The role of leptin, adiponectin and insulin-resistance markers in development of early stages of chronic kidney disease and atherosclerosis of carotid arteries in obese patients


如何引用文章

全文:

详细

Aim. To characterize clinicopathogenetically factors influencing development of early chronic kidney disease (CKD) and impairment of other target organs in obese patients.
Material and methods. The examination of 86 obese patients (64 males and 22 females, mean age 44±11 years) included standard clinical tests, test for albuminuria, calculation of glomerular filtration rate (GFR) by MDRD formula, ultrasound investigation of the carotid arteries to detect atherosclerotic lesion of the carotid arteries, assessment of insulin resistance -IR (plasma concentration of insulin before meal and blood C-peptide, HOMA-index), test for plasma adipokinins (leptin, adiponectin).
Results. Significant direct correlations were found between blood plasma leptin concentration, body mass index (BMI), plasma concentration of insulin and C-peptide, HOMA index, adiponectinemia and albuminuria. CKD patients have significantly higher than patients free of CKD levels of IR markers, waist circumference, BMI, leptinemia (38.2±28.8 and 21.6±19.8 ng/ml, respectively; p < 0.01). Obstructive sleep apnea syndrome was associated with higher IR and albuminuria, significantly lower estimated GFR (81±2 and 95±2 ml/min/1.73 m2, respectively; p < 0.05). Ultrasound evidence for atherosclerotic lesions of the carotid arteries was associated with a significant increase in blood plasma concentration of C-peptide, reduction of adiponectinemia (14.9±10.8 and 32.5±22.5 mcg/ml; p < 0.01), a rise in proportion fasting insulinemia/adiponectinemia (1.6±1.2 and 0.6±0.8, respectively; p < 0.05) and reduction of estimated GFR (86±19 and 102±25 ml/min/1.73 m2, respectively; p = 0.001).
Conclusion. In obesity, CKD at early stages develops in parallel with atherosclerotic lesion of the carotid arteries, which correlates with progression of leptinemia, IR and attenuation of organ-protecting properties of adiponectin.

