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Zhang X, Yang B. The serum levels of gasdermin D in uremic patients and its relationship with the prognosis: a prospective observational cohort study. Ren Fail 2024; 46:2312534. [PMID: 38486504 PMCID: PMC10946257 DOI: 10.1080/0886022x.2024.2312534] [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: 08/23/2023] [Accepted: 01/27/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE This study aimed to explore the serum levels of gasdermin D (GSDMD) in uremic (end-stage kidney disease, ESKD) patients and their correlation with vascular calcification (VC) and clinical results. METHODS This prospective observational cohort study enrolled 213 ESKD patients who were undergoing regular maintenance hemodialysis (MHD) for > 3 months in our hospital from August 2019 to July 2022. The abdominal aortic calcification score (AACS) was used to assess the VC condition of patients with ESKD. Serum GSDMD, caspase-1, interleukin (IL)-6, IL-1β, IL-18 and C-reactive protein (CRP) levels were measured using enzyme-linked immunosorbent assay (ELISA). Demographic and clinical data were obtained. All patients were followed up for 1 year, and patients with major adverse cardiovascular events (MACE) were defined as having a poor prognosis. All data used SPSS 26.0 to statistical analyses. RESULTS The serum total cholesterol (TC) levels of patients in the AACS > 4 group were significantly elevated compared with those in the AACS ≤ 4 group. In addition, ESKD patients with an AACS > 4 had significantly higher serum levels of GSDMD, caspase-1, IL-6, IL-18 and IL-1β. Moreover, Pearson's analysis supported a positive correlation between GSDMD and caspase-1, IL-6, and IL-1β. In addition, we found that GSDMD levels were positively correlated with the clinical data (AACS scores and serum TC levels) of patients with ERSD. Additionally, ROC curves showed that the serum levels of GSDMD could be a potential predictive biomarker of moderate/severe VC and prognosis in patients with ESKD. Finally, the results of logistic regression indicated that GSDMD and AACS scores were risk factors for poor prognosis in patients with ESKD. CONCLUSION Serum GSDMD levels were remarkably elevated in patients with ESKD with moderate/severe calcification. In addition, serum levels of GSDMD could be a potential predictive biomarker of moderate/severe VC and prognosis in patients with ESKD.
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Affiliation(s)
- XiaPing Zhang
- Department of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Bo Yang
- Department of Clinical Nursing, The Second Xiangya Hospital of Central South University, Changsha, China
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Czaja-Stolc S, Chatrenet A, Potrykus M, Ruszkowski J, Torreggiani M, Lichodziejewska-Niemierko M, Dębska-Ślizień A, Piccoli GB, Małgorzewicz S. Adipokines and Myokines as Markers of Malnutrition and Sarcopenia in Patients Receiving Kidney Replacement Therapy: An Observational, Cross-Sectional Study. Nutrients 2024; 16:2480. [PMID: 39125361 PMCID: PMC11314363 DOI: 10.3390/nu16152480] [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: 06/25/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
Chronic kidney disease (CKD) is linked to an elevated risk of malnutrition and sarcopenia, contributing to the intricate network of CKD-related metabolic disorders. Adipokines and myokines are markers and effectors of sarcopenia and nutritional status. The aim of this study was to assess whether the adipokine-myokine signature in patients on kidney replacement therapy could help identify malnutrition and sarcopenia. The study involved three groups: 84 hemodialysis (HD) patients, 44 peritoneal dialysis (PD) patients, and 52 kidney transplant recipients (KTR). Mean age was 56.1 ± 16.3 years. Malnutrition was defined using the 7-Point Subjective Global Assessment (SGA) and the Malnutrition-Inflammation Score (MIS). Sarcopenia was diagnosed based on reduced handgrip strength (HGS) and diminished muscle mass. Concentrations of adipokines and myokines were determined using the enzyme-linked immunosorbent assay (ELISA). 32.8% of all study participants were identified as malnourished and 20.6% had sarcopenia. For malnutrition, assessed using the 7-Point SGA, in ROC analysis albumin (area under the curve (AUC) 0.67 was the best single biomarker identified. In dialysis patients, myostatin (AUC 0.79) and IL-6 (AUC 0.67) had a high discrimination value for sarcopenia, and we were able to develop a prediction model for sarcopenia, including age, albumin, adiponectin, and myostatin levels, with an AUC of 0.806 (95% CI: 0.721-0.891). Adipokines and myokines appear to be useful laboratory markers for assessing malnutrition and sarcopenia. The formula we propose could contribute to a better understanding of sarcopenia and potentially lead to more effective interventions and management strategies for dialysis patients.
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Affiliation(s)
- Sylwia Czaja-Stolc
- Department of Clinical Nutrition and Dietetics, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland; (S.C.-S.); (S.M.)
| | - Antoine Chatrenet
- Department of Nephrology, Centre Hospitalier du Mans, 72037 Le Mans, France; (A.C.); (M.T.); (G.B.P.)
