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Fang Y, Dou A, Zhang Y, Xie H, Zhang Y, Cui Y, Xie K. Association between stress hyperglycemia ratio and acute kidney injury development in patients with sepsis: a retrospective study. Front Endocrinol (Lausanne) 2025; 16:1542591. [PMID: 40303646 PMCID: PMC12039311 DOI: 10.3389/fendo.2025.1542591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Accepted: 03/26/2025] [Indexed: 05/02/2025] Open
Abstract
Background Stress hyperglycemia ratio (SHR), which adjusts blood glucose levels using glycated hemoglobin to eliminate the influence of chronic hyperglycemia, has been demonstrated to have superior predictive value than absolute hyperglycemia. However, its predictive value for sepsis-associated acute kidney injury (SA-AKI) remains unclear. This study aimed to investigate the relationship between the SHR and the risk of developing SA-AKI. Methods Data were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Restricted cubic splines (RCS) were employed to depict the relationship between SHR and the likelihood of SA-AKI, determining an optimal cut-off value. Based on this threshold, patients were categorized into two groups. Logistic regression was utilized to evaluate SHR's predictive value for SA-AKI, with adjustments for confounding variables. Propensity score matching (PSM) was applied to balance baseline characteristics. Subgroup and sensitivity analyses were conducted. Results A total of 2,249 patients were included. The RCS curve indicated a non-linear positive association between SHR and the likelihood of SA-AKI (P for non-linearity < 0.001), with an optimal cut-off at 1.55. Accordingly, patients were divided into SHR ≤ 1.55 and SHR > 1.55 subgroups, comprising 1,131 and 1,118 individuals, respectively. A higher incidence of SA-AKI was observed in the SHR > 1.55 group (38.64% vs. 27.23%, P < 0.001). This association persisted after baseline adjustment through PSM. Logistic regression analysis confirmed that SHR > 1.55 was linked to increased odds of SA-AKI in both unadjusted (OR: 1.68, P < 0.001) and adjusted models (OR: 1.73, P < 0.001), with SHR ≤ 1.55 serving as the reference. In subgroup analysis, all subgroups consistently demonstrated a significant association between SHR > 1.55 and elevated odds of SA-AKI (all OR > 1). Sensitivity analysis validated that SHR > 1.55 remained significantly correlated with SA-AKI occurrence in the survival subgroup (OR: 1.46, P < 0.001) and the non-CKD subgroup (OR: 1.69, P < 0.001). Conclusion The findings indicate a non-linear positive relationship between SHR and the likelihood of SA-AKI in patients with sepsis, suggesting that SHR could be a potential predictor for SA-AKI.
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Affiliation(s)
- Yipeng Fang
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Aizhen Dou
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Ying Zhang
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Hui Xie
- Firth Clinical College, Xinxiang Medical University, Xinxiang, Henan, China
| | | | - Yan Cui
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China
- Department of Pathogen Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Keliang Xie
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China
- Department of Anesthesiology, Tianjin Institute of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, China
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Shi Y, Duan H, Liu J, Shi X, Zhao M, Zhang Y. Risk analysis and mediation analysis of stress hyperglycemia ratio and all-cause mortality in patients with acute kidney injury. Diabetol Metab Syndr 2025; 17:112. [PMID: 40176163 PMCID: PMC11963474 DOI: 10.1186/s13098-025-01675-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 03/17/2025] [Indexed: 04/04/2025] Open
Abstract
BACKGROUND Stress hyperglycemia ratio (SHR) has been associated with increased mortality from various cerebrovascular events and a higher incidence of acute kidney injury (AKI) in certain patient populations. However, the relationship between SHR and the mortality risk in patients with AKI has not been fully elucidated. Our study sought to comprehensively investigate the association and potential mediating effects between SHR and 28-day and 90-day mortality in patients with AKI. METHODS 3703 patients with AKI were included in this study. Feature importance variables were screened by a random forest algorithm, and the independent association of SHR with mortality risk was determined by Kaplan ‒ Meier survival analysis with Cox regression analysis. Restricted cubic spline (RCS) was conducted to assess the non-linear relationship between SHR and mortality risk. Mediation analysis was deployed to investigate the indirect effect of SHR on respiratory failure (RF) -mediated mortality risk. RESULTS Among the patients with AKI included in this study, the 28-day mortality was 13.6% and the 90-day mortality was 18.7%. Fully adjusted Cox regression demonstrated that SHR was an independent risk factor for 28-day mortality (HR, 1.77 [95% CI 1.38-2.27], P < 0.001) and 90-day mortality (HR, 1.69 [95% CI 1.36-2.11], P < 0.001) in patients with AKI. RCS analysis revealed a linear relationship between SHR and outcome events. Additionally, the effect of SHR on 28-day and 90-day mortality risk were mediated by an increased RF risk in 6.62% and 6.54%, respectively. CONCLUSION High SHR is an independent risk factor for 28-day and 90-day mortality in patients with AKI, and its effect is partly mediated by an increased risk of RF.
