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Ho HY, Chen YH, Lo CJ, Tang HY, Chang SW, Fan CM, Ho YH, Lin G, Chiu CY, Lin CM, Cheng ML. Combined Plasma DHA-Containing Phosphatidylcholine PCaa C38:6 and Tetradecanoyl-Carnitine as an Early Biomarker for Assessing the Mortality Risk among Sarcopenic Patients. Nutrients 2024; 16:611. [PMID: 38474739 DOI: 10.3390/nu16050611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
The coming of the hyper-aged society in Taiwan prompts us to investigate the relationship between the metabolic status of sarcopenic patients and their most adverse outcome-death. We studied the association between any plasma metabolites and the risk for mortality among older Taiwanese sarcopenic patients. We applied a targeted metabolomic approach to study the plasma metabolites of adults aged ≥65 years, and identified the metabolic signature predictive of the mortality of sarcopenic patients who died within a 5.5-year follow-up period. Thirty-five sarcopenic patients who died within the follow-up period (Dead cohort) had shown a specific plasma metabolic signature, as compared with 54 patients who were alive (Alive cohort). Only 10 of 116 non-sarcopenic individuals died during the same period. After multivariable adjustment, we found that sex, hypertension, tetradecanoyl-carnitine (C14-carnitine), and docosahexaenoic acid (DHA)-containing phosphatidylcholine diacyl (PCaa) C38:6 and C40:6 were important risk factors for the mortality of sarcopenic patients. Low PCaa C38:6 levels and high C14-carnitine levels correlated with an increased mortality risk; this was even the same for those patients with hypertension (HTN). Our findings suggest that plasma PCaa C38:6 and acylcarnitine C14-carnitine, when combined, can be a better early biomarker for evaluating the mortality risk of sarcopenia patients.
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Grants
- BMRP819, BMRP564, CMRPD1L0161, CMRPD1L0162, CMRPD1M0351, CMRPD1J0263, CMRPD1M0341 and CLRPG3K0023 Chang Gung Memorial Hospital
- 110-2320-B-182-017-MY3 and 111-2320-B-182-011 National Science and Technology Council (Taiwan region)
- EMRPD1K0441, EMRPD1K0481, and EMRPD1L0421 Ministry of Education (Taiwan region)
- MOST 111-2634-F-182-001 The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE)(Taiwan region) and the National Science and Technology Council (NSTC)(Taiwan region)
- CMRPD1M0352, CMRPD1N0151, CMRPD1M0342, CMRPD1N0071,112-2320-B-182-020-MY3 Chang Gung Memorial Hospital
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Affiliation(s)
- Hung-Yao Ho
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Yuan-Ho Chen
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chi-Jen Lo
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
| | - Hsiang-Yu Tang
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
| | - Su-Wei Chang
- Department of Artificial Intelligence, College of Intelligent Computing, Chang Gung University, Taoyuan 333, Taiwan
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
| | - Chun-Ming Fan
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
| | - Yu-Hsuan Ho
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Gigin Lin
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan 333, Taiwan
| | - Chih-Yung Chiu
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 333, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital at Keelung and Chang Gung University, Taoyuan 333, Taiwan
| | - Chih-Ming Lin
- Division of Internal Medicine, Chang Gung Memorial Hospital at Taipei, Taipei 105, Taiwan
- Department of Health Management, Chang Gung Health and Culture Village, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Mei-Ling Cheng
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
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Zhang Y, Man L. Albumin-to-fibrinogen ratio is an independent predictor of corticosteroid response and prognosis in patients with IgA nephropathy. Eur J Med Res 2023; 28:146. [PMID: 37013663 PMCID: PMC10069077 DOI: 10.1186/s40001-023-01106-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The objective of this study was to investigate whether the albumin-to-fibrinogen ratio (AFR) can predict corticosteroid response and prognosis prediction among IgA nephropathy (IgAN) patients. METHODS Eligible participants with diagnosed IgAN who were scheduled to receive corticosteroid therapy for persistent proteinuria were recruited. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of AFR or estimated glomerular filtration rate (eGFR) for corticosteroid response in IgAN patients. Risk factors for corticosteroid response and prognosis were validated using univariate and multivariate Cox proportional analyses. RESULTS AFR and eGFR were both effective predictors of corticosteroid response in IgAN patients, with area under the curve (AUC) values of 0.686 and 0.643, respectively (P < 0.001 and P = 0.002). Baseline AFR level at biopsy was an independent risk factor for remission after corticosteroid therapy (HR: 2.38, 95% CI 1.32-4.07, P = 0.015), 50% decline in eGFR (HR: 0.78, 95% CI 0.69-0.89, P = 0.025), kidney failure (HR: 2.46, 95%CI 1.16-3.71, P = 0.016), and a composite event (HR: 2.13, 95%CI 1.28-3.34, P = 0.009) in IgAN patients. CONCLUSIONS AFR level at biopsy was a potential predictor of corticosteroid response and prognosis among IgAN patients.