- APCoSS—Institute of Physical Education and Sports Sciences (IFEPSA), UCO, 49136 Angers, France
| | - Marta Potrykus
- Department of Oncological, Transplant, and General Surgery, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland
| | - Jakub Ruszkowski
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland; (J.R.); (A.D.-Ś.)
| | - Massimo Torreggiani
- Department of Nephrology, Centre Hospitalier du Mans, 72037 Le Mans, France; (A.C.); (M.T.); (G.B.P.)
| | | | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland; (J.R.); (A.D.-Ś.)
| | - Giorgina Barbara Piccoli
- Department of Nephrology, Centre Hospitalier du Mans, 72037 Le Mans, France; (A.C.); (M.T.); (G.B.P.)
- Department of Nephrology, University of Angers, 49035 Angers, France
| | - Sylwia Małgorzewicz
- Department of Clinical Nutrition and Dietetics, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland; (S.C.-S.); (S.M.)
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Sakashita M, Hamasaki Y, Oki R, Komaru Y, Miyamoto Y, Yoshida T, Matsuura R, Doi K, Nangaku M. Serum Myostatin at Dialysis Initiation May Predict 1-Year Mortality and Hospitalization. Nephron Clin Pract 2024; 148:544-552. [PMID: 38522414 PMCID: PMC11332307 DOI: 10.1159/000538533] [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: 10/17/2023] [Accepted: 03/22/2024] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE Myostatin, which is known as a negative skeleton muscle regulator, is associated with mortality in maintenance hemodialysis patients. However, the significance of serum myostatin concentrations at dialysis initiation has not been established. We investigated the relation between serum myostatin concentrations and mortality or hospitalization within 1 year in incident dialysis patients. METHODS After a patient initiating hemodialysis or peritoneal dialysis during 2016-2018 was enrolled, the patient's serum myostatin at dialysis initiation was measured. Composite outcomes comprising mortality and hospitalization within 1 year after dialysis initiation were compared between two groups divided according to myostatin levels. The Cox proportional hazards model was used to assess significant relations between myostatin and outcomes. RESULTS This study examined 104 incident dialysis patients with a mean age of 65.5 ± 14.0 years (68% male). Kaplan-Meier analyses indicated the 1-year hospitalization-free and survival rate as significantly lower in the lower myostatin group than in the higher myostatin group (p = 0.0020). Cox proportional hazards regression analyses revealed that the value of myostatin logarithm at dialysis initiation was inversely associated with the occurrence of a composite outcome, independently of age (hazard ratio 0.16, 95% confidence interval: 0.05-0.57). Receiver operating characteristic analysis showed the area under the curve of serum myostatin for predicting death or hospitalization within 1 year as higher than those of clinical indices of nutritional disturbance and frailty. CONCLUSION Serum myostatin concentration at dialysis initiation is inversely associated with adverse outcomes in these dialysis-initiated patients.
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Affiliation(s)
- Midori Sakashita
- Department of Hemodialysis and Apheresis, The University of Tokyo Hospital, Tokyo, Japan,
| | - Yoshifumi Hamasaki
- Department of Hemodialysis and Apheresis, The University of Tokyo Hospital, Tokyo, Japan
| | - Rikako Oki
- Department of Hemodialysis and Apheresis, The University of Tokyo Hospital, Tokyo, Japan
| | - Yohei Komaru
- Department of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan
| | - Yoshihisa Miyamoto
- Department of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan
| | - Teruhiko Yoshida
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ryo Matsuura
- Department of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan
| | - Kent Doi
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Masaomi Nangaku
- Department of Hemodialysis and Apheresis, The University of Tokyo Hospital, Tokyo, Japan
- Department of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan
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Ibrahim AH, Kasim SA, Ezzat AA, Ibrahim NE, Hassan DA, Ibrahim AS, Abouelgreed TA, Abdo EM, Aboelsoud NM, Abdelmonem NM, Alnajem MT, Aboomar AA. Relation between myostatin levels and malnutrition and muscle wasting in hemodialysis patients. Arch Ital Urol Androl 2023; 95:11869. [PMID: 38117215 DOI: 10.4081/aiua.2023.11869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND AND AIM Malnutrition is one of the most troublesome comorbidities among hemodialysis patients (HD). Myostatin (MSTN) belongs to the transforming growth factor-β superfamily. In HD patients, MSTN effects are not limited to skeletal muscle growth. The present study aimed to assess MSTN levels in HD patients and its relation to various clinical and biochemical parameters. PATIENTS AND METHODS The present case control study included 60 patients on HD for at least three years. In addition, there were age and sex-matched healthy subjects who constitutes the control group. Nutritional status was evaluated using the malnutrition inflammation score (MIS). Muscle wasting in the present study was evaluated using the lean tissue index (LTI) as assessed by the body composition monitor (BCM). Rectus Femoris Muscle (RFM) thickness was also measured as indicator for nutritional status of patient. RESULTS The present study included 60 HD patients, and ageand sex-matched healthy controls. Patients expressed significantly higher myostatin levels when compared to controls [median (IQR): 221.3 (153.5-688.2) versus 144.8 (97.0-281.7), p < 0.001]. According to MIS, patients were classified into those with no/mild malnutrition (n = 22) and others with moderate/severe malnutrition (n = 38). Comparison between the two subgroups revealed that the former group had significantly lower myostatin levels [167.7 (150.3-236.3) versus 341.7 (160.9-955.9), p = 0.004]. According to LTI, patients were classified into those with muscle wasting (n = 23) and others without muscle wasting (n = 37). Comparative analysis showed that patients in the former group had significantly higher myostatin levels [775.1 (325.1-2133.7) versus 161.8 (142.6-302.3), p < 0.001]. CONCLUSIONS Myostatin seems to be a promising marker for identification of malnutrition and muscle wasting in HD patients.