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Affiliation(s)
- Yue Shi
- Department of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Hangyu Duan
- Department of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Jing Liu
- Department of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xiujie Shi
- Deparment of Nephrology, The First Hospital of Tsinghua University, Beijing, 100016, China
| | - Mingming Zhao
- Department of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Yu Zhang
- Department of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
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Zhao Y, Zhao Y, Wang S, Fan Z, Wang Y, Liu F, Liu Z. Association between stress hyperglycemia ratio and contrast-induced nephropathy in ACS patients undergoing PCI: a retrospective cohort study from the MIMIC-IV database. BMC Cardiovasc Disord 2025; 25:135. [PMID: 40000936 PMCID: PMC11863500 DOI: 10.1186/s12872-025-04573-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Accepted: 02/14/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Contrast-induced nephropathy (CIN) is a significant complication in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The role of the stress hyperglycemia ratio (SHR) as a predictor of CIN and mortality in these patients remains unclear and warrants investigation. OBJECTIVE To assess the relationship between SHR and CIN, as well as its impact on short-term mortality in ACS patients undergoing PCI. METHODS We conducted a retrospective cohort study using the MIMIC-IV database, including 552 ACS patients. SHR was calculated as the ratio of admission glucose to estimated average glucose from hemoglobin A1c. CIN was defined as a ≥ 0.5 mg/dL or ≥ 25% increase in serum creatinine within 48 h of PCI. Logistic regression and spline models were used to analyze the association between SHR and CIN, while Kaplan-Meier curves assessed 30-day mortality. RESULTS Higher SHR levels were independently associated with increased CIN risk (OR 2.36, 95% CI: 1.56-3.57, P < 0.0001). A J-shaped relationship was observed, with CIN risk rising sharply when SHR exceeded 1.06. SHR was also a predictor of higher 30-day mortality (P < 0.0001). Subgroup analysis revealed a stronger SHR-CIN association in non-diabetic patients. CONCLUSION SHR is an independent predictor of CIN and short-term mortality in ACS patients undergoing PCI. It offers potential for risk stratification and clinical decision-making, especially in non-diabetic patients.
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Affiliation(s)
- Yanlong Zhao
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuanyuan Zhao
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shuai Wang
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhenxing Fan
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Yanling Wang
- Department of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Fangyan Liu
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhi Liu
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China.
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Xia J, Li X, Bai C, Han X. Research Progress of Coenzyme Q in Diabetes Mellitus and Its Common Complications. Diabetes Metab Syndr Obes 2024; 17:3629-3641. [PMID: 39376660 PMCID: PMC11457790 DOI: 10.2147/dmso.s481690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 09/16/2024] [Indexed: 10/09/2024] Open
Abstract
Coenzyme Q has garnered significant attention due to its potential role in enhancing cellular energy production and its antioxidant properties. We delve into the therapeutic potential of coenzyme Q in managing diabetes mellitus and its complications, highlighting its capacity to improve mitochondrial function, reduce inflammation and oxidative stress, and correct lipid profiles. Coenzyme Q has shown promise in ameliorating insulin resistance and alleviating complications such as diabetic peripheral neuropathy, kidney disease, retinopathy, and cardiomyopathy. However, its clinical application is limited by poor bio-availability. This review also provides a comprehensive overview of current therapeutic strategies for diabetes complications involving coenzyme Q, including stimulating endogenous synthesis and utilizing carrier transport systems, offering insights into mechanisms for enhancing coenzyme Q bio-availability. These findings suggest that, with improved delivery methods, coenzyme Q could become a valuable adjunct therapy in the management of diabetes mellitus.
