Kałużna Małgorzata, Pawlaczyk Krzysztof, Schwermer Krzysztof, Hoppe Krzysztof, Człapka-Matyasik Magdalena, Ibrahim Aisha Yusuf, Sawicka-Gutaj Nadia, Minczykowski Andrzej, Ziemnicka Katarzyna, Oko Andrzej, Ruchała Marek
Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poland.
Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland.
Adv Clin Exp Med. 2019 Mar;28(3):347-353. doi: 10.17219/acem/81538.
The new polypeptide hormones adropin and irisin have a broad impact on human metabolism and energy homeostasis. They could be potential biomarkers of cardiac injury. In end-stage renal disease (ESRD), the clinical importance of adropin and irisin is yet to be investigated.
The aim of this study was to determine the relationship between these peptides and cardiac status in ESRD patients.
Seventy-nine ESRD patients on hemodialysis (HD), peritoneal dialysis (PD) or after renal transplantation (Tx), and 40 healthy, ageand sex-matched controls (CON) were included in this study. Serum concentrations of adropin and irisin were measured with enzyme-linked immunosorbent assay (ELISA). Cardiac status was estimated by transthoracic echocardiography and the plasma concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT).
The levels of irisin were significantly lower in HD patients as compared to CON. During HD sessions, the concentrations of adropin did not change significantly, whereas the concentrations of irisin increased with borderline significance. Positive correlations were evident between adropin concentration and cTnT as well as NT-proBNP. Adropin was also correlated with left ventricular systolic internal diameter (LVIDs) (r = 0.375, p = 0.045) and relative wall thickness (RWT) (r = -0.382, p = 0.034). Irisin was correlated with right ventricular diameter (RVd) (r = -0.363, p = 0.045). No correlations were found between irisin and adropin, and blood pressure (BP) measurements.
Adropin could be a new candidate marker of cardiac dysfunction in HD patients. The cause of low levels of irisin found in HD patients is still unclear. These 2 myokines should be further investigated as potential prognostic markers of cardiac status in HD patients.
新型多肽激素内脂素和鸢尾素对人体代谢和能量稳态有广泛影响。它们可能是心脏损伤的潜在生物标志物。在终末期肾病(ESRD)中,内脂素和鸢尾素的临床重要性尚待研究。
本研究旨在确定这些肽与ESRD患者心脏状态之间的关系。
本研究纳入了79例接受血液透析(HD)、腹膜透析(PD)或肾移植(Tx)后的ESRD患者,以及40例年龄和性别匹配的健康对照者(CON)。采用酶联免疫吸附测定(ELISA)法测定血清内脂素和鸢尾素浓度。通过经胸超声心动图以及N端脑钠肽前体(NT-proBNP)和心肌肌钙蛋白T(cTnT)的血浆浓度评估心脏状态。
与CON相比,HD患者的鸢尾素水平显著降低。在HD治疗期间,内脂素浓度无显著变化,而鸢尾素浓度有临界显著性升高。内脂素浓度与cTnT以及NT-proBNP之间存在明显的正相关。内脂素还与左心室收缩内径(LVIDs)(r = 0.375,p = 0.045)和相对室壁厚度(RWT)(r = -0.382,p = 0.034)相关。鸢尾素与右心室直径(RVd)(r = -0.363,p = 0.045)相关。未发现鸢尾素与内脂素以及血压测量值之间存在相关性。
内脂素可能是HD患者心脏功能障碍的新候选标志物。HD患者中鸢尾素水平低的原因仍不清楚。这两种肌动蛋白应作为HD患者心脏状态的潜在预后标志物进行进一步研究。