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Affiliation(s)
- Amal H Ibrahim
- Department of Internal Medicine, Nephrology Unit, Al-Azhar University, Cairo.
| | - Sammar A Kasim
- Department of Internal Medicine, Nephrology Unit, Al-Azhar University, Cairo.
| | - Alshimaa A Ezzat
- Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo.
| | - Noha E Ibrahim
- Department of Microbial Biotechnology, Biotechnology Research Institute, National Research Centre (NRC), Giza.
| | - Donia A Hassan
- Department of Clinical Pathology, Al-Azhar University, Cairo.
| | - Amira Sh Ibrahim
- Department of Rheumatology and Rehabilitation, Faculty of Medicine for girls, Al-Azhar University, Cairo.
| | | | - Ehab M Abdo
- Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo.
| | - Naglaa M Aboelsoud
- Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo.
| | | | | | - Ahmed A Aboomar
- Department of internal medicine, Nephrology Unit, Faculty Medicine, Tanta University, Tanta.
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Silva MZC, Vogt BP, Reis NSC, Minicucci FC, Dorna MS, Minicucci MF, Caramori JCT. Serum myostatin levels are associated with physical function and hospitalization in peritoneal dialysis patients. Eur J Clin Nutr 2023; 77:292-294. [PMID: 36329200 DOI: 10.1038/s41430-022-01227-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/03/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Myostatin functions as a negative regulator of skeletal muscle growth. The association of myostatin with muscle parameters in dialysis patients is inconsistent, and there are no studies associating myostatin with physical function and outcomes in peritoneal dialysis (PD) patients. Therefore, we assessed the association of serum myostatin with lean mass, physical function, and hospitalization in a prospective cohort of PD patients. METHODS Lean mass, physical function, and serum myostatin were assessed at baseline. Patients were followed up for at least 24 months and hospitalization was recorded. RESULTS Serum myostatin levels were positively correlated with handgrip strength and Appendicular Lean Mass Index among male patients. Binary logistic regression models were performed including myostatin levels and physical function parameters as independent variables. Serum myostatin, handgrip strength, gait speed, and Short Physical Performance Battery were associated with hospitalization. CONCLUSION Lower serum myostatin and physical function were associated with hospitalization in PD patients.
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Affiliation(s)
| | - Barbara Perez Vogt
- Federal University of Uberlândia (UFU), Graduate Program in Health Sciences, Medicine Faculty, Uberlândia, Brazil
| | - Nayrana Soares Carmo Reis
- Internal Medicine Department, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil
| | - Fernanda Chiuso Minicucci
- Internal Medicine Department, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil
| | - Mariana Souza Dorna
- Internal Medicine Department, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil
| | - Marcos Ferreira Minicucci
- Internal Medicine Department, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil
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Lee SM, Jeong EG, Jeong YI, Rha SH, Kim SE, An WS. Omega-3 fatty acid and menaquinone-7 combination are helpful for aortic calcification prevention, reducing osteoclast area of bone and Fox0 expression of muscle in uremic rats. Ren Fail 2022; 44:1873-1885. [PMID: 36632744 PMCID: PMC9848285 DOI: 10.1080/0886022x.2022.2142140] [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] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Osteopenia, sarcopenia, and vascular calcification (VC) are prevalent in patients with chronic kidney disease and often coexist. In the absence of proven therapies, it is necessary to develop therapeutic or preventive nutrients supplementation for osteopenia, sarcopenia, and VC. The present study investigated the effect of omega-3 fatty acid (FA) and menaquinone-7 (MK-7) on osteopenia, sarcopenia, and VC in adenine and low-protein diet-induced uremic rats. METHODS Thirty-two male Sprague-Dawley rats were fed diets containing 0.75% adenine and 2.5% protein for three weeks. Rats were randomly divided into four groups that were fed diets containing 2.5% protein for four weeks: adenine control (0.9% saline), omega-3 FA (300 mg/kg/day), MK-7 (50 µg/kg/day), and omega-3 FA/MK-7. Von Kossa staining for aortic calcification assessment was performed. Osteoclast surface/bone surface ratio (OcS/BS) of bone and muscle fiber were analyzed using hematoxylin and eosin staining. Osteoprotegerin (OPG) immunohistochemical staining was done in the aorta and bone. Molecules related with sarcopenia were analyzed using western blotting. RESULTS Compared to the normal control, OcS/BS and aortic calcification, and OPG staining in the aorta and bone were significantly increased in the adenine controls. OPG staining and aortic calcification progressed the least in the group supplemented with both omega-3 FA/MK-7. In the adenine controls, the regular arrangement of muscle fiber was severely disrupted, and inflammatory cell infiltration was more prominent. These findings were reduced after combined supplementation with omega-3 FA/MK-7. Furthermore, decreased mammalian target of rapamycin and increased Forkhead box protein 1 expression was significantly restored by combined supplementation. CONCLUSIONS Combined nutrients supplementation with omega-3 FA and MK-7 may be helpful for aortic VC prevention, reducing osteoclast activation and improving sarcopenia-related molecules in adenine and low-protein diet induced uremic rats.
