-mail:
| | - Joshua R. Lewis
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead, Sydney, Australia
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Robin M. Turner
- School of Public Health, The University of New South Wales, Sydney, Australia
| | - Ee M. Lim
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
- PathWest, Sir Charles Gairdner Hospital, Perth, Australia
| | - Peter L. Thompson
- Department of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Richard L. Prince
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
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Medici M, Porcu E, Pistis G, Teumer A, Brown SJ, Jensen RA, Rawal R, Roef GL, Plantinga TS, Vermeulen SH, Lahti J, Simmonds MJ, Husemoen LLN, Freathy RM, Shields BM, Pietzner D, Nagy R, Broer L, Chaker L, Korevaar TIM, Plia MG, Sala C, Völker U, Richards JB, Sweep FC, Gieger C, Corre T, Kajantie E, Thuesen B, Taes YE, Visser WE, Hattersley AT, Kratzsch J, Hamilton A, Li W, Homuth G, Lobina M, Mariotti S, Soranzo N, Cocca M, Nauck M, Spielhagen C, Ross A, Arnold A, van de Bunt M, Liyanarachchi S, Heier M, Grabe HJ, Masciullo C, Galesloot TE, Lim EM, Reischl E, Leedman PJ, Lai S, Delitala A, Bremner AP, Philips DIW, Beilby JP, Mulas A, Vocale M, Abecasis G, Forsen T, James A, Widen E, Hui J, Prokisch H, Rietzschel EE, Palotie A, Feddema P, Fletcher SJ, Schramm K, Rotter JI, Kluttig A, Radke D, Traglia M, Surdulescu GL, He H, Franklyn JA, Tiller D, Vaidya B, de Meyer T, Jørgensen T, Eriksson JG, O'Leary PC, Wichmann E, Hermus AR, Psaty BM, Ittermann T, Hofman A, Bosi E, Schlessinger D, Wallaschofski H, Pirastu N, Aulchenko YS, de la Chapelle A, Netea-Maier RT, Gough SCL, Meyer zu Schwabedissen H, Frayling TM, Kaufman JM, Linneberg A, Räikkönen K, Smit JWA, Kiemeney LA, Rivadeneira F, Uitterlinden AG, Walsh JP, Meisinger C, den Heijer M, Visser TJ, Spector TD, Wilson SG, Völzke H, Cappola A, Toniolo D, Sanna S, Naitza S, Peeters RP. Identification of novel genetic Loci associated with thyroid peroxidase antibodies and clinical thyroid disease. PLoS Genet 2014; 10:e1004123. [PMID: 24586183 PMCID: PMC3937134 DOI: 10.1371/journal.pgen.1004123] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 12/03/2013] [Indexed: 12/14/2022] Open
Abstract
Autoimmune thyroid diseases (AITD) are common, affecting 2-5% of the general population. Individuals with positive thyroid peroxidase antibodies (TPOAbs) have an increased risk of autoimmune hypothyroidism (Hashimoto's thyroiditis), as well as autoimmune hyperthyroidism (Graves' disease). As the possible causative genes of TPOAbs and AITD remain largely unknown, we performed GWAS meta-analyses in 18,297 individuals for TPOAb-positivity (1769 TPOAb-positives and 16,528 TPOAb-negatives) and in 12,353 individuals for TPOAb serum levels, with replication in 8,990 individuals. Significant associations (P<5×10(-8)) were detected at TPO-rs11675434, ATXN2-rs653178, and BACH2-rs10944479 for TPOAb-positivity, and at TPO-rs11675434, MAGI3-rs1230666, and KALRN-rs2010099 for TPOAb levels. Individual and combined effects (genetic risk scores) of these variants on (subclinical) hypo- and hyperthyroidism, goiter and thyroid cancer were studied. Individuals with a high genetic risk score had, besides an increased risk of TPOAb-positivity (OR: 2.18, 95% CI 1.68-2.81, P = 8.1×10(-8)), a higher risk of increased thyroid-stimulating hormone levels (OR: 1.51, 95% CI 1.26-1.82, P = 2.9×10(-6)), as well as a decreased risk of goiter (OR: 0.77, 95% CI 0.66-0.89, P = 6.5×10(-4)). The MAGI3 and BACH2 variants were associated with an increased risk of hyperthyroidism, which was replicated in an independent cohort of patients with Graves' disease (OR: 1.37, 95% CI 1.22-1.54, P = 1.2×10(-7) and OR: 1.25, 95% CI 1.12-1.39, P = 6.2×10(-5)). The MAGI3 variant was also associated with an increased risk of hypothyroidism (OR: 1.57, 95% CI 1.18-2.10, P = 1.9×10(-3)). This first GWAS meta-analysis for TPOAbs identified five newly associated loci, three of which were also associated with clinical thyroid disease. With these markers we identified a large subgroup in the general population with a substantially increased risk of TPOAbs. The results provide insight into why individuals with thyroid autoimmunity do or do not eventually develop thyroid disease, and these markers may therefore predict which TPOAb-positives are particularly at risk of developing clinical thyroid dysfunction.
