C-reactive Protein Positively Correlates With Metabolic Syndrome in Kidney Transplantation Patients

ObjectiveC-reactive protein (CRP) is an independent risk factor for renal allograft loss and predicts all-cause mortality in kidney transplantation patients. Metabolic syndrome has also been associated with increased mortality in kidney transplantation patients. The aim of this study was to investigate the relationship between CRP and metabolic syndrome in kidney transplantation patients.Materials and MethodsFasting blood samples were obtained from 55 kidney transplantation patients. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.ResultsIn total, 13 kidney transplantation patients (23.6%) had metabolic syndrome. Fasting CRP levels positively correlated with metabolic syndrome (p = 0.001). Univariate linear regression analysis indicated that fasting serum CRP values were positively correlated with body weight (p = 0.001), waist circumference (p = 0.008), body mass index (p < 0.001), and body fat mass (p = 0.042). Multivariate forward stepwise linear regression analysis of the significant variables showed that body mass index (β = 0.455, R2 = 0.207, p < 0.001) was an independent predictor of serum CRP levels in kidney transplantation patients.ConclusionCRP level positively correlated with metabolic syndrome in kidney transplantation patients. Body mass index was an independent predictor of serum CRP levels in kidney transplantation patients

High Serum Adipocyte Fatty Acid Binding Protein Is Associated with Metabolic Syndrome in Patients with Type 2 Diabetes

Adipocyte fatty acid binding protein (A-FABP) is a key mediator of obesity-related metabolic syndrome (MetS). The aim of this study was to evaluate the relationship between A-FABP concentration and MetS in type 2 diabetes mellitus (DM) patients. Fasting blood samples were obtained from 165 type 2 DM volunteers. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation. Among 165 DM patients, 113 patients (68.5%) had MetS. Diabetic persons who had MetS had significantly higher A-FABP levels ( &lt; 0.001) than those without MetS. Female DM persons had higher A-FABP level than man ( &lt; 0.001). No statistically significant differences in A-FABP levels were found in use of statin, fibrate, or antidiabetic drugs. Multivariate forward stepwise linear regression analysis revealed that body fat mass ( &lt; 0.001), logarithmically transformed creatinine (log-creatinine; &lt; 0.001), female DM patients ( &lt; 0.001), and logarithmically transformed high sensitive C-reactive protein (log-hs-CRP; = 0.013) were positively correlated, while albumin ( = 0.004) and glomerular filtration rate (GFR; = 0.043) were negatively correlated with serum A-FABP levels in type 2 DM patients. In this study, higher serum A-FABP level was positively associated with MetS in type 2 DM patients

Galectin-3 contributes to pathogenesis of IgA nephropathy.

IgA nephropathy (IgAN) is the most common type of glomerulonephritis that frequently progresses to kidney failure. However, the molecular pathogenesis underlying IgAN remains largely unknown. Here, we investigated the role of galectin-3 (Gal-3), a galactoside-binding protein in IgAN pathogenesis and showed that Gal-3 expression by the kidney was significantly enhanced in patients with IgAN. In both TEPC-15 hybridoma-derived IgA-induced, passive, and spontaneous "grouped" ddY IgAN models, Gal-3 expression was clearly increased with disease severity in the glomeruli, peri-glomerular regions, and some kidney tubules. Gal-3 knockout (KO) in the passive IgAN model had significantly improved proteinuria, kidney function and reduced severity of kidney pathology, including neutrophil infiltration and decreased differentiation of Th17 cells from kidney-draining lymph nodes, despite increased percentages of regulatory T cells. Gal-3 KO also inhibited the NLRP3 inflammasome, yet it enhanced autophagy and improved kidney inflammation and fibrosis. Moreover, administration of 6-de-O-sulfated, N-acetylated low-molecular-weight heparin, a competitive Gal-3 binding inhibitor, restored kidney function and improved kidney lesions in passive IgAN mice. Thus, our results suggest that Gal-3 is critically involved in IgAN pathogenesis by activating the NLRP3 inflammasome and promoting Th17 cell differentiation. Hence, targeting Gal-3 action may represent a new therapeutic strategy for treatment of this kidney disease

Serum Osteocalcin Level is Negatively Associated with Vascular Reactivity Index by Digital Thermal Monitoring in Kidney Transplant Recipients