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Affiliation(s)
- Su Mi Lee
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Eu Gene Jeong
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Yu In Jeong
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Seo Hee Rha
- Department of Pathology, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Seong Eun Kim
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Won Suk An
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea,CONTACT Won Suk An Department of Internal Medicine, Dong-A University, 3Ga-1, Dongdaesin-Dong, Seo-Gu, Busan, 602-715, Republic of Korea
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Sarcopenia and cardiovascular disease in patients with and without kidney disease: what do we know? Int Urol Nephrol 2022; 55:1161-1171. [PMID: 36327007 DOI: 10.1007/s11255-022-03393-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
Cardiovascular disease (CVD) incidence is high in patients with chronic kidney disease (CKD) and is the most frequent cause of mortality in this population. Advanced age, hypertension, uremic toxins, endothelial dysfunction, atherosclerosis, hyperhomocysteinemia, oxidative stress, and inflammation are among the leading causes of increased CVD in advanced stages of CKD. Although defined as a decrease in muscle strength associated with aging, sarcopenia is also prevalent in CKD patients. Sarcopenia causes physical disability, low quality of life, and mortality. Regular exercise and nutritional supplementation may slow the progression of sarcopenia. Recent studies have shown that sarcopenia increases the risk of CVD and mortality in people with or without kidney disease. This review discusses the relationship between sarcopenia and CVD in light of the current literature.
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Indoxyl Sulfate Might Play a Role in Sarcopenia, While Myostatin Is an Indicator of Muscle Mass in Patients with Chronic Kidney Disease: Analysis from the RECOVERY Study. Toxins (Basel) 2022; 14:toxins14100660. [PMID: 36287929 PMCID: PMC9610577 DOI: 10.3390/toxins14100660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Serum myostatin and indoxyl sulfate (IS) levels increase with kidney function decline and may function as uremic toxins in chronic kidney disease (CKD)-related sarcopenia. Herein, we analyzed the association between serum myostatin and IS levels and sarcopenia in patients with CKD, by performing a post hoc analysis of baseline data extracted from the RECOVERY study (clinicaltrials.gov: NCT03788252) of 150 patients with CKD. We stratified patients into two groups according to the median value of myostatin (cutoff 4.5 ng/mL) and IS levels (cutoff 0.365 mg/dL). The proportion of patients with sarcopenia was higher in those with high IS levels but lower in those with high myostatin levels. The skeletal muscle mass index (SMI) and handgrip strength (HGS) were significantly lower in patients with high IS levels but significantly higher in patients with high myostatin levels. IS levels showed a negative correlation with glomerular filtration rate (GFR), SMI, and HGS. However, myostatin levels were positively correlated with SMI and HGS, but not with GFR. Sarcopenia was independently associated with age and IS level after adjustment. Increased levels of serum total IS might play a role in sarcopenia, while increased levels of serum myostatin are associated with muscle mass in patients with CKD.
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Hsu BG, Lee MC, Lin HH, Ho CC, Chen YC, Ho GJ. Serum myostatin level is a positive predictor of endothelial function measured by digital thermal monitoring of vascular reactivity in kidney transplantation patients. Tzu Chi Med J 2022; 34:62-68. [PMID: 35233358 PMCID: PMC8830547 DOI: 10.4103/tcmj.tcmj_268_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/24/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives: Myostatin is a myokine predominantly expressed and secreted in skeletal muscle in response to stimulations, including oxidative stress or inflammation. We investigated a potential association between myostatin levels and endothelial function among kidney transplantation (KT) patients. Materials and Methods: Fasting blood samples were collected from 64 KT patients. The endothelial function that indicated by vascular reactivity index (VRI) was measured by digital thermal monitoring test. Serum myostatin levels were measured using a commercial enzyme-linked immunosorbent assay kit. All patients were categorized into three groups according to their VRI values: poor vascular reactivity was considered if VRI <1.0; 1.0 ≤VRI <2.0 indicated intermediate vascular reactivity, and VRI ≥2.0 was grouped as good vascular reactivity. Results: Seven KT patients (10.9%) were categorized as poor vascular reactivity, 24 KT patients (37.5%) were grouped as intermediate vascular reactivity, and 33 KT patients had good vascular reactivity. Advanced age (r = −0.372, P = 0.002) and serum alkaline phosphate (ALP) level (r = −0.341, P = 0.006) were negatively correlated with VRI. However, serum myostatin level (r = 0.430, P < 0.001) was positively correlated with VRI. In multivariable forward stepwise linear regression analysis, high serum level of myostatin (β = 0.441, adjusted R2 change = 0.171; P < 0.001), advanced age (β = −0.317, adjusted R2 change = 0.138; P = 0.003), and serum ALP level (β = −0.270, adjusted R2 change = 0.060; P = 0.011) were significantly associated with VRI in KT patients. Conclusion: Our study showed that fasting myostatin level was positively associated with VRI and endothelial function among KT patients.