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Affiliation(s)
- Marco Medici
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- * E-mail:
| | - Eleonora Porcu
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
- Dipartimento di Scienze Biomediche, Universita di Sassari, Sassari, Italy
| | - Giorgio Pistis
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Alexander Teumer
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - Suzanne J. Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Richard A. Jensen
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, Washington, United States of America
| | - Rajesh Rawal
- Institute for Genetic Epidemiology, Helmholtz Zentrum Munich, Munich/Neuherberg, Germany
| | - Greet L. Roef
- Department of Endocrinology and Internal Medicine, University Hospital Ghent and Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Theo S. Plantinga
- Internal Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Sita H. Vermeulen
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Matthew J. Simmonds
- Oxford Centre for Diabetes, Endocrinology and Metabolism and NIHR Oxford Biomedical Research Centre, Oxford, UK Churchill Hospital, Headington, Oxford, United Kingdom
| | - Lise Lotte N. Husemoen
- Research Centre for Prevention and Health, Glostrup University Hospital, the Capital Region of Denmark, Glostrup, Denmark
| | - Rachel M. Freathy
- Genetics of Complex Traits, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Beverley M. Shields
- Peninsula NIHR Clinical Research Facility, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Diana Pietzner
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Rebecca Nagy
- Comprehensive Cancer Center, Ohio State University, Columbus, Ohio, United States of America
| | - Linda Broer
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Layal Chaker
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tim I. M. Korevaar
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maria Grazia Plia
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Cinzia Sala
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - J. Brent Richards
- Departments of Medicine, Human Genetics, Epidemiology and Biostatistics, Lady Davis Institute, McGill University, Montreal, Canada
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Fred C. Sweep
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Christian Gieger
- Institute for Genetic Epidemiology, Helmholtz Zentrum Munich, Munich/Neuherberg, Germany
| | - Tanguy Corre
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland
- Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Betina Thuesen
- Research Centre for Prevention and Health, Glostrup University Hospital, the Capital Region of Denmark, Glostrup, Denmark
| | - Youri E. Taes
- Department of Endocrinology and Internal Medicine, University Hospital Ghent and Faculty of Medicine, Ghent University, Ghent, Belgium
| | - W. Edward Visser
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Andrew T. Hattersley
- Peninsula NIHR Clinical Research Facility, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Alexander Hamilton
- Oxford Centre for Diabetes, Endocrinology and Metabolism and NIHR Oxford Biomedical Research Centre, Oxford, UK Churchill Hospital, Headington, Oxford, United Kingdom
| | - Wei Li
- Comprehensive Cancer Center, Ohio State University, Columbus, Ohio, United States of America
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - Monia Lobina
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Stefano Mariotti
- Dipartimento di Scienze Biomediche, Universita di Sassari, Sassari, Italy
| | | | - Massimiliano Cocca
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christin Spielhagen
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Alec Ross
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Alice Arnold
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Martijn van de Bunt
- Oxford Centre for Diabetes, Endocrinology and Metabolism and NIHR Oxford Biomedical Research Centre, Oxford, UK Churchill Hospital, Headington, Oxford, United Kingdom
| | - Sandya Liyanarachchi
- Comprehensive Cancer Center, Ohio State University, Columbus, Ohio, United States of America
| | - Margit Heier
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany
| | - Hans Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, HELIOS Hospital Stralsund, Greifswald, Germany
| | - Corrado Masciullo
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Tessel E. Galesloot
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ee M. Lim
- Pathwest Laboratory Medicine WA, Nedlands, Western Australia, Australia
| | - Eva Reischl
- Research Unit of Molecular Epidemiology Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Peter J. Leedman
- School of Medicine and Pharmacology, the University of Western Australia, Crawley, Western Australia, Australia
- UWA Centre for Medical Research, Western Australian Institute for Medical Research, Perth, Western Australia, Australia
| | - Sandra Lai
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | | | - Alexandra P. Bremner
- School of Population Health, University of Western Australia, Nedlands, Western Australia, Australia
| | - David I. W. Philips
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, United Kingdom
| | - John P. Beilby
- Pathwest Laboratory Medicine WA, Nedlands, Western Australia, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Antonella Mulas
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Matteo Vocale
- High Performance Computing and Network, CRS4, Parco Tecnologico della Sardegna, Pula, Italy
| | - Goncalo Abecasis
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Tom Forsen
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
- Vaasa Health Care Centre, Diabetes Unit, Vaasa, Finland
| | - Alan James
- School of Medicine and Pharmacology, the University of Western Australia, Crawley, Western Australia, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Jennie Hui
- Pathwest Laboratory Medicine WA, Nedlands, Western Australia, Australia
| | - Holger Prokisch
- Institute of Human Genetics, Helmholtz Zentrum Munich, Munich, Germany
- Institute of Human Genetics, Technische Universität München, Munich, Germany
| | - Ernst E. Rietzschel
- Department of Cardiology and Internal Medicine, University Hospital Ghent and Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, United Kingdom
- Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, Finland
| | | | | | - Katharina Schramm
- Institute of Human Genetics, Helmholtz Zentrum Munich, Munich, Germany
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute, Torrance, California, United States of America
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Dörte Radke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Michela Traglia
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Gabriela L. Surdulescu
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Huiling He
- Comprehensive Cancer Center, Ohio State University, Columbus, Ohio, United States of America
| | - Jayne A. Franklyn
- School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, Univeristy of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Daniel Tiller
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Bijay Vaidya
- Diabetes, Endocrinology and Vascular Health Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Tim de Meyer
- BIOBIX Lab. for Bioinformatics and Computational Genomics, Dept. of Mathematical Modelling, Statistics and Bioinformatics. Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Torben Jørgensen
- Research Centre for Prevention and Health, Glostrup University Hospital, the Capital Region of Denmark, Glostrup, Denmark
- Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Johan G. Eriksson
- National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland
- Folkhalsan Research Centre, Helsinki, Finland
- Vasa Central Hospital, Vasa, Finland
| | - Peter C. O'Leary
- School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia
- Curtin Health Innovation Research Institute, Curtin University of Technology, Bentley, Western Australia, Australia
| | - Eric Wichmann
- Institute of Epidemiology I, Helmholtz Zentrum Munich, Munich, Germany
| | - Ad R. Hermus
- Internal Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, Washington, United States of America
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington, United States of America
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Emanuele Bosi
- Department of Internal Medicine, Diabetes & Endocrinology Unit, San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - David Schlessinger
- Laboratory of Genetics, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Henri Wallaschofski
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Nicola Pirastu
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, Trieste, Italy
- University of Trieste, Trieste, Italy
| | - Yurii S. Aulchenko
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Albert de la Chapelle
- Comprehensive Cancer Center, Ohio State University, Columbus, Ohio, United States of America
| | - Romana T. Netea-Maier
- Internal Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Stephen C. L. Gough
- Oxford Centre for Diabetes, Endocrinology and Metabolism and NIHR Oxford Biomedical Research Centre, Oxford, UK Churchill Hospital, Headington, Oxford, United Kingdom
| | | | - Timothy M. Frayling
- Genetics of Complex Traits, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Jean-Marc Kaufman
- Department of Endocrinology and Internal Medicine, University Hospital Ghent and Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Allan Linneberg
- Research Centre for Prevention and Health, Glostrup University Hospital, the Capital Region of Denmark, Glostrup, Denmark
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Johannes W. A. Smit
- Internal Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Lambertus A. Kiemeney
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Netherlands Consortium for Healthy Aging, Netherlands Genomics Initiative, Leiden, The Netherlands
| | - André G. Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Netherlands Consortium for Healthy Aging, Netherlands Genomics Initiative, Leiden, The Netherlands
| | - John P. Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Medicine and Pharmacology, the University of Western Australia, Crawley, Western Australia, Australia
| | - Christa Meisinger
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany
| | - Martin den Heijer
- Department of Internal Medicine, VU Medical Center, Amsterdam, The Netherlands
| | - Theo J. Visser
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Timothy D. Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Scott G. Wilson
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Medicine and Pharmacology, the University of Western Australia, Crawley, Western Australia, Australia
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anne Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Daniela Toniolo
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
- Institute of Molecular Genetics-CNR, Pavia, Italy
| | - Serena Sanna
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Silvia Naitza
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Robin P. Peeters
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
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Lewis JR, Lim WH, Zhu K, Wong G, Dhaliwal SS, Lim EM, Ueland T, Bollerslev J, Prince RL. Elevated osteoprotegerin predicts declining renal function in elderly women: a 10-year prospective cohort study. Am J Nephrol 2014; 39:66-74. [PMID: 24457210 DOI: 10.1159/000357787] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 12/04/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Elevated osteoprotegerin (OPG) levels are inversely correlated with creatinine clearance and end-stage renal disease in patients with diabetes, however its role in predicting decline in renal function and progression to a more advanced stage disease in the elderly general population is unknown. METHODS This was a prospective cohort study of 1,157 elderly women with serum OPG measured in 1998 and renal function estimated using serum creatinine and cystatin C-based estimated glomerular filtration rate (eGFR) at 5-yearly intervals. The primary objective of the study was to determine the relationship of circulating OPG levels with 5- and 10-year renal decline. RESULTS At baseline, participants with elevated OPG above the median (≥2.2 ng/ml) had a 5.0% lower CKD-EPI-creatinine and cystatin C eGFR compared to participants with lower OPG levels. In multivariable-adjusted linear regression models, elevated OPG levels at baseline were associated with greater 5- and 10-year decline in CKD-EPI-creatinine and cystatin C eGFR (-0.105, p = 0.002 and -0.104, p = 0.010, respectively). Elevated OPG at baseline was associated with increased 5- and 10-year risk of rapid renal decline (OR 2.13, 95% CI 1.33-3.43, p = 0.002 and OR 4.10, 95% CI 1.49-11.27, p = 0.006, respectively) and renal disease hospitalizations or deaths (HR 1.99, 95% CI 1.31-3.03, p = 0.001) after adjusting for known risk factors. CONCLUSION Elevated OPG levels are associated with long-term renal dysfunction and may be provide a useful biomarker to predict the trajectory of renal decline in older women.
