Madhusudan Ambarkar1, Srinivasarao V L N Pemmaraju2, Sivakrishna Gouroju3, Suchitra M Manohar4, Aparna R Bitla4, Naresh Yajamanam5, Sivakumar Vishnubhotla6. 1. PhD Scholar, Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences (SVIMS) , Alipiri Road, Tirupati, Andhra Pradesh, India . 2. Professor and Head, Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences (SVIMS) , Alipiri Road, Tirupati, Andhra Pradesh, India . 3. Phd Scholar, Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences (SVIMS) , Alipiri Road, Tirupati, Andhra Pradesh, India . 4. Associate Professor, Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences (SVIMS) , Alipiri Road, Tirupati, Andhra Pradesh, India . 5. Senior Resident, Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences (SVIMS) , Alipiri Road, Tirupati, Andhra Pradesh, India . 6. Professor and Head, Department of Nephrology, Sri Venkateswara Institute of Medical Sciences (SVIMS) , Alipiri Road, Tirupati, Andhra Pradesh, India .
Abstract
INTRODUCTION: Chronic Kidney Disease (CKD) patients are at high risk of cardiovascular diseases (CVDs). Reduced nitric oxide (NO) bioavailability is a key element in connecting kidney disease to endothelial dysfunction (ED) and cardiovascular (CV) complications. Further, inflammation is implicated in ED in CKD. Besides these, adipose tissue factors were thought to have a role in inflammation and ED in CKD. AIM: It is proposed to evaluate the concentration changes of adipokines, inflammatory and ED markers in CKD patients compared to healthy controls. Further, to assess the associations between adipokines, inflammation and ED in CKD patients. MATERIALS AND METHODS: A total of 120 CKD patients were included and classified into 3 groups based on Glomerular filtration rate (GFR). Group I (n=40) patients had a GFR between 60-119 ml/min/1.73m(2) (stage I, II), group II (n=40) had 15-59 ml/min/1.73m(2) (stage III, IV) and group III (n=40) had <15 ml/min/1.73m(2) (stage V). Forty healthy subjects served as controls. Adiponectin, Leptin, Interleukin-10 (IL-10), Interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) were estimated by ELISA. High sensitivity C-reactive protein (hsCRP) was estimated by immunoturbidimetry and NO by Griess method. STATISTICAL ANALYSIS: Mann-Whitney U test was used to compare the difference in variables between controls and CKD patients. One-way ANOVA Kruskalwallis test was used for comparison of variables between groups in CKD patients. Spearman's rank correlation was used to explore the associations between variables. Simple univariate linear regression analysis was used to predict the value of variable from another variable. RESULTS: A significant increase in leptin, IL-6, TNF-α, IL-6/IL-10 ratio, hsCRP and decrease in adiponectin, IL-10, NO was observed in CKD patients compared to controls (p<0.05). In CKD patients, adiponectin, leptin, IL-6, IL-6/IL-10 ratio, TNF-α were significantly increased and IL-10 levels were decreased from group I to group III (p<0.05). In group III CKD patients IL-6 showed a significant negative correlation with NO (r=-0.557; p=0.005). In linear regression analysis also, IL-6 showed a significant negative association with NO (B±SE=-0.038±0.11; p=0.002) in CKD patients. CONCLUSION: The present study demonstrates that adipokine levels are altered from initial to final stages of CKD due to renal dysfunction which in association with an exaggerated inflammation may contribute to the ED and CV events.
INTRODUCTION:Chronic Kidney Disease (CKD) patients are at high risk of cardiovascular diseases (CVDs). Reduced nitric oxide (NO) bioavailability is a key element in connecting kidney disease to endothelial dysfunction (ED) and cardiovascular (CV) complications. Further, inflammation is implicated in ED in CKD. Besides these, adipose tissue factors were thought to have a role in inflammation and ED in CKD. AIM: It is proposed to evaluate the concentration changes of adipokines, inflammatory and ED markers in CKDpatients compared to healthy controls. Further, to assess the associations between adipokines, inflammation and ED in CKDpatients. MATERIALS AND METHODS: A total of 120 CKDpatients were included and classified into 3 groups based on Glomerular filtration rate (GFR). Group I (n=40) patients had a GFR between 60-119 ml/min/1.73m(2) (stage I, II), group II (n=40) had 15-59 ml/min/1.73m(2) (stage III, IV) and group III (n=40) had <15 ml/min/1.73m(2) (stage V). Forty healthy subjects served as controls. Adiponectin, Leptin, Interleukin-10 (IL-10), Interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) were estimated by ELISA. High sensitivity C-reactive protein (hsCRP) was estimated by immunoturbidimetry and NO by Griess method. STATISTICAL ANALYSIS: Mann-Whitney U test was used to compare the difference in variables between controls and CKDpatients. One-way ANOVA Kruskalwallis test was used for comparison of variables between groups in CKDpatients. Spearman's rank correlation was used to explore the associations between variables. Simple univariate linear regression analysis was used to predict the value of variable from another variable. RESULTS: A significant increase in leptin, IL-6, TNF-α, IL-6/IL-10 ratio, hsCRP and decrease in adiponectin, IL-10, NO was observed in CKDpatients compared to controls (p<0.05). In CKDpatients, adiponectin, leptin, IL-6, IL-6/IL-10 ratio, TNF-α were significantly increased and IL-10 levels were decreased from group I to group III (p<0.05). In group III CKDpatientsIL-6 showed a significant negative correlation with NO (r=-0.557; p=0.005). In linear regression analysis also, IL-6 showed a significant negative association with NO (B±SE=-0.038±0.11; p=0.002) in CKDpatients. CONCLUSION: The present study demonstrates that adipokine levels are altered from initial to final stages of CKD due to renal dysfunction which in association with an exaggerated inflammation may contribute to the ED and CV events.
Authors: B Spoto; D Leonardis; R M Parlongo; P Pizzini; A Pisano; S Cutrupi; A Testa; G Tripepi; C Zoccali; F Mallamaci Journal: Nutr Metab Cardiovasc Dis Date: 2011-09-08 Impact factor: 4.222
Authors: Daniela V Barreto; Fellype C Barreto; Sophie Liabeuf; Mohammed Temmar; Horst-Dieter Lemke; Christophe Tribouilloy; Gabriel Choukroun; Raymond Vanholder; Ziad A Massy Journal: Kidney Int Date: 2009-12-16 Impact factor: 10.612
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Authors: Joanna Gertow; Chang Zhi Ng; Rui Miguel Mamede Branca; Olivera Werngren; Lei Du; Sanela Kjellqvist; Peter Hemmingsson; Annette Bruchfeld; Helen MacLaughlin; Per Eriksson; Jonas Axelsson; Rachel M Fisher Journal: Kidney Int Rep Date: 2017-07-29