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The Correlation of Serum Myostatin Levels with Gait Speed in Kidney Transplantation Recipients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010465. [PMID: 35010726 PMCID: PMC8744722 DOI: 10.3390/ijerph19010465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 12/10/2022]
Abstract
The primary role of myostatin is to negatively regulate skeletal muscle growth. The gait speed is a noninvasive, reliable parameter that predicts cardiovascular risk and mortality. This study evaluated the relationship between serum myostatin concentrations and gait speeds in patients who had undergone kidney transplantation (KT). A total of 84 KT recipients were evaluated. A speed of less than 1.0 m/s was categorized into the low gait speed group. We measured serum myostatin concentrations with a commercial enzyme-linked immunosorbent assay. KT recipients in the low gait speed group had significantly older age, as well as higher body weight, body mass index (BMI), skeletal muscle index, serum triglyceride levels, glucose levels, and blood urea nitrogen levels, lower estimated glomerular filtration rates and serum myostatin levels, a higher percentage of steroid use, and a lower proportion of mycophenolate mofetil use. Multivariable logistic regression analysis revealed that lower myostatin levels and lower frequency of mycophenolate mofetil use were independently associated with low gait speed. In multivariable stepwise linear regression analysis, myostatin levels were positively correlated with gait speeds, and age and BMI were negatively correlated with gait speeds. In the study, serum myostatin levels were significantly lower in the low gait speed group. Subjects in the low gait speed group also had greater BMI and older age.
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Esposito P, Picciotto D, Battaglia Y, Costigliolo F, Viazzi F, Verzola D. Myostatin: Basic biology to clinical application. Adv Clin Chem 2022; 106:181-234. [PMID: 35152972 DOI: 10.1016/bs.acc.2021.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Myostatin is a member of the transforming growth factor (TGF)-β superfamily. It is expressed by animal and human skeletal muscle cells where it limits muscle growth and promotes protein breakdown. Its effects are influenced by complex mechanisms including transcriptional and epigenetic regulation and modulation by extracellular binding proteins. Due to its actions in promoting muscle atrophy and cachexia, myostatin has been investigated as a promising therapeutic target to counteract muscle mass loss in experimental models and patients affected by different muscle-wasting conditions. Moreover, growing evidence indicates that myostatin, beyond to regulate skeletal muscle growth, may have a role in many physiologic and pathologic processes, such as obesity, insulin resistance, cardiovascular and chronic kidney disease. In this chapter, we review myostatin biology, including intracellular and extracellular regulatory pathways, and the role of myostatin in modulating physiologic processes, such as muscle growth and aging. Moreover, we discuss the most relevant experimental and clinical evidence supporting the extra-muscle effects of myostatin. Finally, we consider the main strategies developed and tested to inhibit myostatin in clinical trials and discuss the limits and future perspectives of the research on myostatin.
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Affiliation(s)
- Pasquale Esposito
- Clinica Nefrologica, Dialisi, Trapianto, Department of Internal Medicine, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - Daniela Picciotto
- Clinica Nefrologica, Dialisi, Trapianto, Department of Internal Medicine, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Yuri Battaglia
- Nephrology and Dialysis Unit, St. Anna University Hospital, Ferrara, Italy
| | - Francesca Costigliolo
- Clinica Nefrologica, Dialisi, Trapianto, Department of Internal Medicine, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Francesca Viazzi
- Clinica Nefrologica, Dialisi, Trapianto, Department of Internal Medicine, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Daniela Verzola
- Clinica Nefrologica, Dialisi, Trapianto, Department of Internal Medicine, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genova, Italy
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Kim JS, Hwang HS. Vascular Calcification in Chronic Kidney Disease: Distinct Features of Pathogenesis and Clinical Implication. Korean Circ J 2021; 51:961-982. [PMID: 34854578 PMCID: PMC8636761 DOI: 10.4070/kcj.2021.0995] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/27/2021] [Accepted: 10/13/2021] [Indexed: 01/10/2023] Open
Abstract
Chronic kidney disease (CKD) is associated with a higher prevalence of vascular calcification (VC) and cardiovascular disease. VC in CKD patients showed different pathophysiological features from those of the general population. The pathogenesis of VC in CKD is a highly organized process, and prior studies have suggested that patients with CKD have their own specific contributors to the phenotypic change of vascular smooth muscle cells (VSMCs), including uremic toxins, CKD-mineral and bone disease (CKD-MBD), inflammation, and oxidative stress. For the diagnosis and monitoring of VC in CKD, several imaging modalities, including plain radiography, ultrasound, and computed tomography have been utilized. VC in CKD patients has distinct clinical features and implications. CKD patients revealed a more intense and more prevalent calcification on the intimal and medial layers, whereas intimal calcification is predominantly observed in the general population. While a higher VC score is clearly associated with a higher risk of all-cause mortality and cardiovascular events, a greater VC score in CKD patients does not fully reflect the burden of atherosclerosis, because they have more calcification at equal volumes of atheromatous plaques. The primary goal of VC treatment in CKD is the prevention of VC progression, and the main management is to control the biochemical components of CKD-MBD. Cinacalcet and non-calcium-containing phosphate binders are the mainstay of VC prevention in CKD-MBD management. VC in patients with CKD is an ongoing area of research and is expected to advance soon.