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Affiliation(s)
- Yu Zhang
- Department of Nephrology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, No. 366 Taihu Road, Jiangsu, 225300, Taizhou, China
| | - Liping Man
- Department of Nephrology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, No. 366 Taihu Road, Jiangsu, 225300, Taizhou, China.
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Glavan MR, Socaciu C, Socaciu AI, Gadalean F, Cretu OM, Vlad A, Muntean DM, Bob F, Milas O, Suteanu A, Jianu DC, Stefan M, Balint L, Ienciu S, Petrica L. Untargeted Metabolomics by Ultra-High-Performance Liquid Chromatography Coupled with Electrospray Ionization-Quadrupole-Time of Flight-Mass Spectrometry Analysis Identifies a Specific Metabolomic Profile in Patients with Early Chronic Kidney Disease. Biomedicines 2023; 11:biomedicines11041057. [PMID: 37189675 DOI: 10.3390/biomedicines11041057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
Chronic kidney disease (CKD) has emerged as one of the most progressive diseases with increased mortality and morbidity. Metabolomics offers new insights into CKD pathogenesis and the discovery of new biomarkers for the early diagnosis of CKD. The aim of this cross-sectional study was to assess metabolomic profiling of serum and urine samples obtained from CKD patients. Untargeted metabolomics followed by multivariate and univariate analysis of blood and urine samples from 88 patients with CKD, staged by estimated glomerular filtration rate (eGFR), and 20 healthy control subjects was performed using ultra-high-performance liquid chromatography coupled with electrospray ionization-quadrupole-time of flight-mass spectrometry. Serum levels of Oleoyl glycine, alpha-lipoic acid, Propylthiouracil, and L-cysteine correlated directly with eGFR. Negative correlations were observed between serum 5-Hydroxyindoleacetic acid, Phenylalanine, Pyridoxamine, Cysteinyl glycine, Propenoylcarnitine, Uridine, and All-trans retinoic acid levels and eGFR. In urine samples, the majority of molecules were increased in patients with advanced CKD as compared with early CKD patients and controls. Amino acids, antioxidants, uremic toxins, acylcarnitines, and tryptophane metabolites were found in all CKD stages. Their dual variations in serum and urine may explain their impact on both glomerular and tubular structures, even in the early stages of CKD. Patients with CKD display a specific metabolomic profile. Since this paper represents a pilot study, future research is needed to confirm our findings that metabolites can serve as indicators of early CKD.
