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学科主题: 临床医学
题名:
Is fetuin-A/alpha 2-Heremans-Schmid glycoprotein associated with the metabolic syndrome in patients with chronic kidney disease?
作者: Axelsson, Jonas1,2; Wang, Xin1,3; Ketteler, Markus4; Qureshi, Abdul Rashid1; Heimburger, Olof1; Barany, Peter1; Lindholm, Bengt1; Nordfors, Louise2; Stenvinkel, Peter1,2
关键词: dyslipidemia ; insulin resistance ; obesity ; chronic kidney disease
刊名: AMERICAN JOURNAL OF NEPHROLOGY
发表日期: 2008
DOI: 10.1159/000121358
卷: 28, 期:4, 页:669-676
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: ALPHA(2)-HEREMANS-SCHMID GLYCOPROTEIN/FETUIN-A ; CORONARY-ARTERY CALCIFICATION ; DIALYSIS PATIENTS ; ALPHA-2-HS GLYCOPROTEIN ; AHSG GENE ; INSULIN-RECEPTOR ; SERUM ; INFLAMMATION ; POLYMORPHISM ; INHIBITOR
英文摘要:

Introduction: Components of the metabolic syndrome are highly prevalent in chronic kidney disease (CKD) patients some of which paradoxically appear to predict an improved outcome in this population. We hypothesized that the circulating calcification inhibitor fetuin-A/AHSG, which is also a natural inhibitor of the tyrosine kinase insulin receptor, could be one factor explaining the association between increased fat mass and a survival advantage in CKD and thus conducted an explorational study to provide preliminary data to support further research into this hypothesis. Patients and Methods: In a cross-sectional study, we evaluated 198 CKD stage 5 patients (GFR 6.8 +/- 0.2 ml/min; 62% males, mean age 52 8 1 years) close to the start of renal replacement therapy. We studied circulating AHSG (ELISA) and two common functional AHSG gene polymorphisms (at amino acids Thr248Met (C-T) and Thr256Ser (C-G) using Pyrosequencing (R)) and related these to multiple components of the metabolic syndrome. Results: Median circulating AHSG was lower (p<0.01) in type-2 (0.22 g/l) and type-1 (0.16 g/l) diabetics as compared to non-diabetic CKD-5 patients (0.24 g/l). AHSG correlated with both total and truncal fat mass in type-2 diabetics (rho 0.37 and 0.39; p < 0.001, respectively), but not in type-1 diabetics or non-diabetics. Both SNPs significantly influenced circulating levels of AHSG, and were also associated with significant differences in serum triglycerides and HDL cholesterol. Furthermore, there were significant differences in the prevalence of metabolic syndrome criteria between the AHSG Thr256Ser (C-G) genotype groups, with a more atherogenic lipid profile in AHSG high producers (Thr/Thr homozygotes). In multivariate analysis, the association between circulating AHSG and fat mass remained significant also after adjustment for age, gender, inflammation (CRP > 10 mg/l), and AHSG genotype. Conclusions: The present, explorational, study supports further, mechanistic, studies into a physiological link between AHSG and body fat mass in patients with CKD. As we observed an association between higher fat mass and elevated AHSG levels, these preliminary results may form the basis of further study to establish if the observed associations may be one reason why obesity has been reported to constitute a survival advantage in CKD. Copyright (C) 2008 S. Karger AG, Basel.

语种: 英语
WOS记录号: WOS:000255896200017
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/56849
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 1.Karolinska Inst, Dept Mol Med, Stockholm, Sweden
2.Klinikum Coburg GmbH, Coburg, Germany
3.Karolinska Inst, Div Renal Med & Baxter Novum, Dept Clin Sci Intervent & Technol, Stockholm, Sweden
4.Peking Univ, Inst Nephrol, Hosp 1, Beijing 100871, Peoples R China

Recommended Citation:
Axelsson, Jonas,Wang, Xin,Ketteler, Markus,et al. Is fetuin-A/alpha 2-Heremans-Schmid glycoprotein associated with the metabolic syndrome in patients with chronic kidney disease?[J]. AMERICAN JOURNAL OF NEPHROLOGY,2008,28(4):669-676.
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