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Affiliation(s)
- Jingdong Xia
- Affiliated Hospital of Chifeng University, Chifeng, The Inner Mongol Autonomous Region, Chifeng, People’s Republic of China
- Key Laboratory of Research on Human Genetic Diseases at Universities of Inner Mongolia Autonomous Region, Chifeng, People’s Republic of China
| | - Xiudan Li
- Affiliated Hospital of Chifeng University, Chifeng, The Inner Mongol Autonomous Region, Chifeng, People’s Republic of China
- Key Laboratory of Research on Human Genetic Diseases at Universities of Inner Mongolia Autonomous Region, Chifeng, People’s Republic of China
| | - Chunying Bai
- Key Laboratory of Research on Human Genetic Diseases at Universities of Inner Mongolia Autonomous Region, Chifeng, People’s Republic of China
| | - Xuchen Han
- Affiliated Hospital of Chifeng University, Chifeng, The Inner Mongol Autonomous Region, Chifeng, People’s Republic of China
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Wang Z, Wang Q, Gong X. Unveiling the Mysteries of Contrast-Induced Acute Kidney Injury: New Horizons in Pathogenesis and Prevention. TOXICS 2024; 12:620. [PMID: 39195722 PMCID: PMC11360536 DOI: 10.3390/toxics12080620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/14/2024] [Accepted: 08/20/2024] [Indexed: 08/29/2024]
Abstract
The utilization of contrast media (CM) in clinical diagnostic imaging and interventional procedures has escalated, leading to a gradual increase in the incidence of contrast-induced acute kidney injury (CI-AKI). Presently, the scarcity of effective pharmacological treatments for CI-AKI poses significant challenges to clinical management. Firstly, we explore the pathogenesis of CI-AKI in this review. Beyond renal medullary ischemia and hypoxia, oxidative stress, cellular apoptosis, and inflammation, emerging mechanisms such as ferroptosis, release of neutrophil extracellular traps (NETs), and nitrosative stress, which offer promising avenues for the management of CI-AKI, are identified. Secondly, a comprehensive strategy for the early prevention of CI-AKI is introduced. Investigating the risk factors associated with CI-AKI is essential for the timely identification of high-risk groups. Additionally, exploring early sensitive biomarkers is crucial for early diagnosis. A synergistic approach that combines these sensitive biomarkers, CI-AKI risk factors, and disease risk prediction models enhances both the accuracy and efficiency of early diagnostic processes. Finally, we explore recent pharmacological and non-pharmacological interventions for the management of Cl-AKI. Beyond the traditional focus on the antioxidant N-acetylcysteine (NAC), we look at active compounds from traditional Chinese medicine, including tetramethylpyrazine (TMP), salvianolic acid B (Sal B), as well as emerging preventive medications like N-acetylcysteine amide (NACA), alprostadil, and others, which all showed potential benefits in animal and clinical studies for CI-AKI prevention. Furthermore, innovative strategies such as calorie restriction (CR), enhanced external counterpulsation (EECP), and mesenchymal stem cell therapy are highlighted as providing fresh insights into Cl-AKI prevention and management.
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Affiliation(s)
| | | | - Xuezhong Gong
- Department of Nephrology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China; (Z.W.); (Q.W.)
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Eraqi WA, El-Sabbagh WA, Aziz RK, Elshahed MS, Youssef NH, Elkenawy NM. Gastroprotective and microbiome-modulating effects of ubiquinol in rats with radiation-induced enteropathy. Anim Microbiome 2024; 6:40. [PMID: 39030597 PMCID: PMC11264694 DOI: 10.1186/s42523-024-00320-9] [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: 10/11/2023] [Accepted: 06/02/2024] [Indexed: 07/21/2024] Open
Abstract
Radiation enteritis is a frequently encountered issue for patients receiving radiotherapy and has a significant impact on cancer patients' quality of life. The gut microbiota plays a pivotal role in intestinal function, yet the impact of irradiation on gut microorganisms is not fully understood. This study explores the gastroprotective effect and gut microbiome-modulating potential of ubiquinol (Ubq), the reduced form of the powerful antioxidant CoQ-10. For this purpose, male albino rats were randomly assigned to four groups: Control, IRR (acute 7 Gy γ-radiation), Ubq_Post (Ubq for 7 days post-irradiation), and Ubq_Pre/Post (Ubq for 7 days pre and 7 days post-irradiation). The fecal microbiomes of all groups were profiled by 16S rRNA amplicon sequencing followed by bioinformatics and statistical analysis. Histopathological examination of intestinal tissue indicated severe damage in the irradiated group, which was mitigated by ubiquinol with enhanced regeneration, goblet cells, and intestinal alkaline phosphatase expression. Compared to the irradiated group, the Ubq-treated groups had a significant recovery of intestinal interleukin-1β, caspase-3, nitric oxide metabolites, and thio-barbituric reactive substances to near-healthy levels. Ubq_Pre/Post group displayed elevated peroxisome proliferator-activated receptor (PPAR-γ) level, suggesting heightened benefits. Serum insulin reduction in irradiated rats improved post-Ubq treatment, with a possible anti-inflammatory effect on the pancreatic tissue. Fecal microbiota profiling revealed a dysbiosis state with a reduction of bacterial diversity post-irradiation, which was re-modulated in the Ubq treated groups to profiles that are indistinguishable from the control group. These findings underscore Ubq's gastroprotective effects against radiation-induced enteritis and its potential in restoring the gut microbiota's diversity and balance.