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Affiliation(s)
- Joshua R Lewis
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, W.A, Australia
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Ivey KL, Lewis JR, Lim WH, Lim EM, Hodgson JM, Prince RL. Associations of proanthocyanidin intake with renal function and clinical outcomes in elderly women. PLoS One 2013; 8:e71166. [PMID: 23940710 PMCID: PMC3734096 DOI: 10.1371/journal.pone.0071166] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 07/01/2013] [Indexed: 11/19/2022] Open
Abstract
Background Progression to chronic renal failure involves accelerated atherosclerosis and vascular calcification. Oxidative stress and endothelial dysfunction play a role in renal failure pathophysiology. In addition to improving vascular health and function, proanthocyanidins have been shown to exert renoprotective effects in animal models. Thus we hypothesize that proanthocyanidins may contribute to the maintenance of healthy renal function. Objective Determine the association of habitual proanthocyanidin intake with renal function and the risk of clinical renal outcomes in a population of elderly women. Design 948 women aged over 75 y, free of prevalent renal disease at baseline, were randomly selected from ambulant Caucasian women. Proanthocyanidin consumption was determined using a validated food frequency questionnaire and the United States Department of Agriculture proanthocyanidin food content database. Fasting serum cystatin C and creatinine were assessed at baseline. Renal failure hospitalisations and deaths were assessed over 5 years of follow-up through the Western Australia Data Linkage System. Results Compared to participants with low consumption, participants in the highest tertile of proanthocyanidin intake had a 9% lower cystatin C concentration (P<0.001). High proanthocyanidin consumers were at 50% lower risk of moderate chronic kidney insufficiency, and 65% lower risk of experiencing a 5-year renal disease event (P<0.05). These relationships remained significant following adjustment for renal disease risk factors and diet-related potential confounders. Conclusion Increased consumption of proanthocyanidins was associated with better renal function and substantially reduced renal associated events, which has been supported by mechanistic and animal model data. Proanthocyanidin intake should be further examined as a dietary contributor to better renal health.
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Affiliation(s)
- Kerry L Ivey
- School of Medicine and Pharmacology Sir Charles Gairdner Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.
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Yong K, Ooi EM, Dogra G, Mannion M, Boudville N, Chan D, Lim EM, Lim WH. Elevated interleukin-12 and interleukin-18 in chronic kidney disease are not associated with arterial stiffness. Cytokine 2013; 64:39-42. [PMID: 23778029 DOI: 10.1016/j.cyto.2013.05.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 05/20/2013] [Accepted: 05/23/2013] [Indexed: 01/04/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) patients are at increased risk of cardiovascular disease (CVD) mortality compared to the general population. Evidence suggests inflammation is important in the pathogenesis of CVD in CKD and inflammatory bio-markers such as C-reactive protein (CRP) and pro-atherogenic cytokines such as interleukin(IL)-6, IL-12 and IL-18 are associated with CVD-related outcomes in the general population and CKD. In the general population, IL-12 and IL-18 are implicated in the pathogenesis of atherosclerosis and are associated with acute CVD events, including mortality. Although IL-12 and IL-18 are increased in CKD, extrapolating an equally important role for these cytokines in the pathogenesis of CVD in CKD remains uncertain. In this study we aim to compare serum levels of pro-atherogenic cytokines in non-dialysis CKD patients and healthy individuals. We will also assess the relationship between these cytokines and arterial stiffness, a surrogate marker of CVD. METHODS We performed a case-control study examining IL-12, IL-18, aortic pulse wave velocity (PWV) and augmentation index (AIx) in healthy volunteers (n=69) and stage 3-4 (n=70) and stage 5 (n=84) CKD subjects. RESULTS IL12 levels were elevated in stage 3-4 (129 pg/mL; IQR 56-222) and stage 5 (125 pg/mL; IQR 45-240) CKD in comparison to healthy controls (65 pg/mL; IQR 5-229). IL18 was elevated in CKD stage 5 (617 pg/mL; IQR 468-793) in comparison to CKD stage 3-4 (417 pg/mL; IQR 288-494) and healthy controls (359 pg/mL; IQR 238-548). In multivariate analysis, only glomerular filtration rate (GFR) remained an independent predictor of IL-18 (p<0.01). Neither IL-12 nor IL-18 were associated with PWV or AIx. CONCLUSION IL-12 and IL-18 are elevated during the earlier stages of CKD but are not associated with arterial stiffness. The association with GFR suggests that IL-18 is largely dependent upon renal clearance.
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Affiliation(s)
- Kenneth Yong
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia; School of Medicine & Pharmacology, University of Western Australia, Perth, Australia.