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Affiliation(s)
- Mihaela-Roxana Glavan
- Department of Internal Medicine II—Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Carmen Socaciu
- Research Center for Applied Biotechnology and Molecular Therapy BIODIATECH, SC Proplanta, 400478 Cluj-Napoca, Romania
| | - Andreea Iulia Socaciu
- Department of Occupational Health, University of Medicine and Pharmacy “Iuliu Haţieganu”, 400347 Cluj-Napoca, Romania
| | - Florica Gadalean
- Department of Internal Medicine II—Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Octavian M. Cretu
- Department of Surgery—Surgical Semiotics, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Adrian Vlad
- Department of Internal Medicine II—Diabetes and Metabolic Diseases, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Danina M. Muntean
- Department of Functional Sciences—Pathophysiology, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Center for Translational Research and Systems Medicine, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Flaviu Bob
- Department of Internal Medicine II—Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Oana Milas
- Department of Internal Medicine II—Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Anca Suteanu
- Department of Internal Medicine II—Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Dragos Catalin Jianu
- Deptartment of Neurosciences—Neurology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Cognitive Research in Neuropsychiatric Pathology, Clinical County Emergency Hospital, Victor Babeș” University of Medicine and Pharmacy, 300723 Timișoara, Romania
| | - Maria Stefan
- Department of Internal Medicine II—Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Lavinia Balint
- Department of Internal Medicine II—Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Silvia Ienciu
- Department of Internal Medicine II—Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Ligia Petrica
- Department of Internal Medicine II—Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
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Broseta JJ, Roca M, Rodríguez-Espinosa D, López-Romero LC, Gómez-Bori A, Cuadrado-Payán E, Bea-Granell S, Devesa-Such R, Soldevila A, Sánchez-Pérez P, Hernández-Jaras J. The metabolomic differential plasma profile between dialysates. Pursuing to understand the mechanisms of citrate dialysate clinical benefits. Front Physiol 2022; 13:1013335. [PMID: 36467686 PMCID: PMC9709283 DOI: 10.3389/fphys.2022.1013335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 10/27/2022] [Indexed: 08/30/2023] Open
Abstract
Background: Currently, bicarbonate-based dialysate needs a buffer to prevent precipitation of bicarbonate salts with the bivalent cations, and acetate at 3-4 mmol/L is the most used. However, citrate is being postulated as a preferred option because of its association with better clinical results by poorly understood mechanisms. In that sense, this hypothesis-generating study aims to identify potential metabolites that could biologically explain these improvements found in patients using citrate dialysate. Methods: A unicentric, cross-over, prospective untargeted metabolomics study was designed to analyze the differences between two dialysates only differing in their buffer, one containing 4 mmol/L of acetate (AD) and the other 1 mmol/L of citrate (CD). Blood samples were collected in four moments (i.e., pre-, mid-, post-, and 30-min-post-dialysis) and analyzed in an untargeted metabolomics approach based on UPLC-Q-ToF mass spectrometry. Results: The 31 most discriminant metabolomic variables from the plasma samples of the 21 participants screened by their potential clinical implications show that, after dialysis with CD, some uremic toxins appear to be better cleared, the lysine degradation pathway is affected, and branched-chain amino acids post-dialysis levels are 9-10 times higher than with AD; and, on its part, dialysis with AD affects acylcarnitine clearance. Conclusion: Although most metabolic changes seen in this study could be attributable to the dialysis treatment itself, this study successfully identifies some metabolic variables that differ between CD and AD, which raise new hypotheses that may unveil the mechanisms involved in the clinical improvements observed with citrate in future research.
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Affiliation(s)
- José Jesús Broseta
- Department of Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marta Roca
- Analytcal Unit Platform, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Diana Rodríguez-Espinosa
- Department of Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Aina Gómez-Bori
- Department of Nephrology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Elena Cuadrado-Payán
- Department of Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sergio Bea-Granell