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Affiliation(s)
- Walaa A Eraqi
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt.
| | - Walaa A El-Sabbagh
- Drug Radiation Research Department, National Center of Radiation and Research Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, 11787, Egypt
| | - Ramy K Aziz
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt
- Microbiology and Immunology Research Program, Children's Cancer Hospital Egypt 57357, Cairo, 11617, Egypt
| | - Mostafa S Elshahed
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, OK, 74074, USA
| | - Noha H Youssef
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, OK, 74074, USA
| | - Nora M Elkenawy
- Drug Radiation Research Department, National Center of Radiation and Research Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, 11787, Egypt.
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Karbasi A, Abbasi A, Mohagheghi A, Poorolajal J, Emami F, Moradkhani S, Khodadadi I, Gholyaf M, Tavilani H. The Effects of Coenzyme Q10 on Contrast-Induced Acute Kidney Injury in Type 2 Diabetes: A Randomized Clinical Trial. Chonnam Med J 2024; 60:59-68. [PMID: 38304125 PMCID: PMC10828077 DOI: 10.4068/cmj.2024.60.1.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 02/03/2024] Open
Abstract
Contrast-induced acute kidney injury (CI-AKI) is a frequent challenge following the injection of contrast media and its subsequent oxidative stress. The aim of the present study was to evaluate the preventive effects of coenzyme Q10 (Q10), as a mitochondrial-targeted antioxidant in CI-AKI in diabetic patients, who account for a large proportion of angiographic cases. A total of 118 diabetic patients were randomly assigned to receive 120 mg of oral coenzyme Q10 (Q10 group) or placebo (Placebo group) for four days, starting 24 hours before contrast media injection. Blood urea nitrogen (BUN), serum and urinary creatinine, estimated glomerular filtration rate (eGFR), urinary malondialdehyde (UMDA), urinary total antioxidant capacity (UTAC), and urinary mitochondrial to nuclearDNA ratios (mtDNA/nDNA ratio) were evaluated before and after the treatment period. Urine sediments were also evaluated to report the urine microscopy score (UMS).The levels of BUN, serum and urine creatinine, and UMS were similar in the Q10 and placebo groups. EGFR was lower in the Q10 group before the treatment (p=0.013) but not after. The urinary mtDNA/nDNA ratio was 3.05±1.68 and 3.69±2.58 in placebo and Q10 groups, but UTAC was found to be lower in Q10 both before (p=0.006) and after the treatment (p<0.001). The incidence of CI-AKI was 14.40% and the mtDNA/nNDA ratio was similar between CI-AKI and non-CI-AKI patients. In conclusion, Q10 treatment shows no favorable effect on prevention of CI-AKI or a urinary mtDNA/nDNA ratio among diabetic patients.
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Affiliation(s)
- Ashkan Karbasi
- Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Abbasi
- Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mohagheghi
- Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farzad Emami
- Department of Cardiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shirin Moradkhani
- Department of Pharmacognosy, School of Pharmacy, Medicinal Plants and Natural Products, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Iraj Khodadadi
- Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahmoud Gholyaf
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Heidar Tavilani
- Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Infectious disease Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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El-Sabbagh WA, Fadel NA, El-Hazek RM, Osman AH, Ramadan LA. Ubiquinol attenuates γ-radiation induced coronary and aortic changes via PDGF/p38 MAPK/ICAM-1 related pathway. Sci Rep 2023; 13:22959. [PMID: 38151557 PMCID: PMC10752893 DOI: 10.1038/s41598-023-50218-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/16/2023] [Indexed: 12/29/2023] Open
Abstract
Endothelial vascular injury is one of the most pivotal disorders emerging during radiotherapy. It is crucial to rely on strong antioxidants to defend against vascular damage. The current study was carried out to investigate the ameliorative effect of ubiquinol (Ubq) against gamma (γ)-radiation induced aortic and coronary changes, with highlighting its role in suppression of p38 mitogen activated protein kinase (MAPK). Exposure to γ-radiation was adopted as a potent detrimental model that induces vascular tissue damage. Concisely, male albino rats were irradiated at a dose level of 7 Gy and treated daily with Ubq (10 mg/kg/day, p.o.) for 7 days pre-and post-irradiation. At the end of the experiment, lipid profile, 8-hydroxydeoxyguanosine (8-OHdG), gene expression of intercellular adhesion molecule (ICAM-1), platelet derived growth factor (PDGF), p38 MAPK and matrix metalloproteinase-9 (MMP-9) were estimated. Exposure to radiation significantly deteriorates aortic and coronary tissues. Conversely, administration of Ubq significantly reduced serum t-cholesterol, LDL and triglycerides (p = 0.001). In addition, Ubq prevented oxidative DNA damage (8-OHdG) (p = 0.1) and reduced serum MMP-9 (p = 0.001) which contributed to the endothelial cells damage. The positive impact of Ubq was more apparent in suppression of both PDGF (p = 0.001) and p38 MAPK (p = 0.1) protein concentrations, leading subsequently in reduction of ICAM-1 (p = 0.001) gene expression. As a conclusion, vascular endothelial damage brought on by γ-radiation is one of the leading causes of coronary and aortic deteriorations which could be successfully mitigated by Ubq.