Background and Objectives: Osteocalcin is the most abundant noncollagenous protein in bone matrix, which is considered a marker of bone formation. Previous studies indicate that circulating osteocalcin can be expressed by osteoblasts and even by osteoblast-like cells in vessel walls, and it is often associated with arterial stiffness. Our study aims to examine the potential association between osteocalcin levels and endothelial function among kidney transplant (KT) recipients. Materials and Methods: Fasting blood samples were obtained from 68 KT recipients. To measure the endothelial function and vascular reactivity index (VRI), a digital thermal monitoring test (VENDYS) was used. A commercial enzyme-linked immunosorbent assay kit was also utilized to measure serum total osteocalcin levels. In this study, a VRI of less than 1.0 indicated poor vascular reactivity; a VRI of 1.0&ndash;2.0 indicated intermediate vascular reactivity; and a VRI of 2.0 or higher indicated good vascular reactivity. Results: Our findings show that 8 KT recipients (11.8%) had poor vascular reactivity (VRI &lt; 1.0), 26 (38.2%) had intermediate vascular reactivity (1.0 &le; VRI &lt; 2.0), and 34 (50%) had good vascular reactivity. Increased serum osteocalcin levels (p &lt; 0.001) were found to be associated with poor vascular reactivity. Advanced age (r = &minus;0.361, p = 0.002), serum alkaline phosphate level (r = &minus;0.254, p = 0.037), and log-transformed osteocalcin levels (r = &minus; 0.432, p &lt; 0.001) were identified to be negatively correlated with VRI in KT recipients. Multivariable forward stepwise linear regression analysis revealed that the serum level of osteocalcin (&beta; = &minus;0.391, adjusted R2 change = 0.174; p &lt; 0.001) and advanced age (&beta; = &minus;0.308, adjusted R2 change = 0.084; p = 0.005) were significantly and independently associated with VRI in KT recipients. Conclusions: Higher serum osteocalcin level was associated with lower VRI and poorer endothelial dysfunction among KT recipients

Negative Correlation of Serum Adiponectin Level with Aortic Stiffness in Elderly Diabetic Persons

Adiponectin has anti-inflammatory activity against atherosclerosis. Aortic stiffness is a common manifestation of atherosclerosis in diabetes mellitus and elderly persons. This study aimed to evaluate whether low serum adiponectin levels were associated with aortic stiffness in geriatric diabetic patients. Blood samples were obtained from 130 diabetic participants aged &ge; 65 years. We defined high aortic stiffness based on a carotid&ndash;femoral pulse wave velocity (cfPWV) of &gt;10 m/s. Circulating adiponectin concentrations were examined using enzyme-linked immunosorbent assays. Sixty-six participants (50.8%) had aortic stiffness. Patients with aortic stiffness had lower serum adiponectin concentrations than those in the control group (p &lt; 0.001). Multivariate logistic regression analysis showed that the adiponectin level (odds ratio: 0.939, 95% confidence interval: 0.898&ndash;0.981, p = 0.005) was an independent predictor of aortic stiffness in elderly diabetic persons. Multivariate forward stepwise linear regression analysis also demonstrated that the adiponectin level (&beta; = &minus;0.256, adjusted R2 change = 0.100, p = 0.003) was negatively associated with cfPWV values in older diabetic patients. In conclusion, serum adiponectin is negatively correlated with cfPWV and is an independent predictor of aortic stiffness in elderly diabetic persons

High Serum Leptin Level is Associated with Peripheral Artery Disease in Geriatric Individuals

Summary: Background: Leptin contributes to the pathogenesis of atherosclerosis, endothelial dysfunction, and thrombosis. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis and is expected to prevail among geriatric individuals. The present study aimed to determine whether serum leptin level is associated with PAD in a geriatric group. Methods: Blood samples were obtained from 60 participants in the study who were >65 years of age. Ankle-brachial index (ABI) values were measured using the automated oscillometric method. PAD was considered to be present if the left or right ABI values were less than 0.90, and these participants were included in the low ABI group. Serum leptin levels were measured using a commercial enzyme immunoassay kit. Results: Of these geriatric participants, ten (16.7%) were in the low ABI group. Compared with the elderly participants in the normal ABI group, those in the low ABI group were current smokers (p = 0.048) and had higher serum C-reactive protein (CRP, p = 0.018) and leptin levels (p = 0.005). Multivariate logistic regression analysis of the factors significantly associated with PAD demonstrated that leptin (odds ratio: 1.078, 95% confidence interval: 1.021–1.138, p = 0.006) was an independent predictor of PAD. Female (p = 0.001), body mass index (p = 0.008), and a logarithmically transformed CRP (log-CRP, p = 0.035) were found to be associated with serum log-leptin levels among geriatric participants after multivariate forward stepwise linear regression analysis. Conclusion: High serum leptin level is a risk marker for PAD in geriatric individuals. Keywords: leptin, peripheral arterial disease, ankle-brachial index, geriatri

