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Circulating Levels of Dickkopf-Related Protein 1 Decrease as Measured GFR Declines and Are Associated with PTH Levels.
Forster, CM, White, CA, Turner, ME, Norman, PA, Ward, EC, Hopman, WM, Adams, MA, Holden, RM
American journal of nephrology. 2020;(11):871-880
Abstract
BACKGROUND The Wnt/β-catenin pathway has been implicated in the development of adynamic bone disease in early-stage chronic kidney disease (CKD). Dickkopf-related protein 1 (DKK1) and sclerostin are antagonists of the Wnt/β-catenin pathway yet have not been widely used as clinical indicators of bone disease. This study characterized levels of DKK1, sclerostin, and other biomarkers of mineral metabolism in participants across a spectrum of inulin-measured glomerular filtration rate (GFR). METHODS GFR was measured by urinary inulin clearance (mGFR) in 90 participants. Blood samples were obtained for measurement of circulating DKK1, sclerostin, fibroblast growth factor 23 (FGF-23), parathyroid hormone (PTH), calcium, phosphate, α-klotho, and vitamin D metabolites including 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3. Spearman correlations and linear regressions were used where appropriate to examine the associations between measured values. RESULTS The median [IQR] age was 64 years [53.0-71.0], and the median [IQR] mGFR was 32.6 [21.7-60.6] mL/min. DKK1 decreased (r = 0.6, p < 0.001) and sclerostin increased (r = -0.4, p < 0.001) as kidney function declined, and both were associated with phosphate, PTH, FGF-23, and 1,25-dihydroxyvitamin D3 in the unadjusted analysis. After adjustment for age and mGFR, DKK1 remained significantly associated with PTH. CONCLUSION The results of this study demonstrate opposing trends in Wnt/β-catenin pathway inhibitors, DKK1 and sclerostin, as mGFR declines. Unlike sclerostin, DKK1 levels decreased significantly as mGFR declined and was independently associated with PTH. Future studies should determine whether measurement of Wnt signaling inhibitors may be useful in predicting bone histomorphometric findings and important clinical outcomes in patients with CKD.
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Circulating LECT2 levels in newly diagnosed type 2 diabetes mellitus and their association with metabolic parameters: An observational study.
Zhang, Z, Zeng, H, Lin, J, Hu, Y, Yang, R, Sun, J, Chen, R, Chen, H
Medicine. 2018;(15):e0354
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Leukocyte cell-derived chemotaxin 2 (LECT2) is a hepatokine expressed in hepatocytes and appears to be involved in energy metabolism. The aim of this study was to determine plasma LECT2 levels in newly diagnosed type 2 diabetic patients and to correlate the results with various metabolic parameters.A total of 93 newly diagnosed type 2 diabetic patients and 80 age- and sex-matched nondiabetes mellitus ones were enrolled in the study. Plasma LECT2 levels were measured by enzyme-linked immunosorbent assay.Circulating LECT2 levels were approximately 1.3 times higher in newly diagnosed type 2 diabetic patients than in controls (mean 30.30 vs 23.23 ng/mL, P < .001). Correlation analysis showed that LECT2 was negatively associated with high-density lipoprotein-cholesterol (HDL-C) levels in type 2 diabetic patients and obese subjects (P < .05). In multiple stepwise regression analysis, HDL-C, HOMA-IR, BMI, FINS, and TG were significantly independent determinants for LECT2 (P < .05).Our study showed that circulating LECT2 concentrations are significantly higher in newly diagnosed type 2 diabetic patients and further elevated in obese type 2 diabetic patients. LECT2 concentrations are significantly negatively associated with HDL-cholesterol levels in newly diagnosed type 2 diabetic patients and obese subjects.
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Systemic Inflammation-Associated Proteins and Retinopathy of Prematurity in Infants Born Before the 28th Week of Gestation.