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Affiliation(s)
- Jin Sug Kim
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Korea
| | - Hyeon Seok Hwang
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Korea.
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13
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Kim SH, Choi G, Song Y, Yoon H, Jeong HM, Gu JE, Han M, Heo J, Yoo JJ, Yoon JW, Kim H. Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access Failure. J Clin Med 2021; 10:3698. [PMID: 34441991 PMCID: PMC8396811 DOI: 10.3390/jcm10163698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/22/2021] [Accepted: 08/11/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Sarcopenia involves an age-related decline in skeletal muscle mass with functional disability or low muscle strength. Vascular calcification (VC) occurs commonly in patients with chronic kidney disease, in whom it is associated with cardiovascular disease. We aimed to investigate the correlations of low muscle mass with the quantified vascular calcification score (VCS) of the arm of vascular access, as well as whether low muscle mass is associated with the incidence of vascular access failure. Methods: The VCS was measured on non-contrast, arm computed tomography using the Agatston method. The lower muscle mass (LMM) group comprised subjects whose skeletal muscle mass of the lower extremities, as measured using bioelectrical impedance, was lower than the median. Higher VC was defined as a score of 500 or above, corresponding to the highest 40% of VCS. The relationship between LMM and VC was explored using univariate and multivariate logistic regression analyses. Results: Seventy-five patients were included, of whom forty-two (56.0%) were men. The median age was 64 years (interquartile range 58-72 years). Of the 75 patients, 73 satisfied the diagnostic criteria for sarcopenia. The median hemodialysis vintage was 49.4 months (range 32.1-99.2 months). No significant differences were found between the non-LMM and LMM groups in sex, end-stage renal disease etiology, and type of vascular access, although the LMM group showed significantly older age and hemodialysis vintage. LMM presented a significant association with VC (hazard ratio (HR) 3.562; 95% CI, 1.341-9.463; p = 0.011). Upon adjustment for hemodialysis vintage, diabetes, and systolic blood pressure, LMM demonstrated an independent association with VC (HR, 10.415; 95% CI, 2.357-46.024; p = 0.002). The risk of vascular access failure was higher in the LMM group (HR, 3.652; 95%, CI 1.135-11.749; p = 0.03). VC was a full mediator in the relationship of LMM with recurrent vascular access failure. Conclusions: We quantified LMM via bioimpedance analysis and found a heretofore-unreported association between LMM and vascular access failure. LMM increases the risk of VC and has the potential to predict vascular access failure.
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Affiliation(s)
- Seok-hyung Kim
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Gwangho Choi
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Youngjin Song
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Hojung Yoon
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Hae Min Jeong
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Jae Eon Gu
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Miyeun Han
- Department of Internal Medicine, Hangang Sacred Heart Hospital, Seoul 07247, Korea;
| | - Jongho Heo
- National Assembly Futures Institute, Seoul 07233, Korea;
| | - Jeong-Ju Yoo
- Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon 14584, Korea;
| | - Jong-woo Yoon
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Hyunsuk Kim
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
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Esposito P, Verzola D, Picciotto D, Cipriani L, Viazzi F, Garibotto G. Myostatin/Activin-A Signaling in the Vessel Wall and Vascular Calcification. Cells 2021; 10:2070. [PMID: 34440838 PMCID: PMC8393536 DOI: 10.3390/cells10082070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 02/07/2023] Open
Abstract
A current hypothesis is that transforming growth factor-β signaling ligands, such as activin-A and myostatin, play a role in vascular damage in atherosclerosis and chronic kidney disease (CKD). Myostatin and activin-A bind with different affinity the activin receptors (type I or II), activating distinct intracellular signaling pathways and finally leading to modulation of gene expression. Myostatin and activin-A are expressed by different cell types and tissues, including muscle, kidney, reproductive system, immune cells, heart, and vessels, where they exert pleiotropic effects. In arterial vessels, experimental evidence indicates that myostatin may mostly promote vascular inflammation and premature aging, while activin-A is involved in the pathogenesis of vascular calcification and CKD-related mineral bone disorders. In this review, we discuss novel insights into the biology and physiology of the role played by myostatin and activin in the vascular wall, focusing on the experimental and clinical data, which suggest the involvement of these molecules in vascular remodeling and calcification processes. Moreover, we describe the strategies that have been used to modulate the activin downward signal. Understanding the role of myostatin/activin signaling in vascular disease and bone metabolism may provide novel therapeutic opportunities to improve the treatment of conditions still associated with high morbidity and mortality.