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Lim WH, Lewis JR, Wong G, Dogra GK, Zhu K, Lim EM, Dhaliwal SS, Prince RL. Five-year decline in estimated glomerular filtration rate associated with a higher risk of renal disease and atherosclerotic vascular disease clinical events in elderly women. QJM 2013; 106:443-50. [PMID: 23407347 DOI: 10.1093/qjmed/hct043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Estimated glomerular filtration rate (eGFR) has been demonstrated to predict atherosclerotic vascular disease (ASVD)-associated clinical events independent of traditional vascular risk factors. Recent studies have demonstrated that eGFR decline over time may improve prediction of ASVD-associated mortality risk in chronic kidney disease (CKD) patients. AIM The aim of this study is to evaluate the association between 5-year change in eGFR with renal disease and ASVD-associated clinical events. DESIGN Prospective observational study. METHODS A total of 1012 women over the age of 70 years from the Calcium Intake Fracture Outcome Study were included. Baseline characteristics including baseline and 5-year creatinine, participants' comorbidities and complete verified 10-year records for ASVD and renal disease-associated hospitalization and/or mortality were obtained using the Western Australian Data Linkage System. RESULTS Participants were stratified according to annual rate of eGFR change in quartiles [≤-1.2 (first quartile), >-1.2 to 0.1 (second quartile), >0.1-1.7 (third quartile) and >1.7 ml/min/1.73 m(2)/year (fourth quartile)]. In the adjusted model, compared with participants in the fourth quartile, those in the first and/or second quartiles of annual eGFR change had significantly higher risk of renal disease and/or ASVD-associated clinical events. However, the association with renal clinical events was more pparent in participants with baseline eGFR of <60 ml/min/1.73 m(2). CONCLUSION The results of this study suggest that the inclusion of long-term eGFR change over time might augment prognostication for renal disease and ASVD-associated clinical events in elderly women.
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Affiliation(s)
- W H Lim
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Western Australia, Australia.
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Porcu E, Medici M, Pistis G, Volpato CB, Wilson SG, Cappola AR, Bos SD, Deelen J, den Heijer M, Freathy RM, Lahti J, Liu C, Lopez LM, Nolte IM, O'Connell JR, Tanaka T, Trompet S, Arnold A, Bandinelli S, Beekman M, Böhringer S, Brown SJ, Buckley BM, Camaschella C, de Craen AJM, Davies G, de Visser MCH, Ford I, Forsen T, Frayling TM, Fugazzola L, Gögele M, Hattersley AT, Hermus AR, Hofman A, Houwing-Duistermaat JJ, Jensen RA, Kajantie E, Kloppenburg M, Lim EM, Masciullo C, Mariotti S, Minelli C, Mitchell BD, Nagaraja R, Netea-Maier RT, Palotie A, Persani L, Piras MG, Psaty BM, Räikkönen K, Richards JB, Rivadeneira F, Sala C, Sabra MM, Sattar N, Shields BM, Soranzo N, Starr JM, Stott DJ, Sweep FCGJ, Usala G, van der Klauw MM, van Heemst D, van Mullem A, H.Vermeulen S, Visser WE, Walsh JP, Westendorp RGJ, Widen E, Zhai G, Cucca F, Deary IJ, Eriksson JG, Ferrucci L, Fox CS, Jukema JW, Kiemeney LA, Pramstaller PP, Schlessinger D, Shuldiner AR, Slagboom EP, Uitterlinden AG, Vaidya B, Visser TJ, Wolffenbuttel BHR, Meulenbelt I, Rotter JI, Spector TD, Hicks AA, Toniolo D, Sanna S, Peeters RP, Naitza S. A meta-analysis of thyroid-related traits reveals novel loci and gender-specific differences in the regulation of thyroid function. PLoS Genet 2013; 9:e1003266. [PMID: 23408906 PMCID: PMC3567175 DOI: 10.1371/journal.pgen.1003266] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 11/12/2012] [Indexed: 12/15/2022] Open
Abstract
Thyroid hormone is essential for normal metabolism and development, and overt abnormalities in thyroid function lead to common endocrine disorders affecting approximately 10% of individuals over their life span. In addition, even mild alterations in thyroid function are associated with weight changes, atrial fibrillation, osteoporosis, and psychiatric disorders. To identify novel variants underlying thyroid function, we performed a large meta-analysis of genome-wide association studies for serum levels of the highly heritable thyroid function markers TSH and FT4, in up to 26,420 and 17,520 euthyroid subjects, respectively. Here we report 26 independent associations, including several novel loci for TSH (PDE10A, VEGFA, IGFBP5, NFIA, SOX9, PRDM11, FGF7, INSR, ABO, MIR1179, NRG1, MBIP, ITPK1, SASH1, GLIS3) and FT4 (LHX3, FOXE1, AADAT, NETO1/FBXO15, LPCAT2/CAPNS2). Notably, only limited overlap was detected between TSH and FT4 associated signals, in spite of the feedback regulation of their circulating levels by the hypothalamic-pituitary-thyroid axis. Five of the reported loci (PDE8B, PDE10A, MAF/LOC440389, NETO1/FBXO15, and LPCAT2/CAPNS2) show strong gender-specific differences, which offer clues for the known sexual dimorphism in thyroid function and related pathologies. Importantly, the TSH-associated loci contribute not only to variation within the normal range, but also to TSH values outside the reference range, suggesting that they may be involved in thyroid dysfunction. Overall, our findings explain, respectively, 5.64% and 2.30% of total TSH and FT4 trait variance, and they improve the current knowledge of the regulation of hypothalamic-pituitary-thyroid axis function and the consequences of genetic variation for hypo- or hyperthyroidism. Levels of thyroid hormones are tightly regulated by TSH produced in the pituitary, and even mild alterations in their concentrations are strong indicators of thyroid pathologies, which are very common worldwide. To identify common genetic variants associated with the highly heritable markers of thyroid function, TSH and FT4, we conducted a meta-analysis of genome-wide association studies in 26,420 and 17,520 individuals, respectively, of European ancestry with normal thyroid function. Our analysis identified 26 independent genetic variants regulating these traits, several of which are new, and confirmed previously detected polymorphisms affecting TSH (within the PDE8B gene and near CAPZB, MAF/LOC440389, and NR3C2) and FT4 (within DIO1) levels. Gender-specific differences in the genetic effects of several variants for TSH and FT4 levels were identified at several loci, which offer clues to understand the known sexual dimorphism in thyroid function and pathology. Of particular clinical interest, we show that TSH-associated loci contribute not only to normal variation, but also to TSH values outside reference range, suggesting that they may be involved in thyroid dysfunction. Overall, our findings add to the developing landscape of the regulation of thyroid homeostasis and the consequences of genetic variation for thyroid related diseases.