Holm, M, Morken, TS, Fichorova, RN, VanderVeen, DK, Allred, EN, Dammann, O, Leviton, A, ,
Investigative ophthalmology & visual science. 2017;(14):6419-6428
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PURPOSE To assess the association between systemic levels of inflammation-associated proteins and severe retinopathy of prematurity (ROP) in extremely preterm infants. METHODS We collected whole blood on filter paper on postnatal days 1, 7, 14, 21, and 28 from 1205 infants born before the 28th week of gestation, and measured the concentrations of 27 inflammation-associated, angiogenic, and neurotrophic proteins. We calculated odds ratios with 95% confidence intervals for the association between top quartile concentrations of each protein and prethreshold ROP. RESULTS During the first three weeks after birth, high concentrations of VEGF-R1, myeloperoxidase (MPO), IL-8, intercellular adhesion molecule (ICAM)-1, matrix metalloproteinase 9, erythropoietin, TNF-α, and basic fibroblast growth factor were associated with an increased risk for prethreshold ROP. On day 28, high levels of serum amyloid A, MPO, IL-6, TNF-α, TNF-R1/-R2, IL-8, and ICAM-1 were associated with an increased risk. Top quartile concentrations of the proinflammatory cytokines TNF-α and IL-6 were associated with increased risks of ROP when levels of neuroprotective proteins and growth factors, including BDNF, insulin-like growth factor 1, IGFBP-1, VEGFR-1 and -2, ANG-1 and PlGF, were not in the top quartile. In contrast, high concentrations of NT-4 and BDNF appeared protective only in infants without elevated inflammatory mediators. CONCLUSIONS Systemic inflammation during the first postnatal month was associated with an increased risk of prethreshold ROP. Elevated concentrations of growth factors, angiogenic proteins, and neurotrophins appeared to modulate this risk, and were capable of reducing the risk even in the absence of systemic inflammation.
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Increased sclerostin and preadipocyte factor-1 levels in prepubertal rhythmic gymnasts: associations with bone mineral density, body composition, and adipocytokine values.
Jürimäe, J, Tillmann, V, Cicchella, A, Stefanelli, C, Võsoberg, K, Tamm, AL, Jürimäe, T
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2016;(3):1239-1243
Abstract
SUMMARY Rhythmic gymnastics as high-impact bone loading sport has positive effects on bone mineralization in prepubertal years. Sclerostin and preadipocyte factor-1 (Pref-1) are hormones that inhibit bone formation. The present study demonstrates that these hormones are higher in gymnasts, and gymnasts present higher bone mineral density (BMD) as compared to controls. INTRODUCTION Rhythmic gymnasts (RG) start their heavy trainings already in prepuberty and despite of low body fat mass (FM) and hypoleptinemia, their BMD is higher than in non-trained normal girls. The specific role of sclerostin and Pref-1, which are the inhibitors of bone formation, in bone development is not well understood. The impact of sclerostin and Pref-1 levels on BMD, body composition, and adipocytokine values was studied in prepubertal RG and untrained controls (UC). METHODS Sixty-four 9-10-year-old girls were divided into RG (n = 32) and UC (n = 32) groups. Bone mineral and body composition values were measured by dual-energy X-ray absorptiometry and bone age by X-ray. Sclerostin, Pref-1, leptin, and adiponectin levels were measured from fasting blood samples. RESULTS Sclerostin (RG 19.8 ± 6.3 pmol/l; UC 15.8 ± 5.4 pmol/l) and Pref-1 (RG 1.6 ± 1.0 ng/ml; UC 1.1 ± 0.5 ng/ml) were higher (p < 0.05) in RG compared with UC. Sclerostin was related to adiponectin (r = 0.41; p < 0.05) in UC. No relationship was found between sclerostin and Pref-1 with BMD values in prepubertal RG and age-matched UC groups. CONCLUSIONS Sclerostin and Pref-1 levels are higher in RG compared to UC girls. Specific physical activity pattern seen in prepubertal RG has a beneficial effect on bone mineralization despite increased levels of hormones that inhibit bone formation.