- Department of Nephrology, Consorci Hospital General Universitari de València, Valencia, Spain
| | - Ramón Devesa-Such
- Department of Nephrology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Amparo Soldevila
- Department of Nephrology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Pilar Sánchez-Pérez
- Department of Nephrology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
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5
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Lu Z, Liu C, Wu Q, Deng Y. High-coverage targeted lipidomics could reveal lipid alterations and evaluate therapeutic efficacy of membranous nephropathy. Nutr Metab (Lond) 2022; 19:68. [PMID: 36224633 PMCID: PMC9559911 DOI: 10.1186/s12986-022-00701-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Membrane nephropathy (MN) often presents as nephrotic syndrome with characteristic lipid metabolism that could not be explained by lipid indicators commonly used in clinical practice. Studies have shown that invigorating spleen and qi, activating blood and detoxication in the treatment of MN is an effective method proved by randomized controlled clinical trial. However, the alterations of lipid profile before and after traditional Chinese medicine (TCM) treatment and the related lipid markers that affect the therapeutic effect have not been fully clarified. Methods We analyzed plasma lipid profiles of 92 patients with MN before and after TCM treatment by high-coverage targeted lipidomics. Results 675 lipids were identified, of which 368 stably expressed lipids (coefficient of variation less than 30% and deletion value less than 10%) were eventually included for statistical analysis. 105 lipids were altered mainly including spingolipids, glycerides, glycerophosholipid, fatty acyl and steroids, among which, the abundance of ceramides (Cers), sphingomyelins (SMs), diacylglycerols (DGs), phosphatidylcholines (PCs) were lower than those before treatment with statistically significant difference. The WGCNA network to analyze the correlation between the collective effect and the therapeutic effect showed that the triglyceride (TG) molecules were most relevant to the therapeutic effect. Analysis of 162 triglyceride molecules showed that 11 TGs were significantly down-regulated in the effective group which were concentrated in carbon atom number of 52–56 and double bond number of 0–4. TGs molecules including TG56:2-FA20:0, TG56:2-FA20:1, TG56:3-FA20:0 and TG56:5-FA20:2 were most closely related to the therapeutic effect of TCM after adjusting the influence of clinical factors. ROC curve analysis showed that these four lipids could further improve the predictive efficacy of treatment based on clinical indicators. Conclusion Our work demonstrated that the therapeutic effect of invigorating spleen and qi, activating blood and detoxication in the treatment of MN may be exerted by regulating lipid metabolism. High-coverage targeted lipidomics provided a non-invasive tool for discovery of lipid markers to improve the predictive efficacy of TCM therapy.
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Affiliation(s)
- Zhenzhen Lu
- Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 725 Wanping Road, Shanghai, 200032, China
| | - Conghui Liu
- Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, 310024, China
| | - Qingqing Wu
- Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai, 200031, China.
| | - Yueyi Deng
- Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 725 Wanping Road, Shanghai, 200032, China.
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Mu X, Yang M, Ling P, Wu A, Zhou H, Jiang J. Acylcarnitines: Can They Be Biomarkers of Diabetic Nephropathy? Diabetes Metab Syndr Obes 2022; 15:247-256. [PMID: 35125878 PMCID: PMC8811266 DOI: 10.2147/dmso.s350233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/13/2022] [Indexed: 12/22/2022] Open
Abstract
Diabetic nephropathy (DN), one of the most serious microvascular complications of diabetes mellitus (DM), may progress to end-stage renal disease (ESRD). Current biochemical biomarkers, such as urinary albumin excretion rate (UAER), have limitations for early screening and monitoring of DN. Recent studies have identified some metabolites as candidate biomarkers for early detection of DN. In this review, we summarize the role of dysregulated acylcarnitines (AcylCNs) in DN pathophysiology. Lower abundance of short- and medium-chain AcylCNs and higher long-chain AcylCNs often occurred in DM with normal albuminuria and microalbuminuria, compared with advanced stages of DN. The increase of long-chain AcylCNs was supposed to be an adaptive compensation in fat acids (FAs) oxidation in the early stage of DN. Conversely, the decrease of long-chain AcylCNs was due to incomplete oxidation of FAs in advanced stage of DN. Thus, AcylCNs may serve as sensitive biomarkers in predicting the risk of DN.
