Decrease in Irisin in Patients with Chronic Kidney Disease

Abstract

Patients with chronic kidney disease have abnormal energy expenditure and metabolism. The mechanisms underlying altered energy expenditure in uremia are unknown and remain to be elucidated. Irisin is a peroxisome proliferator-activated receptor γ coactivator 1-α–dependent myokine, and it increases energy expenditure in the absence of changes in food intake or activity. We hypothesize that chronic kidney disease patients have altered irisin levels. We measured resting irisin levels in 38 patients with stage 5 chronic kidney disease and in 19 age- and sex-matched normal subjects. Plasma irisin levels were significantly decreased in chronic kidney disease patients (58.59%; 95% CI 47.9%–69.2%, p<0.0001). The decrease in irisin levels was inversely correlated with the levels of blood urea nitrogen and creatinine. Further association analysis revealed that irisin level is independently associated with high-density lipoprotein cholesterol level. Our results suggest that chronic kidney disease patients have lower than normal irisin levels at rest. Furthermore, irisin may play a major role in affecting high-density lipoprotein cholesterol levels and abnormal energy expenditure in chronic kidney disease patients.

The Serum Irisin Level in Non-Diabetic Patients with Chronic Kidney Disease

“…Similarly, in the present study the irisin level decreased as CKD stage increased in non-diabetic CKD patients. Furthermore, in the present study the irisin level was negatively correlated with age, fasting blood glucose, creatinine, and LDL-C, and positively correlated with the GFR, as previously reported (32,33,37,38). In a study that included diabetic patients with CKD multivariate linear regression analysis showed that the GFR was an independent predictor of the irisin level (33).…”

“…Another cause might be inhibition of FNDC5 expression and irisin secretion in skeletal muscles by uremic toxins (indoxyl sulphate, etc. ), as was reported by Wen et al (32). Moreover, irisin synthesis might also decrease due to decreased muscle mass in CKD (34), as it is known that the irisin level is positively correlated with muscle mass (35); however, this hypothesis could not be proven in the present study because muscle mass was not measured.…”

Factors associated with increased irisin levels in the type 1 diabetes mellitus

“…In a previous study conducted with patients with chronic renal failure, irisin levels were determined to be negatively correlated with creatinine (Wen et al 2013). Th is case is considered to result from the inhibition of FNDC5, which is the precursor of irisin, by indoxyl sulphate, which is a uremic toxin (Wen et al 2013). We did not found any study examining the relation between irisin and HbA1c in T1DM patients.…”

Longitudinal variation of circulating irisin after an energy restriction‐induced weight loss and following weight regain in obese men and women

“…Surprisingly, a recent report has revealed a significant decrease in circulating irisin and adipose and muscle tissue gene expression levels in obesity, suggesting that irisin is inversely associated with different adiposity markers (Moreno-Navarrete et al, 2013). On the other hand, low circulating irisin levels were associated with chronic kidney disease (Wen et al, 2013), intrahepatic triglycerides content in obese adults with non alcoholic fatty liver disease (Zhang et al, 2013) and with type 2 diabetes (Choi et al, 2013;Liu et al, 2013). All together these reports highlight the need of further research to elucidate the true role of irisin in health and disease (Polyzos et al, 2013).…”