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Affiliation(s)
- Eleonora Porcu
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
- Dipartimento di Scienze Biomediche, Università di Sassari, Sassari, Italy
| | - Marco Medici
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Giorgio Pistis
- Division of Genetics and Cell Biology, San Raffaele Research Institute, Milano, Italy
- Università degli Studi di Trieste, Trieste, Italy
| | - Claudia B. Volpato
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy (Affiliated Institute of the University of Lübeck, Lübeck, Germany)
| | - Scott G. Wilson
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | - Anne R. Cappola
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Steffan D. Bos
- Leiden University Medical Center, Molecular Epidemiology, Leiden, The Netherlands
- Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - Joris Deelen
- Leiden University Medical Center, Molecular Epidemiology, Leiden, The Netherlands
- Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - Martin den Heijer
- Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department of Internal Medicine, Free University Medical Center, Amsterdam, The Netherlands
| | - Rachel M. Freathy
- Genetics of Complex Traits, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, United Kingdom
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Chunyu Liu
- Center for Population Studies, National Heart, Lung, and Blood Institute, Framingham, Massachusetts, United States of America
| | - Lorna M. Lopez
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Ilja M. Nolte
- Unit of Genetic Epidemiology and Bioinformatics, Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jeffrey R. O'Connell
- Department of Medicine, University of Maryland Medical School, Baltimore, Maryland, United States of America
| | - Toshiko Tanaka
- Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Alice Arnold
- Cardiovascular Health Research Unit and Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | | | - Marian Beekman
- Leiden University Medical Center, Molecular Epidemiology, Leiden, The Netherlands
- Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - Stefan Böhringer
- Leiden University Medical Center, Medical Statistics and Bioinformatics, Leiden, The Netherlands
| | - Suzanne J. Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Brendan M. Buckley
- Department of Pharmacology and Therapeutics, University College Cork, Cork, Ireland
| | - Clara Camaschella
- Division of Genetics and Cell Biology, San Raffaele Research Institute, Milano, Italy
- Vita e Salute University, San Raffaele Scientific Institute, Milano, Italy
| | - Anton J. M. de Craen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Gail Davies
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Marieke C. H. de Visser
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ian Ford
- Robertson Center for Biostatistics, University of Glasgow, Glasgow, United Kingdom
| | - Tom Forsen
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland
- Vaasa Health Care Centre, Diabetes Unit, Vaasa, Finland
| | - Timothy M. Frayling
- Genetics of Complex Traits, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, United Kingdom
| | - Laura Fugazzola
- Endocrine Unit, Fondazione Ca' Granda Policlinico and Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Martin Gögele
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy (Affiliated Institute of the University of Lübeck, Lübeck, Germany)
| | - Andrew T. Hattersley
- Peninsula NIHR Clinical Research Facility, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, United Kingdom
| | - Ad R. Hermus
- Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)–sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam, The Netherlands
| | | | - Richard A. Jensen
- Cardiovascular Health Research Unit and Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Eero Kajantie
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
- Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Margreet Kloppenburg
- Department of Clinical Epidemiology and Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ee M. Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Pathwest Laboratory Medicine WA, Nedlands, Western Australia, Australia
| | - Corrado Masciullo
- Division of Genetics and Cell Biology, San Raffaele Research Institute, Milano, Italy
| | - Stefano Mariotti
- Dipartimento di Scienze Mediche, Università di Cagliari, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Cosetta Minelli
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy (Affiliated Institute of the University of Lübeck, Lübeck, Germany)
| | - Braxton D. Mitchell
- Department of Medicine, University of Maryland Medical School, Baltimore, Maryland, United States of America
| | - Ramaiah Nagaraja
- Laboratory of Genetics, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Romana T. Netea-Maier
- Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Aarno Palotie
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, United Kingdom
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, Finland
| | - Luca Persani
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
- Division of Endocrinology and Metabolic Diseases, IRCCS Ospedale San Luca, Milan, Italy
| | - Maria G. Piras
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, Washington, United States of America
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington, United States of America
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - J. Brent Richards
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Department of Medicine, Jewish General Hospital, McGill University, Montréal, Québec, Canada
- Departments of Human Genetics, Epidemiology, and Biostatistics, Jewish General Hospital, Lady Davis Institute, McGill University, Montréal, Québec
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)–sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam, The Netherlands
| | - Cinzia Sala
- Division of Genetics and Cell Biology, San Raffaele Research Institute, Milano, Italy
| | - Mona M. Sabra
- Memorial Sloan Kettering Cancer Center, Medicine-Endocrinology, New York, New York, United States of America
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine, Glasgow, United Kingdom
| | - Beverley M. Shields
- Peninsula NIHR Clinical Research Facility, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, United Kingdom
| | - Nicole Soranzo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, United Kingdom
| | - John M. Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - David J. Stott
- Academic Section of Geriatric Medicine, Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Fred C. G. J. Sweep
- Department of Laboratory Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Gianluca Usala
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Melanie M. van der Klauw
- LifeLines Cohort Study, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Diana van Heemst
- Leiden University Medical Center, Gerontology and Geriatrics, Leiden, The Netherlands
| | - Alies van Mullem
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Sita H.Vermeulen
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W. Edward Visser
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - John P. Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | - Rudi G. J. Westendorp
- Leiden University Medical Center, Gerontology and Geriatrics, Leiden, The Netherlands
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Guangju Zhai
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland, Canada
| | - Francesco Cucca
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
- Dipartimento di Scienze Biomediche, Università di Sassari, Sassari, Italy
| | - Ian J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Johan G. Eriksson
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland
- Folkhalsan Research Centre, Helsinki, Finland
- Vasa Central Hospital, Vasa, Finland
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Caroline S. Fox
- Division of Intramural Research, National Heart, Lung, and Blood Institute, Framingham, Massachusetts, United States of America
- Division of Endocrinology, Hypertension, and Metabolism, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Lambertus A. Kiemeney
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Peter P. Pramstaller
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy (Affiliated Institute of the University of Lübeck, Lübeck, Germany)
- Department of Neurology, General Central Hospital, Bolzano, Italy
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - David Schlessinger
- Laboratory of Genetics, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Alan R. Shuldiner
- Department of Medicine, University of Maryland Medical School, Baltimore, Maryland, United States of America
- Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, Maryland, United States of America
| | - Eline P. Slagboom
- Leiden University Medical Center, Molecular Epidemiology, Leiden, The Netherlands
- Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - André G. Uitterlinden
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)–sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam, The Netherlands
| | - Bijay Vaidya
- Diabetes, Endocrinology and Vascular Health Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Theo J. Visser
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Bruce H. R. Wolffenbuttel
- LifeLines Cohort Study, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ingrid Meulenbelt
- Leiden University Medical Center, Molecular Epidemiology, Leiden, The Netherlands
- Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - Jerome I. Rotter
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Andrew A. Hicks
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy (Affiliated Institute of the University of Lübeck, Lübeck, Germany)
| | - Daniela Toniolo
- Division of Genetics and Cell Biology, San Raffaele Research Institute, Milano, Italy
- Institute of Molecular Genetics–CNR, Pavia, Italy
| | - Serena Sanna
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
- * E-mail: (S Sanna); (RP Peeters); (S Naitza)
| | - Robin P. Peeters
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- * E-mail: (S Sanna); (RP Peeters); (S Naitza)
| | - Silvia Naitza
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
- * E-mail: (S Sanna); (RP Peeters); (S Naitza)
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Yong K, Dogra G, Boudville N, Chan D, Adams L, Ching H, Lim EM, Lim WH. Interleukin-12 is associated with arterial stiffness in healthy individuals. Am J Hypertens 2013; 26:159-62. [PMID: 23382399 DOI: 10.1093/ajh/hps032] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Atherosclerotic cardiovascular disease (CVD) is a chronic inflammatory disease mediated by the proinflammatory cytokines interleukin-12 (IL-12) and interleukin-18 (IL-18). Evidence suggests that IL-12 is dominant in early atherosclerosis, while IL-18 is critical in advanced atherosclerosis. In this study, we explore the association between IL-12 and IL-18 and arterial stiffness in healthy individuals. METHODS We performed a cross-sectional study examining pulse wave velocity (PWV), augmentation index (AIx), IL-12, and IL-18 in healthy individuals (N = 53) without CVD risk factors. RESULTS In multivariate regression, age (P < 0.01), systolic blood pressure (P = 0.05), and IL-12 (P < 0.01) were positively associated with PWV, and high-density lipoprotein (P = 0.04) was negatively associated with PWV (model R (2) = 0.476, P < 0.01). CONCLUSIONS IL-12, but not IL-18, is associated with PWV in healthy individuals without clinical CVD, supporting a role for IL-12 in early atherosclerosis as suggested by animal studies.