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Affiliation(s)
- Xiaodie Mu
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China
| | - Min Yang
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China
| | - Peiyao Ling
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China
| | - Aihua Wu
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China
| | - Hua Zhou
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China
- Correspondence: Hua Zhou; Jingting Jiang, Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China, Tel +86 0519 68872082, Email ;
| | - Jingting Jiang
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China
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Deng Y, Wu Q, Chen W, Zhu L, Liu W, Xia F, Sun L, Lin X, Zeng R. Lipidomics reveals association of circulating lipids with body mass index and outcomes in IgA nephropathy patients. J Mol Cell Biol 2021; 13:mjab040. [PMID: 34272854 PMCID: PMC8697343 DOI: 10.1093/jmcb/mjab040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/16/2021] [Accepted: 03/30/2021] [Indexed: 11/12/2022] Open
Abstract
IgA nephropathy (IgAN) is a leading cause of chronic kidney disease (CKD), which are commonly accompanied by dyslipidemia. Obesity is also associated with dyslipidemia and risk of CKD, but the relation of the dyslipidemia patterns with obesity and disease progression in IgAN patients remains unknown. Traditional Chinese medicine (TCM) and the combined treatment with corticosteroids and TCM have been shown to be of benefit for IgAN patients, but predictive markers for guiding these treatments are lacking. Here, we quantified 545 lipid species in the plasma from 196 participants, including 140 IgAN patients and 56 healthy volunteers, and revealed an altered plasma lipidome in IgAN patients as compared to healthy participants. Association analysis showed that a sub-group of glycerides, particularly triacylglycerols (TGs) containing docosahexaenoic acid, were positively associated with high body mass index (BMI) in under- or normal weight IgAN patients, while several free fatty acids and sphingomyelins were positively associated with high BMI in overweight or obese IgAN patients. Further, our study suggested that elevated levels of eight lipids, mainly TG species containing linolenic acid, were independent risk factors for IgAN progression and also reported the prospective association of circulating lipids with treatment outcomes in IgAN. Taken together, our findings may not only help to achieve precision medicine but also provide a knowledge base for dietary intervention in the treatment of IgAN.
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Affiliation(s)
- Yueyi Deng
- Department of Nephrology, Longhua Hospital, Shanghai University of Traditional
Chinese Medicine, Shanghai 200032, China
| | - Qingqing Wu
- Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in
Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031,
China
| | - Wanjia Chen
- Department of Nephrology, Longhua Hospital, Shanghai University of Traditional
Chinese Medicine, Shanghai 200032, China
| | - Li Zhu
- Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in
Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031,
China
| | - Wangyi Liu
- Department of Nephrology, Longhua Hospital, Shanghai University of Traditional
Chinese Medicine, Shanghai 200032, China
| | - Fangying Xia
- Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in
Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031,
China
| | - Liang Sun
- Shanghai Institute of Nutrition and Health, Chinese Academy of
Sciences, Shanghai 200031, China
| | - Xu Lin
- Shanghai Institute of Nutrition and Health, Chinese Academy of
Sciences, Shanghai 200031, China
| | - Rong Zeng
- Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in
Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031,
China
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8
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Selvaskandan H, Shi S, Twaij S, Cheung CK, Barratt J. Monitoring Immune Responses in IgA Nephropathy: Biomarkers to Guide Management. Front Immunol 2020; 11:572754. [PMID: 33123151 PMCID: PMC7572847 DOI: 10.3389/fimmu.2020.572754] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/17/2020] [Indexed: 11/13/2022] Open
Abstract
IgA nephropathy (IgAN) is the commonest biopsy-reported primary glomerulonephritis worldwide. It has an incidence which peaks among young adults, and 30 to 40% of patients' progress to end stage kidney disease within twenty years of diagnosis. Ten-year kidney survival rates have been reported to be as low as 35% in some parts of the world. The successful management of IgAN is limited by an incomplete understanding of the pathophysiology of IgAN and a poor understanding of how pathophysiology may vary both from patient to patient and between patient groups, particularly across races. This is compounded by a lack of rigorously designed and delivered clinical trials in IgAN. This is slowly changing, with a number of Phase 2 and 3 clinical trials of novel therapies targeting a number of different putative pathogenic pathways in IgAN due to report in the next 5 years. From our current, albeit limited, understanding of the pathophysiology of IgAN it is unlikely a single therapy will be effective in all patients with IgAN. The successful management of IgAN in the future is, therefore, likely to be reliant on targeted therapies, carefully selected based on an individualized understanding of a patient's risk of progression and underlying pathophysiology. The potential role of biomarkers to facilitate personalization of prognostication and treatment of IgAN is immense. Here we review the progress made over the past decade in identifying and validating new biomarkers, with a particular focus on those that reflect immunological responses in IgAN.