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Affiliation(s)
- Walaa A El-Sabbagh
- Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Noha A Fadel
- Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Cairo, Egypt.
| | - Rania M El-Hazek
- Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Ahmed H Osman
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Laila A Ramadan
- Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Cairo, Egypt
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Egyptian Russian University (ERU), Cairo, Egypt
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Shan Y, Lin M, Gu F, Ying S, Bao X, Zhu Q, Tao Y, Chen Z, Li D, Zhang W, Fu G, Wang M. Association between fasting stress hyperglycemia ratio and contrast-induced acute kidney injury in coronary angiography patients: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1300373. [PMID: 38155953 PMCID: PMC10753820 DOI: 10.3389/fendo.2023.1300373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
Aims Stress hyperglycemia ratio (SHR), an emerging indicator of critical illness, exhibits a significant association with adverse cardiovascular outcomes. The primary aim of this research endeavor is to evaluate the association between fasting SHR and contrast-induced acute kidney injury (CI-AKI). Methods This cross-sectional study comprised 3,137 patients who underwent coronary angiography (CAG) or percutaneous coronary intervention (PCI). The calculation of fasting SHR involved dividing the admission fasting blood glucose by the estimated mean glucose obtained from glycosylated hemoglobin. CI-AKI was assessed based on elevated serum creatinine (Scr) levels. To investigate the relationship between fasting SHR and the proportion of SCr elevation, piecewise linear regression analysis was conducted. Modified Poisson's regression analysis was implemented to evaluate the correlation between fasting SHR and CI-AKI. Subgroup analysis and sensitivity analysis were conducted to explore result stability. Results Among the total population, 482 (15.4%) patients experienced CI-AKI. Piecewise linear regression analysis revealed significant associations between the proportion of SCr elevation and fasting SHR on both sides (≤ 0.8 and > 0.8) [β = -12.651, 95% CI (-23.281 to -2.022), P = 0.020; β = 8.274, 95% CI (4.176 to 12.372), P < 0.001]. The Modified Poisson's regression analysis demonstrated a statistically significant correlation between both the lowest and highest levels of fasting SHR and an increased incidence of CI-AKI [(SHR < 0.7 vs. 0.7 ≤ SHR < 0.9) β = 1.828, 95% CI (1.345 to 2.486), P < 0.001; (SHR ≥ 1.3 vs. 0.7 ≤ SHR < 0.9) β = 2.896, 95% CI (2.087 to 4.019), P < 0.001], which was further validated through subgroup and sensitivity analyses. Conclusion In populations undergoing CAG or PCI, both lowest and highest levels of fasting SHR were significantly associated with an increased occurrence of CI-AKI.