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Affiliation(s)
- Kenneth Yong
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia.
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Abstract
OBJECTIVE The use of age-specific reference ranges for TSH is advocated, but the impact of this on laboratory diagnosis of thyroid dysfunction is unclear. Our aims were to determine age-specific TSH reference ranges and to examine interassay differences in performance. DESIGN We analysed TSH results from 223,045 consecutive samples assayed over 1 year by a single pathology provider using the Siemens Centaur assay. We excluded patients with evidence of thyroid disease to derive a reference population of 148,938 individuals and analysed results in the 5-year age bands. We reassayed 120 samples using three other methods (Architect, Roche and Immulite) to assess precision and bias. RESULTS The 2·5th percentile for TSH was consistent across age groups (approximately 0·5 mU/l), whereas the 97·5th percentile increased from age 40 upwards, with the reference range upper limit being 3·75 mU/l at age 40 and 5·0 mU/l at age 90. In most age bands, the use of age-specific upper limits reclassified only 0·1-1·9% of participants as normal or abnormal compared with a common cut-off of 4·0 mU/l; in participants aged 85 years or more, reclassification rates were higher (2·1-4·7%). The four TSH assays showed good agreement at low-normal TSH concentrations (<2 mU/l), but at concentrations of 4·0 mU/l, there were intermethod differences of approximately 1 mU/l. CONCLUSION The use of age-specific reference ranges for TSH has only minor effects on thyroid status, except in the very old. At high-normal TSH concentrations, between-method differences in performance have a comparable impact to that of age and may affect clinical decision-making.
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Panicker V, Wilson SG, Walsh JP, Richards JB, Brown SJ, Beilby JP, Bremner AP, Surdulescu GL, Qweitin E, Gillham-Nasenya I, Soranzo N, Lim EM, Fletcher SJ, Spector TD. A locus on chromosome 1p36 is associated with thyrotropin and thyroid function as identified by genome-wide association study. Am J Hum Genet 2010; 87:430-5. [PMID: 20826269 DOI: 10.1016/j.ajhg.2010.08.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 07/21/2010] [Accepted: 08/13/2010] [Indexed: 10/19/2022] Open
Abstract
Thyroid hormones are key regulators of cellular growth, development, and metabolism, and thyroid disorders are a common cause of ill health in the community. Circulating concentrations of thyrotropin (TSH), thyroxine (T4) and triiodothyronine (T3) have a strong heritable component and are thought to be under polygenic control, but the genes responsible are mostly unknown. In order to identify genetic loci associated with these metabolic phenotypes, we performed a genome-wide association study of 2,120,505 SNPs in 2014 female twins from the TwinsUK study and found a significant association between rs10917469 on chromosome 1p36.13 and serum TSH (p = 3.2 × 10(-8)). The association of rs10917469 with serum TSH was replicated (p = 2.0 × 10(-4)) in an independent community-based sample of 1154 participants in the Busselton Health Study. This SNP is located near CAPZB, which might be a regulator of TSH secretion and thus of pituitary-thyroid axis function. Twenty-nine percent of white individuals carry the variant, and the difference in mean TSH concentrations between wild-type individuals and those homozygous for the minor G allele was 0.5 mU/l, which is likely to be clinically relevant. We also provide evidence of suggestive association (p < 5.0 × 10(-6)) of other SNPs with serum TSH, free T4, and free T3 concentrations, and these SNPs might be good targets for further studies. These results advance understanding of the genetic basis of pituitary-thyroid axis function and metabolic regulation.
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Panicker V, Wilson SG, Spector TD, Brown SJ, Kato BS, Reed PW, Falchi M, Richards JB, Surdulescu GL, Lim EM, Fletcher SJ, Walsh JP. Genetic loci linked to pituitary-thyroid axis set points: a genome-wide scan of a large twin cohort. J Clin Endocrinol Metab 2008; 93:3519-23. [PMID: 18611976 DOI: 10.1210/jc.2007-2650] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Previous studies have shown that circulating concentrations of TSH, free T4, and free T3 are genetically regulated, but the genes responsible remain largely unknown. The aim of this study was to identify genetic loci associated with these parameters. DESIGN We performed a multipoint, nonparametric genome-wide linkage scan of 613 female dizygotic twin pairs. All subjects were euthyroid (TSH 0.4-4.0 mU/liter) with negative thyroid peroxidase antibodies and no history of thyroid disease. The genome scan comprised 737 microsatellite markers supplemented with dinucleotide markers. Data were analyzed using residualized thyroid hormone data after adjustment for age, smoking, and body mass index. RESULTS Multipoint linkage analysis gave linkage peaks for free T4 on chromosome 14q13 and 18q21 [logarithm of odds (LOD) 2.4-3.2]; TSH on chromosomes 2q36, 4q32, and 9q34 (LOD 2.1-3.2); and free T3 on chromosomes 7q36, 8q22, and 18q21 (LOD 2.0-2.3). CONCLUSIONS This study has identified eight genomic locations with linkage of LOD of 2.0 or greater. These results should enable targeted positional candidate and positional cloning studies to advance our understanding of genetic control of the pituitary-thyroid axis.
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Affiliation(s)
- Vijay Panicker
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia 6009
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Panicker V, Wilson SG, Spector TD, Brown SJ, Falchi M, Richards JB, Surdulescu GL, Lim EM, Fletcher SJ, Walsh JP. Heritability of serum TSH, free T4 and free T3 concentrations: a study of a large UK twin cohort. Clin Endocrinol (Oxf) 2008; 68:652-9. [PMID: 17970774 DOI: 10.1111/j.1365-2265.2007.03079.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Thyroid hormone action influences many metabolic and synthetic processes, but the degree of regulation attributed to genes and environmental factors affecting normal variation remains controversial. DESIGN We investigated the magnitude of the genetic and environmental determination of serum concentrations of free (f) T3, fT4, TSH and the fT4 x TSH product and their variation, in a large cohort of twin pairs. Female dizygous and monozygous twins (849 and 213 pairs, respectively) from the TwinsUK registry (mean age 45.5, range 18-80 years) were studied. RESULTS Comparison of thyroid parameters within various groups showed no differences between smoking categories, and higher serum TSH and lower fT3 in subjects with positive thyroid antibodies. Using structural equation modelling, we estimated the heritable contribution to serum thyroid parameters (with 95% confidence intervals) to be 65% (58%-71%) for TSH, 65% (58%-71%) for the fT4 x TSH product, 39% (20%-55%) for fT4 and 23% (3%-41%) for fT3. CONCLUSIONS We conclude that genetic regulation is a particularly important determinant of TSH and the fT4 x TSH product, and is a less important determinant of fT4 and fT3 concentrations in Caucasian women. These data from a large well-characterized cohort suggest that while there is a strong heritable contribution to serum TSH, variation in fT4 and fT3 concentrations may be less explained by genetic factors and more driven by environmental effects than previously thought.