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Affiliation(s)
- Haresh Selvaskandan
- Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Sufang Shi
- Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Sara Twaij
- Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Chee Kay Cheung
- Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Jonathan Barratt
- Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
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Kasepalu T, Kuusik K, Lepner U, Starkopf J, Zilmer M, Eha J, Vähi M, Kals J. Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial. Nutr Metab (Lond) 2020; 17:76. [PMID: 32968425 PMCID: PMC7501679 DOI: 10.1186/s12986-020-00495-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/27/2020] [Indexed: 12/17/2022] Open
Abstract
Background Vascular surgery patients have reduced tissues` blood supply, which may lead to mitochondrial dysfunction and accumulation of acylcarnitines (ACs).
It has been suggested that remote ischaemic preconditioning (RIPC) has its organ protective effect via promoting mitochondrial function.
The aim of this study was to evaluate the effect of RIPC on the profile of ACs in the vascular surgery patients. Methods This is a randomised, sham-controlled, double-blinded, single-centre study. Patients undergoing open surgical repair of abdominal aortic aneurysm, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited non-consecutively. The RIPC protocol consisting of 4 cycles of 5 min of ischaemia, followed by 5 min of reperfusion, was applied. A blood pressure cuff was used for RIPC or a sham procedure. Blood was collected preoperatively and approximately 24 h postoperatively. The profile of ACs was analysed using the AbsoluteIDQp180 kit (Biocrates Life Sciences AG, Innsbruck, Austria). Results Ninety-eight patients were recruited and randomised into the study groups and 45 patients from the RIPC group and 47 patients from the sham group were included in final analysis. There was a statistically significant difference between the groups regarding the changes in C3-OH (p = 0.023)—there was a decrease (− 0.007 µmol/L, ± 0.020 µmol/L, p = 0.0233) in the RIPC group and increase (0.002 µmol/L, ± 0.015 µmol/L, p = 0.481) in the sham group. Additionally, a decrease from baseline to 24 h after surgery (p < 0.05) was detected both in the sham and the RIPC group in the levels of following ACs: C2, C8, C10, C10:1, C12, C12:1, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2. In the sham group, there was an increase (p < 0.05) in the levels of C0 (carnitine) and a decrease in the level of C18:1-OH. In the RIPC group, a decrease (p < 0.05) was noted in the levels of C3-OH, C3-DC (C4-OH), C6:1, C9, C10:2. Conclusions It can be concluded that RIPC may have an effect on the levels of ACs and might therefore have protective effects on mitochondria in the vascular surgery patients. Further larger studies conducted on homogenous populations are needed to make more definite conclusions about the effect of RIPC on the metabolism of ACs. Trial registration ClinicalTrials.gov database, NCT02689414. Registered 24 February 2016—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02689414. Electronic supplementary material The online version of this article (10.1186/s12986-020-00495-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Teele Kasepalu
- Department of Surgery, Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406 Tartu, Estonia.,Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Karl Kuusik
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia.,Department of Cardiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Urmas Lepner
- Department of Surgery, Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406 Tartu, Estonia.,Tartu University Hospital, Tartu, Estonia
| | - Joel Starkopf
- Tartu University Hospital, Tartu, Estonia.,Department of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Mihkel Zilmer
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Jaan Eha
- Department of Cardiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.,Tartu University Hospital, Tartu, Estonia
| | - Mare Vähi
- Institute of Mathematics and Statistics, University of Tartu, Tartu, Estonia
| | - Jaak Kals
- Department of Surgery, Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406 Tartu, Estonia.,Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia.,Tartu University Hospital, Tartu, Estonia
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Lee H, Jang HB, Yoo MG, Park SI, Lee HJ. Amino Acid Metabolites Associated with Chronic Kidney Disease: An Eight-Year Follow-Up Korean Epidemiology Study. Biomedicines 2020; 8:biomedicines8070222. [PMID: 32708997 PMCID: PMC7399801 DOI: 10.3390/biomedicines8070222] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/12/2022] Open