作者简介

Evgeniya Saginova

Email: med02@yandex.ru

Marat Gallyamov

Email: mgtabib@gmail.com

Mariya Severova

Email: mseverova@mail.ru

Ol'ga Surkova

Email: olya-d@mail.ru

Viktor Fomin

Email: fomin-vic@mail.ru

Nikolay Ermakov

Email: nivalerm@mail.ru

Alla Rodina

Email: allrodina@yandex.ru

Nikolay Mukhin

Email: moukhin-nephro@yandex.ru

E Saginova

I.M. Sechenov First State Moscow Medical University

I.M. Sechenov First State Moscow Medical University

M Gallyamov

M.V. Lomonosov State Moscow University

M.V. Lomonosov State Moscow University

M Severova

I.M. Sechenov First State Moscow Medical University

I.M. Sechenov First State Moscow Medical University

O Surkova

M.V. Lomonosov State Moscow University

M.V. Lomonosov State Moscow University

V Fomin

I.M. Sechenov First State Moscow Medical University

I.M. Sechenov First State Moscow Medical University

N Ermakov

Moscow Research Institute of Medical Ecology

Moscow Research Institute of Medical Ecology

A Rodina

I.M. Sechenov First State Moscow Medical University

I.M. Sechenov First State Moscow Medical University

N Mukhin

I.M. Sechenov First State Moscow Medical University

I.M. Sechenov First State Moscow Medical University

参考

  1. Комитет экспертов ВНОК. Диагностика и лечение метаболического синдрома: Российские рекомендации. М.; 2009.
  2. Руденко Т. Е., Кутырина И. М. Ожирение как фактор сосудистого ремоделирования. Клиническая нефрология 2010; 3: 62-65.
  3. Kshatriya S., Reams G. P., Spear R. M. et al. Obesity hypertension: the emerging role of leptin in renal and cardiovascular dyshomeostasis. Curr. Opin. Nephrol. Hypertens. 2010; 19 (1): 72-78.
  4. Wolf G., Ziyadeh F. N. Leptin and renal fibrosis. Contrib. Nephrol. 2006; 151: 175-183.
  5. Foster M. C., Hwang S. J., Larson M. G. et al. Overweight, obesity, and the development of stage 3 CKD: the Framingham Heart Study. Am. J. Kidney Dis. 2008; 52 (1): 39-48.
  6. Gelber R. P., Kurth X., Kausz A. T. et al. Association between body mass index and CKD in apparently healthy men. Am. J. Kidney Dis. 2005; 46 (5): 871-880.
  7. Kramer H., Luke A., Bidani A. et al. Obesity and prevalent and incident CKD: the Hypertension Detection and Follow-Up Program. Am. J. Kidney Dis. 2005; 46 (4): 587-594.
  8. Комитет экспертов РМОАГ/ВНОК. Диагностика и лечение артериальной гипертензии (Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов). Систем. гипертензии 2010; 3: 5-26.
  9. Foppa M., Duncan B. B., Rohde L. E. Echocardiography-based left ventricular mass estimation. How should we define hypertrophy? Cardiovasc. Ultrasound 2005; 3: 17.
  10. Agewall S., Bjorn F. Microalbuminuria and intima-media thickness of the carotid artery in clinically healthy men. Atherosclerosis 2002; 164 (1): 161-166.
  11. McDonald S. P., Maguire G. P., Duarte N. et al. Carotid intima-media thickness, cardiovascular risk factors and albuminuria in a remote Australian Aboriginal community. Atherosclerosis 2004; 177 (2): 423-431.
  12. Huang Y., Chen Y., Xu M. et al. Low-grade albuminuria is associated with carotid intima-media thickness in Chinese type 2 diabetic patients. J. Clin. Endocrinol. Metab. 2010; 95 (11): 5122-5128.
  13. Margetic S., Gazzola C., Pegg G. G., Hill R. A. Leptin: a review of its peripheral actions and interactions. Int. J. Obes. Relat. Metab. Disord. 2002; 26 (11): 1407-1433.
  14. Dube J. J., Bhatt B. A., Dedousis N. et al. Leptin, skeletal muscle lipids, and lipid-induced insulin resistance. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2007; 293 (2): R642-R650.
  15. Antuna-Puente B., Feve B., Fellahi S. Adipokines: the missing link between insulin resistance and obesity. Diabet. Metab. 2008; 34 (1): 2-11.
  16. Hunley T. E., Ma L. J., Kon V. Scope and mechanisms of obesity-related renal disease. Curr. Opin. Nephrol. Hypertens. 2010; 19 (3): 227-234.
  17. Korda M., Kubant R., Patton S., Malinski T. Leptin-induced endothelial dysfunction in obesity. Am. J. Physiol. Heart Circ. Physiol. 2008; 295 (4): H1514-H1521.
  18. Мухин Н. А., Фомин В. В., Сагинова Е. А. и др. Эндотелиальная дисфункция и поражение почек при ожирении. Вестн. РАМН 2006; 12: 25-31.
  19. Ikee R., Hamasaki Y., Oka M. et al. Glucose metabolism, insulin resistance, and renal pathology in non-diabetic chronic kidney disease. Nephron Clin. Pract. 2008; 108 (2): c163- c168.
  20. Cusumano A. M., Bodkin N. L., Hansen B. C. et al. Glomerular hypertrophy is associated with hyperinsulinemia and precedes overt diabetes in aging rhesus monkeys. Am. J. Kidney Dis. 2002; 40: 1075-1085.
  21. Yiannikouris F., Gupte M., Putnam K., Cassis L. Adipokines and blood pressure control. Curr. Opin. Nephrol. Hypertens. 2010; 19 (2): 195-200.
  22. Asferg C., Mogelvang R., Flyvbjerg A. et al. Leptin, not adiponecti, predicts hypertension in the Copenhagen City Heart Study. Am. J. Hypertens. 2010; 23 (3): 327-333.
  23. Чазова И. Е., Литвин А. Ю. Синдром обструктивного апноэ во время сна: механизмы возникновения, клиническое значение, связь с сердечно-сосудистыми заболеваниями, принципы лечения. Кардиол. вестн. 2009; 2: 89- 103.
  24. Tokuda F., Sando Y., Matsui H. et al. Serum levels of adipocytokines, adiponectin and leptin, in patients with obstructive sleep apnea syndrome. Intern. Med. 2008; 47 (21): 1843- 1849.
  25. Adeseun G. A., Rosas S. E. The impact of obstructive sleep apnea on chronic kidney disease. Curr. Hypertens. Rep. 2010; 12 (5): 378-383.
  26. Eun Y. G., Kim M. G., Kwon K. H. et al. Short-term effect of multilevel surgery on adipokines and pro-inflammatory cytokines in patients with obstructive sleep apnea. Acta Otolaryngol. 2010; 130 (12): 1394-1398.
  27. Fleischmann G., Fillafer G., Matterer H. et al. Prevalence of chronic kidney disease in patients with suspected sleep apnoea. Nephrol. Dial. Transplant. 2010; 25 (1): 181-186.
  28. Kato K., Takata Y., Usui Y. et al. Severe obstructive sleep apnea increases cystatin C in clinically latent renal dysfunction. Respir. Med. 2010 Dec 21. [Epub ahead of print].
  29. Han S. H., Sakuma I., Shin E. K., Koh K. K. Antiatherosclerotic and anti-insulin resistance effects of adiponectin: basic and clinical studies. Progr. Cardiovasc. Dis. 2009; 52 (2): 126-140.
  30. Han S. H., Quon M. J., Kim J. A., Koh K. K. Adiponectin and cardiovascular disease: response to therapeutic interventions. J. Am. Coll. Cardiol. 2007; 49 (5): 531-538.
  31. Saarikoski L. A., Huupponen R. K., Viikari J. S. et al. Adiponectin is related with carotid artery intima-media thickness and brachial flow-mediated dilatation in young adults - the Cardiovascular Risk in Young Finns Study. Ann. Med. 2010; 42 (8): 603-611.
  32. Huang S. S., Huang P. H., Chen Y. H. et al. Association of adiponectin with future cardiovascular events in patients after acute myocardial infarction. J. Atheroscler. Thromb. 2010; 17 (3): 295-303.

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Consilium Medicum, 2011

Creative Commons License
此作品已接受知识共享署名-非商业性使用-相同方式共享 4.0国际许可协议的许可。
 

Address of the Editorial Office:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


##common.cookie##