The Impact of Insulin Resistance and Chronic Kidney Disease on Inflammation and Cardiovascular Disease

Kosmas, Constantine E.; Silverio, Delia; Tsomidou, Christiana; Salcedo, Maria D; Montan, Peter D; Guzman, Eliscer

doi:10.1177/1179551418792257

Cited by 53 publications

(36 citation statements)

References 97 publications

(142 reference statements)

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“…CKD prevalence in T2DM patients is over 50% [17]. All the risk factors that trigger and promote the progression of CKD in DM patients are caused by the presence of insulin resistance, which itself causes hypertension, dyslipidaemia, endothelial dysfunction and inflammation [18]. Early CKD develops insulin resistance and promotes the progression to more advanced stages by mechanisms such as sodium retention, activation of the sympathetic nervous system and decrease of the natriuretic peptide system synthesis [19].…”

Section: Chronic Kidney Disease (Ckd)mentioning

confidence: 99%

Current Data Regarding the Relationship between Type 2 Diabetes Mellitus and Cardiovascular Risk Factors

Vesa

Popa²,

Popa

et al. 2020

Diagnostics

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Reducing cardiovascular risk (CVR) is the main focus of diabetes mellitus (DM) management nowadays. Complex pathogenic mechanisms that are the subject of this review lead to early and severe atherosclerosis in DM patients. Although it is not a cardiovascular disease equivalent at the moment of diagnosis, DM subjects are affected by numerous cardiovascular complications, such as acute coronary syndrome, stroke, or peripheral artery disease, as the disease duration increases. Therefore, early therapeutic intervention is mandatory and recent guidelines focus on intensive CVR factor management: hyperglycaemia, hypertension, and dyslipidaemia. Most important, the appearance of oral or injectable antidiabetic medication such as SGLT-2 inhibitors or GLP-1 agonists has proven that an antidiabetic drug not only reduces glycaemia, but also reduces CVR by complex mechanisms. A profound understanding of intimate mechanisms that generate atherosclerosis in DM and ways to inhibit or delay them are of the utmost importance in a society where cardiovascular morbidity and mortality are predominant.

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Section: Chronic Kidney Disease (Ckd)mentioning

confidence: 99%

Current Data Regarding the Relationship between Type 2 Diabetes Mellitus and Cardiovascular Risk Factors

Vesa

Popa²,

Popa

et al. 2020

Diagnostics

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“…Currently, chronic inflammation is considered as a unifying mechanism linking diabetes, kidney pathology, and cardiovascular disease [81]; it can be an important contributor to CKD− related cardiovascular morbidity [82][83][84]. Accordingly, modification of chronic inflammation and fibrosis appears to be importantin the treatment of T2D individuals with CKD.…”

Section: Discussionmentioning

confidence: 99%

Multiplex Bead Array Assay of a Panel of Circulating Cytokines and Growth Factors in Patients with Albuminuric and Non-Albuminuric Diabetic Kidney Disease

Климонтов

Korbut

Орлов

et al. 2020

JCM

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A panel of cytokines and growth factors, mediating low-grade inflammation and fibrosis, was assessed in patients with type 2 diabetes (T2D) and different patterns of chronic kidney disease (CKD). Patients with long-term T2D (N = 130) were classified into four groups: no signs of CKD; estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 without albuminuria; albuminuria and eGFR ≥60 mL/min/1.73 m2; albuminuria and eGFR <60 mL/min/1.73 m2. Thirty healthy subjects were acted as control. Twenty-seven cytokines and growth factors were assessed in serum by multiplex bead array assay. Serum hs-CRP, urinary nephrin, podocine, and WFDC2 were measured by ELISA. Patients with T2D showed elevated IL-1Ra, IL-6, IL-17A, G-CSF, IP-10, MIP-1α, and bFGF levels; concentrations of IL-4, IL-12, IL-15, INF-γ, and VEGF were decreased. IL-6, IL-17A, G-CSF, MIP-1α, and bFGF correlated negatively with eGFR; IL-10 and VEGF demonstrated negative associations with WFDC2; no relationships with podocyte markers were found. Adjusted IL-17A and MIP-1α were predictors of non-albuminuric CKD, IL-13 predicted albuminuria with preserved renal function, meanwhile, IL-6 and hsCRP were predictors of albuminuria with eGFR decline. Therefore, albuminuric and non-albuminuric CKD in T2D patients are associated with different pro-inflammatory shifts in the panel of circulating cytokines.

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“…Previous studies have shown that hyperinsulinemia was an independent predictor of incident myocardial ischemic events in a non-diabetic population [ 7 ]. IR is also an independent risk factor for various chronic diseases, such as hypertension [ 8 ], hepatic steatosis and steatohepatitis [ 9 ], chronic kidney disease [ 10 ], and even lung cancer [ 11 ] and Alzheimer’s disease [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Association between Insulin Resistance and Cardiovascular Disease Risk: A Community-Based Cross-Sectional Study among Taiwanese People Aged over 50 Years

Fang

et al. 2020

IJERPH

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Background and Aims: Previous studies have implied that insulin resistance (IR) could represent a major underlying abnormality leading to cardiovascular disease (CVD). The aim of this study was to evaluate the relationships between IR (estimated by the homeostasis model assessment of IR (HOMA-IR) index) and CVD risk among middle-aged and elderly Taiwanese individuals. Methods: In this cross-sectional, community-based study, a total of 320 participants were interviewed to collect demographical parameters and blood samples. The recruited participants were divided into tertiles according to their levels of HOMA-IR. The Framingham risk score (FRS) was calculated according to the 2008 general CVD risk model from the Framingham Heart Study. Results: The HOMA-IR index was significantly correlated with the FRS, with a Pearson’s coefficient of 0.22. In the multiple logistic regression model, a higher HOMA-IR level was significantly associated with a high FRS (FRS ≥ 20%) (highest tertile vs. lowest tertile of HOMA-IR, crude OR = 3.69; 95% CI = 1.79–7.62), even after adjusting for smoking, fasting plasma glucose (FPG), and systolic blood pressure (SBP) (highest tertile vs. lowest tertile of HOMA-IR, adjusted OR = 11.51; 95% CI = 2.55–51.94). The area under the receiver operating characteristic curve for the HOMA-IR index as the predictor of high FRS was 0.627, and the optimal HOMA-IR cutoff value was 1.215 (sensitivity = 83.6%, specificity = 42.9%). Conclusions: We considered that HOMA-IR is an independent factor but that it cannot be used solely for evaluating the CVD risk due to the low AUC value. Further prospective cohort studies are warranted to better assess the relationship between CVD risk and insulin resistance.

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The Impact of Insulin Resistance and Chronic Kidney Disease on Inflammation and Cardiovascular Disease

Cited by 53 publications

References 97 publications

Current Data Regarding the Relationship between Type 2 Diabetes Mellitus and Cardiovascular Risk Factors

Current Data Regarding the Relationship between Type 2 Diabetes Mellitus and Cardiovascular Risk Factors

Multiplex Bead Array Assay of a Panel of Circulating Cytokines and Growth Factors in Patients with Albuminuric and Non-Albuminuric Diabetic Kidney Disease

The Association between Insulin Resistance and Cardiovascular Disease Risk: A Community-Based Cross-Sectional Study among Taiwanese People Aged over 50 Years

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