Abstract
The discovery of metabolomics-based biomarkers has been a focus of recent kidney dysfunction research. In the present study, we aimed to identify metabolites associated with chronic kidney disease (CKD) in the general population using a cross-sectional study design. At baseline, 6.5% of subjects had CKD. Pearson correlation analysis showed that 28 metabolites were significantly associated with estimated glomerular filtration rate (eGFR) after Bonferroni correction. Among these metabolites, 4 acylcarnitines, 12 amino acids, 4 biogenic amines, 1 phosphatidylcholine, and 1 sphingolipid were associated with CKD (p < 0.05). After eight years, 13.5% of subjects had CKD. Three amino acid metabolites were positively associated with new-onset CKD: citrulline [odds ratio (OR): 2.41, 95% confidence interval (CI): 1.26–4.59], kynurenine (OR: 1.98, 95% CI: 1.05–3.73), and phenylalanine (OR: 2.68, 95% CI: 1.00–7.16). The kynurenine:tryptophan ratio was also associated with CKD (OR: 3.20; 95% CI: 1.57–6.51). The addition of multiple metabolites significantly improved the CKD prediction by C statistics (0.756–0.85, p < 0.0001), and the net reclassification improvement was 0.84 (95% CI: 0.72–0.96). Elevated hs-C reactive protein (CRP) was associated with new-onset CKD (OR: 1.045, 95% CI: 1.005–1.086); however, this association disappeared following adjustment with the kynurenine:tryptophan ratio. The levels of citrulline and kynurenine and their ratio to tryptophan in CKD patients with proteinuria were worse than those with one or neither characteristic. Together, the results of this study demonstrate that amino acid metabolites are associated with CKD eight years after initial metabolite assessment. These results could improve the identification of subjects at high risk of CKD who have modified amino acid metabolism.
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Affiliation(s)
| | | | | | | | - Hye-Ja Lee
- Correspondence: ; Tel.: +82-43-719-8692; Fax: +82-43-719-8702
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11
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Song J, Tao C, Chen G, Chen S, Xu W, Du J, Yang Y, Huang Y. Reduced 24-h Sodium Excretion Is Associated With a Disturbed Plasma Acylcarnitine Profile in Vasovagal Syncope Children: A Pilot Study. Front Pediatr 2020; 8:98. [PMID: 32219086 PMCID: PMC7078237 DOI: 10.3389/fped.2020.00098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/26/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate if the low sodium intake is associated with the plasma carnitine and acylcarnitine profile in children with vasovagal syncope (VVS). Materials and Methods: Twenty-six children suffering from VVS were recruited in the present study and divided into a group of low urinary sodium excretion or a group of normal urinary sodium excretion according to the excretion of 24-h urinary sodium <3 or 3-6 g, respectively. The excretion of 24-h urinary sodium was detected with ion-selective electrode approach. Plasma carnitine and acylcarnitine concentrations were measured with tandem mass spectrometry. Each participant completed the head-up tilt test. The demographics, clinical characteristics, hemodynamic parameters and plasma carnitine and acylcarnitine concentrations were compared between the two groups. A bivariate correlation between plasma acylcarnitine profiles and the excretion of 24-h urinary sodium was conducted with Spearman's correlation coefficients. Results: Of the enrolled VVS patients, 14 patients were assigned to the group of low urinary sodium excretion and the remaining 12 patients were assigned to the group of normal urinary sodium excretion. Symptoms of fatigue were more prevalent in the group of low urinary sodium excretion than in the group of normal urinary sodium excretion (p = 0.009). Aside from fatigue, no other differences in the demographics, clinical characteristics or hemodynamic parameters during the head-up tilt test were found between the two groups (p > 0.05). Concentrations of plasma tiglylcarnitine (C5:1), hydroxyhexadecanoylcarnitine (C16OH), hydroxyoctadecanoylcarnitine (C18OH), and carnitine C22 were significantly higher in the group of low urinary sodium excretion than in the group of normal urinary sodium excretion (all p-values = 0.048); moreover, they were all negatively correlated with 24-h urinary sodium levels (all p-values = 0.016). There were no differences between the two groups in other acylcarnitines or free carnitine. Conclusions: Reduced excretion of 24-h urinary sodium is associated with a disturbed plasma acylcarnitine profile in children with VVS. The findings suggest that restricted sodium intake-induced disturbance of plasma acylcarnitines and related cellular energy metabolism might be involved in the pathogenesis of VVS in children.