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Affiliation(s)
- Pasquale Esposito
- Department of Internal Medicine, University of Genova, 16132 Genova, Italy; (P.E.); (D.V.); (L.C.); (F.V.)
- IRCCS Ospedale Policlinico San Martino, Clinica Nefrologica, Dialisi, Trapianto, 16132 Genova, Italy;
| | - Daniela Verzola
- Department of Internal Medicine, University of Genova, 16132 Genova, Italy; (P.E.); (D.V.); (L.C.); (F.V.)
| | - Daniela Picciotto
- IRCCS Ospedale Policlinico San Martino, Clinica Nefrologica, Dialisi, Trapianto, 16132 Genova, Italy;
| | - Leda Cipriani
- Department of Internal Medicine, University of Genova, 16132 Genova, Italy; (P.E.); (D.V.); (L.C.); (F.V.)
| | - Francesca Viazzi
- Department of Internal Medicine, University of Genova, 16132 Genova, Italy; (P.E.); (D.V.); (L.C.); (F.V.)
- IRCCS Ospedale Policlinico San Martino, Clinica Nefrologica, Dialisi, Trapianto, 16132 Genova, Italy;
| | - Giacomo Garibotto
- Department of Internal Medicine, University of Genova, 16132 Genova, Italy; (P.E.); (D.V.); (L.C.); (F.V.)
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15
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Choi SJ, Lee MS, Kang DH, Ko GJ, Lim HS, Yu BC, Park MY, Kim JK, Kim CH, Hwang SD, Kim JC, Won CW, An WS. Myostatin/Appendicular Skeletal Muscle Mass (ASM) Ratio, Not Myostatin, Is Associated with Low Handgrip Strength in Community-Dwelling Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147344. [PMID: 34299795 PMCID: PMC8307565 DOI: 10.3390/ijerph18147344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 01/08/2023]
Abstract
Background/Aims: Elevated levels of serum myostatin have been proposed as a biomarker for sarcopenia. Recent studies have shown that elevated level of serum myostatin was associated with physical fitness and performance. This study aimed to examine the significance of myostatin in the association between muscle mass and physical performance in the elderly. Methods: This cross-sectional study is based on the Korean Frailty and Aging Cohort study involving 1053 people aged 70 years or over. Anthropometric, physical performance, and laboratory data were collected. Results: The mean age of the participants was 75.8 years, and 50.7% of them were female. Serum myostatin levels in men (3.7 ± 1.2 vs. 3.2 ± 1.1 ng/mL, p < 0.001) were higher compared with that in women. Serum myostatin level was associated with appendicular skeletal muscle mass (ASM) index and eGFR by cystatin C. Serum myostatin/ASM ratio was associated with handgrip strength in women. Conclusion: Higher serum myostatin levels were related with higher muscle mass and better physical performances in the elderly. Serum myostatin/ASM ratio may be a predictor for physical performance rather than myostatin.
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Affiliation(s)
- Soo Jeong Choi
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Min Sung Lee
- Division of Nephrology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul 07804, Korea; (M.S.L.); (D.-H.K.)
| | - Duk-Hee Kang
- Division of Nephrology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul 07804, Korea; (M.S.L.); (D.-H.K.)
| | - Gang Jee Ko
- Division of Nephrology, Department of Internal Medicine, Korea University College of Medicine, Seoul 08308, Korea;
| | - Hee-Sook Lim
- Department of Food Sciences and Nutrition, Yeonsung University, Anyang 14011, Korea;
| | - Byung Chul Yu
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Moo Yong Park
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Jin Kuk Kim
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Chul-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14854, Korea;
| | - Seung Duk Hwang
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Jun Chul Kim
- Division of Nephrology, Department of Internal Medicine, CHA University School of Medicine, Gumi 39295, Korea;
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University School of Medicine, Seoul 02447, Korea
- Correspondence: (C.W.W.); (W.S.A.)
| | - Won Suk An
- Division of Nephrology, Department of Internal Medicine, Dong-A University College of Medicine, Busan 49201, Korea
- Correspondence: (C.W.W.); (W.S.A.)
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Han M, Kim H, Kim HJ, Kang E, Kim YS, Choi KH, Kim SW, Ahn C, Oh KH. Serum uric acid is associated with coronary artery calcification in early chronic kidney disease: a cross-sectional study. BMC Nephrol 2021; 22:247. [PMID: 34218791 PMCID: PMC8255010 DOI: 10.1186/s12882-021-02463-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/19/2021] [Indexed: 01/06/2023] Open
Abstract
Background Although uric acid (UA) is regarded as a risk factor for cardiovascular disease, whether UA is an independent risk factor contributing to coronary artery calcification in chronic kidney disease (CKD) is not well known. We evaluated whether UA level is associated with coronary artery calcium (CAC) score in a predialysis CKD cohort. Methods A total of 1,350 subjects who underwent coronary computed tomography as part of the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease were analysed. We conducted a logistic regression analysis to evaluate the association between UA and the presence of CAC. Results CAC was detected in 705 (52.2 %) patients, and the level of UA was significantly higher in CAC > 0 patients. UA showed a positive relationship with CAC > 0 in age- and sex-adjusted logistic regression analysis (Odds ratio (OR) 1.11, 95 % confidence interval (CI) 1.04–1.19, P = 0.003). However, UA showed no association with CAC > 0 in multivariate analysis. Further analysis showed that UA showed a positive association with CAC > 0 only in estimated glomerual filtration rate (eGFR) > 60 ml/min/1.73 m2 (OR 1.23, 95 % CI 1.02–1.49, P = 0.036) but not in eGFR 30–59 ml/min/1.73 m2 (OR 0.92, 95 % CI 0.78–1.08, P = 0.309) or < 30 ml/min/1.73 m2 (OR 0.92, 95 % CI 0.79–1.08, P = 0.426). Conclusions UA level was significantly associated with CAC in early CKD, but not in advanced CKD. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-021-02463-2.