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Affiliation(s)
- V Panicker
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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Lim WH, Lim EM, McDonald S. Lean body mass-adjusted Cockcroft and Gault formula improves the estimation of glomerular filtration rate in subjects with normal-range serum creatinine. Nephrology (Carlton) 2006; 11:250-6. [PMID: 16756641 DOI: 10.1111/j.1440-1797.2006.00560.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Assessment of glomerular filtration rate (GFR) in individuals with normal-range serum creatinine is important in certain clinical situations, such as in potential living kidney donors. Accurate measurements of GFR invariably involve using an invasive method (e.g. inulin clearances), but is inconvenient. The aim of the present study was to determine whether serum creatinine-based prediction formulae adjusted for lean body mass (LBM) could improve the accuracy of GFR estimation in these subjects. METHODS Glomerular filtration rate was determined by the clearance of technetium-99m-labelled diethylenetriamine penta-acetic acid ((99m)Tc DTPA) from plasma in 56 subjects with normal serum creatinine. For each subject, GFR was estimated using prediction formulae +/- LBM adjustment and compared with measured GFR. Formulae analysed include Cockcroft-Gault, Levey, Gates, Mawer, Hull, Toto, Jellife and Bjornsson. RESULTS All formulae +/- LBM adjustment underestimated measured GFR, with poor precision, poor agreement and correlation (r (2) <or= 0.25). Between 69% and 95% of the estimated GFR determined by the formulae correctly classified those with a normal measured GFR. LBM-adjusted formulae significantly improved the accuracy of GFR estimation compared with unadjusted formulae. CONCLUSION The lean body mass-adjusted Cockcroft-Gault formula was the closest to measured GFR but is not accurate enough to replace radionuclide GFR measurement. Prediction formulae should be adjusted for LBM to improve GFR estimation.
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Affiliation(s)
- Wai H Lim
- Renal Unit, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.
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Stuckey BG, Lim EM, Kent GN, Ward LC, Gutteridge DH. Bisphosphonate therapy for Paget's disease in a patient with hypoparathyroidism: profound hypocalcemia, rapid response, and prolonged remission. J Bone Miner Res 2001; 16:1719-23. [PMID: 11547843 DOI: 10.1359/jbmr.2001.16.9.1719] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Bisphosphonate treatment for severe Paget's disease leads to hypocalcemia followed by a secondary hyperparathyroid response to restore normocalcemia. A case is presented of a 60-year-old woman with polyostotic Paget's disease and postsurgical hypoparathyroidism. In 1993 her Paget's disease--alkaline phosphatase (ALP), 1260 U/liter (35-135 U/liter), and fasting urinary hydroxyproline excretion, 13.7 micromol/liter GF (0.4-1.9 micromol/liter)--was treated with intravenous pamidronate. Symptomatic hypocalcemia followed the first 60-mg dose, requiring large doses of calcium supplementation and calcitriol. Pamidronate therapy to a total dose of 360 mg was followed by rapid and prolonged remission with indices of bone turnover in the normal range within 2 months and persisting for at least 19 months after treatment. In 1999 relapse of Paget's disease--ALP, 511 U/liter (35-135 U/liter), and fasting urinary deoxypyridinoline/creatinine 53.1 micromol/mol (5-27 micromol/mol)--was treated with alendronate, 10 mg daily. Symptomatic hypocalcemia occurred again, requiring increased calcium and calcitriol therapy. Indices of bone turnover were within the normal range 9 weeks after the start of therapy. These responses were significantly more rapid and sustained than those observed in euparathyroid subjects. This case suggests that the lack of parathyroid response may modify the response to bisphosphonates by: (a) increasing intrinsic uptake of bisphosphonate into the pagetic skeleton, allowing response to a smaller dose; (b) increasing duration and severity of hypocalcemia after bisphosphonate therapy; and (c) removing the hyperparathyroid drive to reactivation of pagetic osteoclasts, leading to a prolonged remission. These observations have implications for optimizing bisphosphonate therapy both in Paget's disease and in osteoporosis.
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Affiliation(s)
- B G Stuckey
- Keogh Institute for Medical Research, QEII Medical Center, Nedlands, Western Australia, Australia
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Abstract
Lactobacillus delbrueckii subsp. bulgaricus (L. bulgaricus) is a homofermentative bacterium that produces lactic acid during growth. We adapted the two-dimensional electrophoresis (2-DE) technique to study the response of this bacterium to acidity. De novo protein synthesis was monitored by [35S]methionine labeling of exponentially growing cultures under standard (pH 6) and acidic (pH 4.75) conditions. After 2-DE separation, the protein patterns were compared. The protein spots showing increased radioactivity levels under acid conditions were considered acid-induced. We determined the N-terminal amino acid sequence of three highly induced proteins; comparing these proteins to databases we identified them to be the well-known heat shock proteins GroES, GroEL, and DnaK. Their induction levels were measured and compared. This is the first study by 2-DE of stress response in L. bulgaricus. We established the method and present a protein map which will be useful for future studies.
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Affiliation(s)
- E M Lim
- Génétique Microbienne, Institut National de la Recherche Agronomique, Jouy-en-Josas, France.
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Lim EM, Lagranderie M, Le Grand R, Rauzier J, Gheorghiu M, Gicquel B, Winter N. Recombinant Mycobacterium bovis BCG producing the N-terminal half of SIVmac251 Env antigen induces neutralizing antibodies and cytotoxic T lymphocyte responses in mice and guinea pigs. AIDS Res Hum Retroviruses 1997; 13:1573-81. [PMID: 9430249 DOI: 10.1089/aid.1997.13.1573] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Recombinant Mycobacterium bovis bacillus Calmette-Guérin (rBCG) represents a good candidate for the development of vaccines against AIDS. Several HIV or SIV genes including nef, gag, and env have already been expressed by rBCG strains and shown to induce strong humoral and cellular immune responses in experimental animals. Because a broad immune response directed to multiple HIV/SIV antigens is highly desirable in order to develop effective vaccines, we have also investigated the immune response induced by an rBCG strain expressing a large N-terminal portion of the SIVmac251 Env gp110-encoding gene. The rBCG(SIVmac251Env) strain obtained was able to induce strong CTL responses in mice as well as humoral immune responses in mice and guinea pigs immunized by parenteral routes. The anti-gp110 IgGs produced were able to neutralize in vitro growth of virulent SIVmac251 field isolates. Moreover, guinea pigs immunized by the oral route produced significant levels of anti-gp110 IgAs in the feces, demonstrating that rBCG is able to induce local humoral immunity in the intestinal mucosa. These data provide further evidence of the utility of BCG as a candidate vaccine vector against AIDS.