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Affiliation(s)
- Jinqing Song
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Chunyan Tao
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Guozhen Chen
- Department of Pediatrics, Peking University First Hospital, Beijing, China
- Department of Pediatrics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Selena Chen
- Division of Biological Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Wenrui Xu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yanling Yang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yaqian Huang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
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Xu ZR, Zhu XY, Lu W, Sun WH, Cheng RQ, Ni JW, Xi L, Hussain K, Luo FH, Zhang MY. Altered Serum Amino Acid and Acylcarnitine Profiles in Hyperinsulinemic Hypoglycemia and Ketotic Hypoglycemia. Front Endocrinol (Lausanne) 2020; 11:577373. [PMID: 33133020 PMCID: PMC7579424 DOI: 10.3389/fendo.2020.577373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/22/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In addition to inborn metabolic disorders, altered metabolic profiles were reported to be associated with the risk and prognosis of some non-metabolic diseases, while as a rare metabolic disease, the overall secondary metabolic spectrum in congenital hyperinsulinemic hypoglycemia (HH) is largely undetermined. Therefore, we investigated metabolic profiles in HH patients and used ketotic hypoglycemia (KH) patients as a control cohort to unveil their distinct metabolic features. METHODS A total of 97 hypoglycemia children, including 74 with hyperinsulinemic hypoglycemia and 23 with ketotic hypoglycemia, and 170 euglycemia control subjects were studied retrospectively. Clinical and biochemical data were collected. The normoglycemic spectra of amino acids and acylcarnitines were determined by liquid chromatography tandem mass spectrometry. The serum insulin and fatty acid concentrations during standardized fasting tests in hypoglycemia patients were also collected. Receiver operating characteristic curve analysis was performed to screen potential biomarkers. RESULTS Among the normoglycemic spectra of amino acids, blood valine (p < 0.001), arginine (p < 0.001), threonine (p = 0.001), glutamate (p = 0.002), methionine (p = 0.005), ornithine (p = 0.008), leucine (p = 0.014), alanine (p = 0.017), proline (p = 0.031), citrulline (p = 0.042), aspartate (p = 0.046), and glycine (p = 0.048) levels differed significantly among the three groups. Significantly decreased levels of long- (C14:1, p < 0.001; C18, p < 0.001), medium- (C8, p < 0.001; C10, p < 0.001; C10:1, p < 0.001), and short-chain (C4-OH, p < 0.001; C5OH, p < 0.001) acylcarnitines were found in the hyperinsulinemic hypoglycemia group. Hyperinsulinemic hypoglycemia children with focal lesions and diffuse lesions had similar amino acid and acylcarnitine spectra. C10:1 < 0.09 μmol/L, threonine > 35 μmol/L, and threonine/C10:1 > 440 showed sensitivities of 81.1, 66.2, and 81.1% and specificities of 72.7, 78.3, and 81.8%, respectively, in distinguishing HH from KH. CONCLUSIONS We found significantly different altered serum amino acid and acylcarnitine profiles at normoglycemia, especially decreased C10:1 and increased threonine levels, between HH and KH children, which may reflect the insulin ketogenesis inhibition effect in HH patients; however, the detailed mechanisms and physiological roles remain to be studied in the future.
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Affiliation(s)
- Zhen-Ran Xu
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Xiao-Yi Zhu
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Wei Lu
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Wei-Hua Sun
- Pediatric Research Institute, Children's Hospital of Fudan University, Shanghai, China
| | - Ruo-Qian Cheng
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Jin-Wen Ni
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Li Xi
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Khalid Hussain
- Department of Pediatric Medicine, Weill Cornell Medicine, Division of Endocrinology, Doha, Qatar
| | - Fei-Hong Luo
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Miao-Ying Zhang
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, Shanghai, China
- *Correspondence: Miao-Ying Zhang,
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