PMID- 30956091
OWN - NLM
STAT- MEDLINE
DCOM- 20210609
LR  - 20210609
IS  - 1532-8503 (Electronic)
IS  - 1051-2276 (Linking)
VI  - 30
IP  - 1
DP  - 2020 Jan
TI  - Synergistic Effect of Inflammatory Cytokines and Body Adiposity on Insulin 
      Resistance and Endothelial Markers in Patients With Stages 3-5 Chronic Kidney 
      Disease.
PG  - 36-45
LID - S1051-2276(19)30034-2 [pii]
LID - 10.1053/j.jrn.2019.02.001 [doi]
AB  - BACKGROUND: High body adiposity, inflammatory cytokines, insulin resistance (IR), 
      and the endothelial markers-soluble intercellular adhesion molecule-1 (sICAM-1) 
      and soluble vascular adhesion molecule-1 (sVCAM-1)-are among cardiovascular risk 
      factors observed in chronic kidney disease (CKD). Synergistic interaction of 
      inflammatory cytokines with adiposity on IR, sICAM-1, and sVCAM-1 has not been 
      reported in nondialysis-dependent CKD (NDD-CKD) patients. Thus the study aim was 
      to evaluate the interaction of inflammatory cytokines on the association of body 
      adiposity with the cardiometabolic risk factors-IR, sICAM-1, and sVCAM-1-in 
      NDD-CKD patients. Cytokines association with estimated glomerular filtration rate 
      (eGFR) and body adiposity was also examined. DESIGN AND METHODS: A 
      cross-sectional study was conducted in an interdisciplinary outpatient Nephrology 
      Clinic. SUBJECTS AND MEASUREMENTS: NDD-CKD adults with eGFR 
      </=60 mL/minute/1.73 m(2) under regular treatment. Inflammatory cytokines, 
      homeostasis model assessment of insulin resistance (HOMA-IR), sICAM-1, sVCAM-1, 
      eGFR (by CKD-Epidemiology collaboration equation)-EPI equation, and body 
      composition assessed by dual-energy X-ray absorptiometry and anthropometry were 
      evaluated. Synergistic effects of inflammatory markers with body adiposity on 
      studied cardiometabolic risk factors were assessed by interaction and mediation 
      analysis. RESULTS: The study cohort comprised 241 NDD-CKD patients (54.8% men; 
      eGFR = 29.4 +/- 12.9 mL/minute/1.73 m(2)). Variables evaluated: Inflammatory 
      cytokines were not associated with eGFR and not different among CKD stages. 
      Percentage of total body adiposity (%TBA) was independently associated with tumor 
      necrosis factor-alpha (TNFalpha) and HOMA-IR. Waist-to-height ratio was independently 
      associated with TNFalpha, interleukin-8, monocyte chemoattractant protein-1 (MCP1), 
      and HOMA-IR. Interaction analysis showed TNFalpha, interleukin-8, and MCP1 as 
      independent mediators of the effects of high percentage of total body adiposity 
      and waist-to-height ratio on HOMA-IR (P < .0001). Body adiposity did not 
      associate with sICAM-1 and sVCAM-1. TNFalpha (beta = 0.40) and MCP1 (beta = 0.31) were 
      independently associated with sVCAM-1 (P < .01). CONCLUSIONS: In NDD-CKD 
      patients, inflammatory cytokines synergistically mediated the effects of body 
      adiposity, enhancing the cardiometabolic risk. Inflammation was associated with 
      sVCAM-1, but not with eGFR.
CI  - Copyright (c) 2019 National Kidney Foundation, Inc. Published by Elsevier Inc. All 
      rights reserved.
FAU - Barreto Silva, Maria Ines
AU  - Barreto Silva MI
AD  - Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State 
      University, Rio de Janeiro, Brazil; Department of Applied Nutrition, Nutrition 
      School, Federal University of Rio de Janeiro State, Rio de Janeiro, Brazil. 
      Electronic address: mibsab@terra.com.br.
FAU - Klein, Marcia R S T
AU  - Klein MRST
AD  - Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State 
      University, Rio de Janeiro, Brazil.
FAU - Cardoso, Erida S
AU  - Cardoso ES
AD  - Post-Graduation Program in Medical Science, Rio de Janeiro State University, Rio 
      de Janeiro, Brazil.
FAU - Costa, Mariana S
AU  - Costa MS
AD  - Post-Graduation Program in Medical Science, Rio de Janeiro State University, Rio 
      de Janeiro, Brazil.
FAU - Martins, Cyro J M
AU  - Martins CJM
AD  - Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State 
      University, Rio de Janeiro, Brazil.
FAU - Bregman, Rachel
AU  - Bregman R
AD  - Nephrology Division, Rio de Janeiro State University, Rio de Janeiro, Brazil.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190405
PL  - United States
TA  - J Ren Nutr
JT  - Journal of renal nutrition : the official journal of the Council on Renal 
      Nutrition of the National Kidney Foundation
JID - 9112938
RN  - 0 (Biomarkers)
RN  - 0 (Cytokines)
RN  - 0 (Vascular Cell Adhesion Molecule-1)
RN  - 126547-89-5 (Intercellular Adhesion Molecule-1)
SB  - IM
MH  - *Adiposity
MH  - Aged
MH  - Biomarkers/blood
MH  - Brazil
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Cytokines/blood
MH  - Endothelium, Vascular/*physiopathology
MH  - Female
MH  - Humans
MH  - Inflammation/*blood/complications
MH  - *Insulin Resistance
MH  - Intercellular Adhesion Molecule-1/*blood
MH  - Male
MH  - Middle Aged
MH  - Renal Insufficiency, Chronic/*blood/complications
MH  - Risk Factors
MH  - Vascular Cell Adhesion Molecule-1/*blood
EDAT- 2019/04/09 06:00
MHDA- 2021/06/10 06:00
CRDT- 2019/04/09 06:00
PHST- 2018/09/30 00:00 [received]
PHST- 2019/01/08 00:00 [revised]
PHST- 2019/02/10 00:00 [accepted]
PHST- 2019/04/09 06:00 [pubmed]
PHST- 2021/06/10 06:00 [medline]
PHST- 2019/04/09 06:00 [entrez]
AID - S1051-2276(19)30034-2 [pii]
AID - 10.1053/j.jrn.2019.02.001 [doi]
PST - ppublish
SO  - J Ren Nutr. 2020 Jan;30(1):36-45. doi: 10.1053/j.jrn.2019.02.001. Epub 2019 Apr 
      5.