Zhong Chenyu, Bai Xu, Chen Qinghuo, Ma Yanhong, Li Jianhui, Zhang Jie, Luo Qun, Cai Kedan
Department of Nephrology, HwaMei Hospital, University of Chinese Academy of Sciences, 41 Xibei Street, Ningbo, 315010, Zhejiang Province, People's Republic of China.
The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
Acta Diabetol. 2022 Nov;59(11):1469-1477. doi: 10.1007/s00592-022-01948-2. Epub 2022 Aug 10.
Valerate and caproate are two subtypes of short-chain fatty acids produced by gut microbiota. We aimed to measure the serum valerate and caproate levels and analyze the associations between them and renal prognosis of diabetic nephropathy (DN).
The serum samples of patients with biopsy-confirmed diagnosis of DN were collected in the First Affiliated Hospital of Zhejiang University, from April 1, 2013, to March 31, 2018. One hundred patients were included and divided into an early DN group (eGFR ≥ 60 ml/min, n = 42) and an advanced DN group (eGFR < 60 ml/min, n = 58). The valerate and caproate were measured using gas chromatography-mass spectrometry. Participants were followed up until the cutoff date of August 31, 2018, or if they met the primary endpoint of end-stage renal disease (ESRD).
There were 71 males and 29 females in this study, and 29 patients developed ESRD. We observed a significant lower concentration of valerate and caproate in the advanced DN group. There were negative correlations between valerate and glomerular classification (r = - 0.20, P = 0.03) and between caproate and interstitial fibrosis and tubular atrophy (IFTA) (r = - 0.24, P = 0.01). And there were positive correlations between valerate or caproate and eGFR (r = 0.22, P = 0.02; r = 0.38, P < 0.01). Multivariate Cox analysis revealed higher levels of valerate and caproate were negatively related to progression to ESRD (HR = 0.024, P = 0.016; HR = 0.543, P = 0.030). The area under the curve values of valerate and caproate levels were 0.66 and 0.63, respectively, in predicting progression to ESRD.
This study showed alterations in serum valerate and caproate in DN and demonstrates lower valerate and caproate levels with progression of DN to ESRD.
戊酸和己酸是肠道微生物群产生的两种短链脂肪酸亚型。我们旨在测量血清戊酸和己酸水平，并分析它们与糖尿病肾病（DN）肾脏预后之间的关联。
2013年4月1日至2018年3月31日期间，在浙江大学第一附属医院收集经活检确诊为DN的患者的血清样本。纳入100例患者，分为早期DN组（估算肾小球滤过率[eGFR]≥60 ml/分钟，n = 42）和晚期DN组（eGFR < 60 ml/分钟，n = 58）。采用气相色谱 - 质谱法测量戊酸和己酸。对参与者进行随访，直至2018年8月31日截止日期，或直至他们达到终末期肾病（ESRD）的主要终点。
本研究中有71名男性和29名女性，29例患者发展为ESRD。我们观察到晚期DN组中戊酸和己酸的浓度显著较低。戊酸与肾小球分级之间呈负相关（r = -0.20，P = 0.03），己酸与间质纤维化和肾小管萎缩（IFTA）之间呈负相关（r = -0.24，P = 0.01）。戊酸或己酸与eGFR之间呈正相关（r = 0.22，P = 0.02；r = 0.38，P < 0.01）。多变量Cox分析显示，戊酸和己酸水平较高与进展为ESRD呈负相关（风险比[HR] = 0.024，P = 0.016；HR = 0.543，P = 0.030）。在预测进展为ESRD方面，戊酸和己酸水平的曲线下面积值分别为0.66和0.63。
本研究显示DN患者血清戊酸和己酸发生改变，并表明随着DN进展至ESRD，戊酸和己酸水平降低。