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Affiliation(s)
- Yu Shan
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Maoning Lin
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Fangfang Gu
- Department of Cardiology, The Affiliated Huzhou Hospital (Huzhou Central Hospital), College of Medicine, Zhejiang University, Huzhou, Zhejiang, China
| | - Shuxin Ying
- Department of Endocrinology and Metabolism, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoyi Bao
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Qiongjun Zhu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Yecheng Tao
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Zhezhe Chen
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Duanbin Li
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Wenbin Zhang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Guosheng Fu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Min Wang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
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Sadek SA, Marzouk M, Mohamed HRH, El-Sallam BFA, Elfiky AA, Sayed AA. Chia seeds and coenzyme Q 10 alleviate iron overload induced hepatorenal toxicity in mice via iron chelation and oxidative stress modulation. Sci Rep 2023; 13:19773. [PMID: 37957293 PMCID: PMC10643458 DOI: 10.1038/s41598-023-47127-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/09/2023] [Indexed: 11/15/2023] Open
Abstract
Iron overload (IOL) can cause hepatorenal damage due to iron-mediated oxidative and mitochondrial damage. Remarkably, combining a natural iron chelator with an antioxidant can exert greater efficacy than monotherapy. Thus, the present study aimed to evaluate the efficacy of Chia and CoQ10 to chelate excess iron and prevent hepatorenal oxidative damage in IOL mice. Male Swiss albino mice (n = 49) were randomly assigned to seven groups: control, dietary Chia, CoQ10, IOL, IOL + Chia, IOL + CoQ10, and IOL + Chia + CoQ10. Computational chemistry indicates that the phytic acid found in the Chia seeds is stable, reactive, and able to bind to up to three iron ions (both Fe2+ and Fe3+). IOL induced a significant (P < 0.05) increase in serum iron, ferritin, transferrin, TIBC, TSI, RBCs, Hb, MCV, MCH, WBCs, AST, ALT, creatinine, and MDA. IOL causes a significant (P < 0.05) decrease in UIBC, platelets, and antioxidant molecules (GSH, SOD, CAT, and GR). Also, IOL elicits mitochondrial membrane change depolarization, and DNA fragmentation and suppresses mitochondrial DNA copies. Furthermore, substantial changes in hepatic and renal tissue, including hepatocellular necrosis and apoptosis, glomerular degeneration, glomerular basement membrane thickening, and tubular degeneration, were observed in the IOL group. Dietary Chia and CoQ10 induced significant (P < 0.05) amelioration in all the mentioned parameters. They can mostly repair the abnormal architecture of hepatic and renal tissues induced by IOL, as signified by normal sinusoids, normal central veins, and neither glomerular damage nor degenerated tubules. In conclusion, the combined treatment with Chia + CoQ10 exerts more pronounced efficacy than monotherapy in hepatorenal protection via chelating excess iron and improved cellular antioxidant status and hepatorenal mitochondrial function in IOL mice.
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Affiliation(s)
- Shimaa A Sadek
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Mohamed Marzouk
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Hanan R H Mohamed
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt.
| | | | - Abdo A Elfiky
- Biophysics Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Amany A Sayed
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt
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11
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Tan X, Yang X, Xu X, Peng Y, Li X, Deng Y, Zhang X, Qiu W, Wu D, Ruan Y, Zhi C. Investigation of anti-diabetic effect of a novel coenzyme Q10 derivative. Front Chem 2023; 11:1280999. [PMID: 37927560 PMCID: PMC10620959 DOI: 10.3389/fchem.2023.1280999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction: The rising incidence of type 2 diabetes has seriously affected international public health. The search for more drugs that can effectively treat diabetes has become a cutting-edge trend in research. Coenzyme Q10 (CoQ10) has attracted much attention in the last decade due to its wide range of biological activities. Many researchers have explored the clinical effects of CoQ10 in patients with type 2 diabetes. However, CoQ10 has low bio-availability due to its high lipophilicity. Therefore, we have structurally optimized CoQ10 in an attempt to exploit the potential of its pharmacological activity. Methods: A novel coenzyme Q10 derivative (L-50) was designed and synthesized by introducing a group containing bromine atom and hydroxyl at the terminal of coenzyme Q10 (CoQ10), and the antidiabetic effect of L-50 was investigated by cellular assays and animal experiments. Results: Cytotoxicity results showed that L-50 was comparatively low toxicity to HepG2 cells. Hypoglycemic assays indicated that L-50 could increase glucose uptake in IR-HepG2 cells, with significantly enhanced hypoglycemic capacity compared to the CoQ10. In addition, L-50 improved cellular utilization of glucose through reduction of reactive oxygen species (ROS) accumulated in insulin-resistant HepG2 cells (IR-HepG2) and regulation of JNK/AKT/GSK3β signaling pathway, resulting in hypoglycemic effects. Furthermore, the animal experiments demonstrated that L-50 could restore the body weight of HFD/STZ mice. Notably, the findings suggested that L-50 could improve glycemic and lipid metabolism in HFD/STZ mice. Moreover, L-50 could increase fasting insulin levels (FINS) in HFD/STZ mice, leading to a decrease in fasting blood glucose (FBG) and hepatic glycogen. Furthermore, L-50 could recover triglycerides (TG), total cholesterol (T-CHO), lipoprotein (LDL-C) and high-density lipoprotein (HDL-C) levels in HFD/STZ mice. Discussion: The addition of a bromine atom and a hydroxyl group to CoQ10 could enhance its anti-diabetic activity. It is anticipated that L-50 could be a promising new agent for T2DM.