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Affiliation(s)
- E M Lim
- Unité de Génétique Mycobactérienne, Institut Pasteur, Paris, France
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Berthet FX, Rauzier J, Lim EM, Philipp W, Gicquel B, Portnoï D. Characterization of the Mycobacterium tuberculosis erp gene encoding a potential cell surface protein with repetitive structures. Microbiology (Reading) 1995; 141 ( Pt 9):2123-30. [PMID: 7496523 DOI: 10.1099/13500872-141-9-2123] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Using the phoA gene fusion methodology adapted to mycobacteria, several Mycobacterium tuberculosis DNA fragments encoding exported proteins were recently identified. In this paper, the molecular cloning, genomic positioning, nucleotide sequence determination and transcriptional start site mapping of a new M. tuberculosis gene, identified by this methodology, are reported. This gene was called erp (for exported repetitive protein) and has a sequence similar to that of the Mycobacterium leprae 28 kDa antigen irg gene M. tuberculosis erp gene contains a putative iron box close to the mapped transcriptional start site. The predicted Erp protein displays a typical N-terminal signal sequence, a hydrophobic domain at the C-terminus and harbours repeated amino acid motifs. These structural features are reminiscent of cell-wall-associated surface proteins from Gram-positive bacteria. We found that these repeats are conserved among M. tuberculosis isolates, and are absent from the published M. leprae irg gene sequence. In addition to being present in M. leprae, erp sequences were found in other members of the M. tuberculosis complex, but not in other mycobacteria tested. These results suggest that erp might encode a cell surface component shared by major pathogenic mycobacteria.
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Affiliation(s)
- F X Berthet
- Unité de Génétique Mycobactérienne (CNRS, URA 1300), Institut Pasteur, Paris, France
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Winter N, Triccas JA, Rivoire B, Pessolani MC, Eiglmeier K, Lim EM, Hunter SW, Brennan PJ, Britton WJ. Characterization of the gene encoding the immunodominant 35 kDa protein of Mycobacterium leprae. Mol Microbiol 1995; 16:865-76. [PMID: 7476185 DOI: 10.1111/j.1365-2958.1995.tb02314.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Analysis of the interaction between the host immune system and the intracellular parasite Mycobacterium leprae has identified a 35 kDa protein as a dominant antigen. The native 35 kDa protein was purified from the membrane fraction of M. leprae and termed MMPI (major membrane protein I). As the purified protein was not amenable to N-terminal sequencing, partial proteolysis was used to establish the sequences of 21 peptides. A fragment of the 35 kDa protein-encoding gene was amplified by the polymerase chain reaction from M. leprae chromosomal DNA with oligonucleotide primers derived from internal peptide sequences and the whole gene was subsequently isolated from a M. leprae cosmid library. The nucleotide sequence of the gene revealed an open reading frame of 307 amino acids containing most of the peptide sequences derived from the native 35 kDa protein. The calculated subunit mass was 33.7 kDa, but the native protein exists as a multimer of 950 kDa. Database searches revealed no identity between the 35 kDa antigen and known protein sequences. The gene was expressed in Mycobacterium smegmatis under the control of its own promoter or at a higher level using an 'up-regulated' promoter derived from Mycobacterium fortuitum. The gene product reacted with monoclonal antibodies raised to the native protein. Using the bacterial alkaline phosphatase reporter system, we observed that the 35 kDa protein was unable to be exported across the membrane of recombinant M. smegmatis. The 35 kDa protein-encoding gene is absent from members of the Mycobacterium tuberculosis complex, but homologous sequences were detected in Mycobacterium avium, Mycobacterium haemophilum and M. smegmatis. The availability of the recombinant 35 kDa protein will permit dissection of both antibody- and T-cell-mediated immune responses in leprosy patients.
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Affiliation(s)
- N Winter
- Centenary Institute of Cancer Medicine and Cell Biology, Newtown, New South Wales, Australia
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Lim EM, Rauzier J, Timm J, Torrea G, Murray A, Gicquel B, Portnoi D. Identification of mycobacterium tuberculosis DNA sequences encoding exported proteins by using phoA gene fusions. J Bacteriol 1995; 177:59-65. [PMID: 7798150 PMCID: PMC176556 DOI: 10.1128/jb.177.1.59-65.1995] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The activity of bacterial alkaline phosphatase (PhoA) is dependent on it being exported across the plasma membrane. A plasmid vector (pJEM11) allowing fusions between phoA and genes encoding exported proteins was constructed to study protein export in mycobacteria. Introduction of the Mycobacterium fortuitum beta-lactamase gene (blaF*) into this vector led to the production in M. smegmatis of protein fusions with PhoA activity. A genomic library from M. tuberculosis was constructed in pJEM11 and screened in M. smegmatis for clones with PhoA activity. Sequences of the M. tuberculosis inserts directing the production of protein fusions in these PhoA-positive clones were determined. They include part of the already-known exported 19-kDa lipoprotein, a sequence with similarities to the exported 28-kDa antigen from M. leprae, a sequence encoding a protein sharing conserved amino acid motifs with stearoyl-acyl-carrier-protein desaturases, and unknown sequences. This approach thus appears to identify sequences directing protein export, and we expect that more extensive screening of such libraries will lead to a better understanding of protein export in M. tuberculosis.
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Affiliation(s)
- E M Lim
- Unité de Génétique Mycobactérienne, Centre National de la Recherche Scientifique, URA 1300, Institut Pasteur, Paris, France
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Abstract
A series of Escherichia coli-mycobacteria shuttle plasmids for the isolation and study of gene regulatory sequences was constructed. These pJEM vectors contain an efficient transcription terminator and multiple cloning sites and allow either operon or gene fusions to lacZ. By constructing operon fusions with pJEM15, we assessed various previously characterized mycobacterial promoters in the fast-growing species Mycobacterium smegmatis and the slow-growing species M. bovis BCG. Our results suggest that M. smegmatis and M. bovis BCG RNA polymerases do not share the same specificity. To isolate new mycobacterial promoters, an M. tuberculosis DNA library was generated, using pJEM13, and screened in M. smegmatis. Several Lac+ clones were isolated, and the beta-galactosidase activity was measured.
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Affiliation(s)
- J Timm
- Unité de Génétique Mycobactérienne, CNRS URA 1300, Institut Pasteur, Paris, France
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