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Affiliation(s)
- Miyeun Han
- Department of Internal Medicine, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea
| | - Hyunsuk Kim
- Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Hyo Jin Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Eunjeong Kang
- Department of Internal Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Yong-Soo Kim
- Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Kyu Hun Choi
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Curie Ahn
- Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Chong No Gu, 03080, Seoul, Korea
| | - Kook-Hwan Oh
- Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Chong No Gu, 03080, Seoul, Korea.
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Morioka T. Myostatin: The Missing Link between Sarcopenia and Cardiovascular Disease in Chronic Kidney Disease? J Atheroscler Thromb 2020; 27:1036-1038. [PMID: 32435012 PMCID: PMC7585907 DOI: 10.5551/jat.ed129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Tomoaki Morioka
- Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine
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18
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Bataille S, Chauveau P, Fouque D, Aparicio M, Koppe L. Myostatin and muscle atrophy during chronic kidney disease. Nephrol Dial Transplant 2020; 36:1986-1993. [PMID: 32974666 DOI: 10.1093/ndt/gfaa129] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic kidney disease (CKD) patients often exhibit a low muscle mass and strength, leading to physical impairment and an increased mortality. Two major signalling pathways control protein synthesis, the insulin-like growth factor-1/Akt (IGF-1/Akt) pathway, acting as a positive regulator, and the myostatin (Mstn) pathway, acting as a negative regulator. Mstn, also known as the growth development factor-8 (GDF-8), is a member of the transforming growth factor-β superfamily, which is secreted by mature muscle cells. Mstn inhibits satellite muscle cell proliferation and differentiation and induces a proteolytic phenotype of muscle cells by activating the ubiquitin-proteasome system. Recent advances have been made in the comprehension of the Mstn pathway disturbance and its role in muscle wasting during CKD. Most studies report higher Mstn concentrations in CKD and dialysis patients than in healthy subjects. Several factors increase Mstn production in uraemic conditions: low physical activity, chronic or acute inflammation and oxidative stress, uraemic toxins, angiotensin II, metabolic acidosis and glucocorticoids. Mstn seems to be only scarcely removed during haemodialysis or peritoneal dialysis, maybe because of its large molecule size in plasma where it is linked to its prodomain. In dialysis patients, Mstn has been proposed as a biomarker of muscle mass, muscle strength or physical performances, but more studies are needed in this field. This review outlines the interconnection between Mstn activation, muscle dysfunction and CKD. We discuss mechanisms of action and efficacy of pharmacological Mstn pathway inhibition that represents a promising treatment approach of striated muscle dysfunction. Many approaches and molecules are in development but until now, no study has proved a benefit in CKD.
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Affiliation(s)
- Stanislas Bataille
- Phocean Nephrology Institute, Clinique Bouchard, ELSAN, Marseille, France.,Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | | | - Denis Fouque
- Department of Nephrology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, Lyon, France.,Univ. Lyon, CarMeN lab, INSA-Lyon, INSERM U1060, INRA, Université Claude Bernard Lyon 1, Villeurbanne, France
| | | | - Laetitia Koppe
- Department of Nephrology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, Lyon, France.,Univ. Lyon, CarMeN lab, INSA-Lyon, INSERM U1060, INRA, Université Claude Bernard Lyon 1, Villeurbanne, France
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Garibotto G, Esposito P, Picciotto D, Verzola D. Activin/myostatin receptor signaling and vascular calcifications in chronic kidney disease: A "liaison dangereuse"? Kidney Res Clin Pract 2019; 38:407-410. [PMID: 31640302 PMCID: PMC6913597 DOI: 10.23876/j.krcp.19.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/09/2019] [Accepted: 08/09/2019] [Indexed: 02/05/2023] Open
Affiliation(s)
- Giacomo Garibotto
- Division of Nephrology, Dialysis and Transplantation, University of Genova, Genova,
Italy
- Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, Genova,
Italy
| | - Pasquale Esposito
- Division of Nephrology, Dialysis and Transplantation, University of Genova, Genova,
Italy
- Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, Genova,
Italy
| | - Daniela Picciotto
- Division of Nephrology, Dialysis and Transplantation, University of Genova, Genova,
Italy
- Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, Genova,
Italy
| | - Daniela Verzola
- Division of Nephrology, Dialysis and Transplantation, University of Genova, Genova,
Italy
- Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, Genova,
Italy
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