Serum Phenylacetylglutamine among Potential Risk Factors for Arterial Stiffness Measuring by Carotid–Femoral Pulse Wave Velocity in Patients with Kidney Transplantation

Phenylacetylglutamine (PAG), a gut microbiota metabolite, is associated with cardiovascular diseases. Arterial stiffness (AS), which is a marker of aging-associated vascular diseases, is an independent risk factor for cardiovascular morbidity and mortality. This study aimed to assess the correlation between serum PAG levels and AS in kidney transplantation (KT) patients, potentially uncovering new insights into the cardiovascular risks in this population. In this study, 100 KT patients were included. Carotid–femoral pulse wave velocity (cfPWV) was measured, and patients with cfPWV > 10 m/s were categorized as the AS group. Serum PAG levels were assessed using liquid chromatography–tandem mass spectrometry. Thirty KT patients (30.0%) exhibited AS, with higher percentages of diabetes mellitus, older age, and elevated levels of systolic blood pressure, serum fasting glucose, and PAG than the control group. After adjusting for factors significantly associated with AS by multivariate logistic regression analysis, serum PAG, age, fasting glucose levels, and systolic blood pressure were independent factors associated with AS. Furthermore, PAG levels had a negative correlation with the estimated glomerular filtration rate and a positive correlation with cfPWV values. Serum PAG levels are positively associated with cfPWV values and are a biomarker of AS in KT patients

Serum Osteoprotegerin Level Is Negatively Associated with Bone Mineral Density in Patients Undergoing Maintenance Hemodialysis

Background and Objectives: Osteoprotegerin (OPG), a potent osteoclast activation inhibitor, decreases bone resorption and plays a role in mediating bone mineral density (BMD). Our aim was to evaluate the relationship between BMD and serum OPG in maintenance hemodialysis (MHD) patients. Materials and Methods: Fasting blood samples were obtained from 75 MHD patients. BMD was measured by dual-energy X-ray absorptiometry in lumbar vertebrae (L2–L4). The WHO classification criteria were applied to define osteopenia and osteoporosis. A commercial enzyme-linked immunosorbent assay was used to measure serum OPG values. Results: Among all MHD patients, seven (9.3%) and 20 patients (26.7%) were defined as osteoporosis and osteopenia, respectively. Female patients had lower lumbar BMD than males (p = 0.002). Older age (p = 0.023), increased serum OPG (p &lt; 0.001) urea reduction rate (p = 0.021), Kt/V (p = 0.027), and decreased body mass index (p = 0.006) and triglycerides (p = 0.020) were significantly different between the normal, osteopenia, and osteoporosis groups. Lumbar spine BMD was positively correlated with body mass index (BMI) (p &lt; 0.001) but negatively correlated with OPG (p &lt; 0.001) and age (p = 0.003). After grouping patients into T scores &lt; −1 and &lt; −2.5, female sex and OPG (adjusted odds ratio [aOR] 1.022, 95% confidence interval [C.I.] 1.011–1.034, p &lt; 0.001) were predictors of T scores &lt; −1, whereas only OPG was predictive of T scores &lt; −2.5 (aOR 1.015, 95% C.I. 1.005–1.026, p = 0.004) by multivariate stepwise logistic regression analysis. The areas under the curve for predicting T scores &lt; −1 or &lt; −2.5 were 0.920 (95% C.I. 0.834–0.970, p &lt; 0.001) and 0.958 (95% C.I. 0.885–0.991, p &lt; 0.001), respectively. Conclusions: Increased serum OPG negatively correlated with lumbar BMD and could be a potential biomarker predictive of osteoporosis in MHD patients