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Affiliation(s)
- Xiaojun Tan
- School of Pharmacy, Guangdong Medical University, Dongguan, China
| | - Xinyi Yang
- School of Pharmacy, Guangdong Medical University, Dongguan, China
| | - Xun Xu
- School of Pharmacy, Guangdong Medical University, Dongguan, China
| | - Yuwei Peng
- School of Pharmacy, Guangdong Medical University, Dongguan, China
| | - Xin Li
- School of Pharmacy, Guangdong Medical University, Dongguan, China
| | - Yongxing Deng
- School of Pharmacy, Guangdong Medical University, Dongguan, China
| | - Xueyang Zhang
- School of Pharmacy, Guangdong Medical University, Dongguan, China
| | - Wenlong Qiu
- School of Pharmacy, Guangdong Medical University, Dongguan, China
| | - Dudu Wu
- School of Pharmacy, Guangdong Medical University, Dongguan, China
| | - Yongdui Ruan
- The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, China
| | - Chen Zhi
- School of Pharmacy, Guangdong Medical University, Dongguan, China
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12
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Elkenawy NM, Ghaiad HR, Ibrahim SM, Aziz RK, Rashad E, Eraqi WA. Ubiquinol preserves immune cells in gamma-irradiated rats: Role of autophagy and apoptosis in splenic tissue. Int Immunopharmacol 2023; 123:110647. [PMID: 37499399 DOI: 10.1016/j.intimp.2023.110647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/02/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023]
Abstract
Radiation has been applied in cancer treatment to eradicate tumors and displayed great therapeutic benefits for humans. However, it is associated with negative impacts on normal cells, not only cancer cells. Irradiation can trigger cell death through several mechanisms, such as apoptosis, necrosis, and autophagy. This study aimed to investigate the radioprotective efficacy of ubiquinol against radiation-induced splenic tissue injury in animals and the related involved mechanisms. Animals were classified into four groups: group 1 (normal untreated rats) received vehicle 5 % Tween 80; group 2 received 7 Gy γ-radiation; group 3 received 10 mg/Kg oral ubiquinol post-irradiation; and group 4 received 10 mg/Kg oral ubiquinol before and after (pre/post-) irradiation. Ubiquinol restored the spleen histoarchitecture, associated with improved immunohistochemical quantification of B and T lymphocyte markers and ameliorated hematological alterations induced by irradiation. Such effects may be due to an enhanced antioxidant pathway through stimulation of p62, Nrf2, and GSH, associated with reduced Keap1 and MDA. Moreover, ubiquinol decreased mTOR, thus enhanced autophagy markers viz. LC3-II. Furthermore, ubiquinol showed an antiapoptotic effect by enhancing Bcl-2 and reducing caspase-3 and Bax. Consequently, ubiquinol exerts a splenic-protective effect against irradiation via enhancing antioxidant, autophagic, and survival pathways.
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Affiliation(s)
- Nora Mohamed Elkenawy
- Drug Radiation Research Department, National Center of Radiation and Research Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo 11787, Egypt.
| | - Heba Ramadan Ghaiad
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Sherehan Mohamed Ibrahim
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.
| | - Ramy Karam Aziz
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt; Microbiology and Immunology Research Program, Children's Cancer Hospital (Egypt 57357), Cairo 11617, Egypt
| | - Eman Rashad
- Cytology and Histology Department, Faculty of Veterinary Medicine, Cairo University, Giza 12211, Egypt
| | - Walaa Ahmed Eraqi
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
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13
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Aramli MS, Sarvi Moghanlou K, Imani A. Effect of dietary antioxidant supplements (selenium forms, alpha-tocopherol, and coenzyme Q10) on growth performance, immunity, and physiological responses in rainbow trout (Oncorhynchus mykiss) using orthogonal array design. FISH & SHELLFISH IMMUNOLOGY 2023; 134:108615. [PMID: 36775181 DOI: 10.1016/j.fsi.2023.108615] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Dietary supplements containing antioxidants play an important role in reducing the risk of peroxidative attack in aquatic animals. In this work, an orthogonal array design (L9: 34) was used to evaluate the effect of four dietary antioxidant supplements on the physiological responses of rainbow trout at three levels. The supplements included different (A) selenium (Se) forms (inorganic, organic, and nanoparticle), (B) Se content (0, 0.3, & 0.5 mg/kg feed), (C) vitamin E (VE) content (0, 100, & 150 mg/kg feed), and (D) coenzyme Q10 (CoQ10) content (0, 10, & 20 mg/kg feed). Fish with an average body weight of 8.35 ± 0.33 g were randomly allocated to different experimental groups. According to the results, the antioxidant supplements included in the diet had no significant effects on the growth performance of fish (P > 0.05). Immunological and antioxidant parameters were mainly improved by the Se form (Nano-Se) and dietary CoQ10 supplementation. In addition, Se form and VE were more effective in digestive enzyme activities and hematology indices in comparison to other dietary antioxidants. Additionally, diets supplemented with nano-Se along with CoQ10 and VE improved fish resistance/stamina against stress. In conclusion, a more effective combination of the four antioxidant supplements was A2/3B2/3C3D3 (i.e., 0.5 mg/kg organic/nano-Se, 150 mg/kg VE, and 20 mg/kg CoQ10), which could mainly improve the physiological responses of rainbow trout.
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Affiliation(s)
| | | | - Ahmad Imani
- Department of Fisheries, Faculty of Natural Resources, Urmia University, Urmia, Iran.
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14
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Zhao S, Wu W, Liao J, Zhang X, Shen M, Li X, Lin Q, Cao C. Molecular mechanisms underlying the renal protective effects of coenzyme Q10 in acute kidney injury. Cell Mol Biol Lett 2022; 27:57. [PMID: 35869439 PMCID: PMC9308331 DOI: 10.1186/s11658-022-00361-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/06/2022] [Indexed: 12/18/2022] Open
Abstract
AbstractCoenzyme Q10 (CoQ10), an endogenous antioxidant, has been reported frequently to exert an outstanding protective effect on multiple organ injury, including acute kidney injury (AKI). In this study, we aim to summarize all the current evidence of the protective action of CoQ10 against AKI as there are presently no relevant reviews in the literature. After a systematic search, 20 eligible studies, either clinical trials or experimental studies, were included and further reviewed. CoQ10 treatment exhibited a potent renal protective effect on various types of AKI, such as AKI induced by drugs (e.g., ochratoxin A, cisplatin, gentamicin, L-NAME, and nonsteroidal anti-inflammatory drug), extracorporeal shock wave lithotripsy (ESWL), sepsis, contrast media, and ischemia–reperfusion injury. The renal protective role of CoQ10 against AKI might be mediated by the antiperoxidative, anti-apoptotic, and anti-inflammatory potential of CoQ10. The molecular mechanisms for the protective effects of CoQ10 might be attributed to the regulation of multiple essential genes (e.g., caspase-3, p53, and PON1) and signaling cascades (e.g., Nrf2/HO-1 pathway). This review highlights that CoQ10 may be a potential strategy in the treatment of AKI.
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15
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Exploring the effects of edaravone in rats with contrast-induced acute kidney injury. Life Sci 2022; 309:121006. [PMID: 36174711 DOI: 10.1016/j.lfs.2022.121006] [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: 07/20/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022]
Abstract
AIMS Oxidative stress and inflammatory response play a vital role in the pathogenesis of contrast-induced acute kidney injury (CI-AKI). This study investigated the effects of edaravone in rats with CI-AKI. MAIN METHODS Male Sprague Dawley rats were randomly assigned into four groups (n = 11-14/group): control, edaravone (30 mg/kg/day intraperitoneally (IP)), CI-AKI, and edaravone with CI-AKI. The induction of CI-AKI was performed by dehydration and the administration of contrast media (iohexol) and inhibitors of prostaglandin (indomethacin) and nitric oxide synthesis (L-NAME: N-nitro L-arginine methyl ester). Edaravone was administered for two weeks before the induction of CI-AKI. Serum creatinine and urea, renal oxidative stress and inflammatory biomarkers, and histopathological alterations were evaluated after 48 h of contrast exposure. KEY FINDINGS Rats with CI-AKI showed a significant increase in serum creatinine and urea. The levels of antioxidant biomarkers including glutathione peroxidase, superoxide dismutase and reduced glutathione were significantly decreased in CI-AKI group versus control. Pre-treatment of rats with edaravone normalized kidney function and protected the kidney from oxidative damage as demonstrated by normalization of previous biomarkers. Furthermore, edaravone partially ameliorated renal histopathological alterations relative to the CI-AKI group, notably in the nephrons. No changes were observed in inflammatory biomarkers including tumour necrosis factor-alpha and interleukin-6 among all groups. SIGNIFICANCE The current findings suggest that edaravone could be a potential strategy to ameliorate developing CI-AKI possibly by improving renal antioxidant capacity. Further studies are warranted to expand the current understanding of the use of edaravone in the various models of AKI.
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