This page has only limited features, please log in for full access.
Background. Adipocyte fatty acid-binding protein (A-FABP) plays essential roles in lipolysis, insulin resistance, and atherosclerosis. This study aimed to evaluate the relationship between serum A-FABP levels and carotid-femoral pulse wave velocity (cfPWV) in peritoneal dialysis (PD) patients. Methods. This study obtained fasting blood samples from 76 PD patients. A validated tonometry system was used to measure cfPWV. Patients with cfPWV values >10 m/s were classified into the high arterial stiffness group, whereas patients with values ≤10 m/s were classified into the low arterial stiffness group, according to the ESH-ESC 2013 guidelines. Serum A-FABP levels were measured using a commercial enzyme-linked immunosorbent assay kit. Results. Twenty-five (32.9%) of the 76 PD patients were classified in the high arterial stiffness group. Compared with the patients in the low arterial stiffness group, the high arterial stiffness group was older ( P = 0.002) and had a longer PD vintage ( P = 0.011), higher diastolic blood pressure (DBP, P = 0.036), higher fasting glucose levels ( P = 0.012), higher serum C reactive protein levels ( P = 0.001), and higher serum A-FABP levels ( P < 0.001). A multivariate logistic regression analysis of the factors significantly associated with central arterial stiffness revealed that A-FABP (odds ratio (OR): 1.165, 95% confidence interval (CI): 1.056–1.284, P = 0.002), age (OR: 1.423, 95% CI: 1.153–1.757, P = 0.001), PD vintage (OR: 1.049, 95% CI: 1.015–1.085, P = 0.005), and DBP (OR: 1.152, 95% CI: 1.033–1.285, P = 0.011) were independent predictors of central arterial stiffness in PD patients. Furthermore, serum A-FABP levels (β = 0.476, adjusted R2 change: 0.197, P < 0.001) were significantly positively correlated with cfPWV according to the multivariable forward stepwise linear regression analysis. Conclusions. A-FABP levels are an independent marker of central arterial stiffness in PD patients.
Cheng-Hao Sung; Bang-Gee Hsu; Jen-Pi Tasi; Chih-Hsien Wang; Chiu-Huang Kuo. Positive Associations between Adipocyte Fatty Acid-Binding Protein Level and Central Arterial Stiffness in Peritoneal Dialysis Patients. International Journal of Hypertension 2021, 2021, 1 -8.
AMA StyleCheng-Hao Sung, Bang-Gee Hsu, Jen-Pi Tasi, Chih-Hsien Wang, Chiu-Huang Kuo. Positive Associations between Adipocyte Fatty Acid-Binding Protein Level and Central Arterial Stiffness in Peritoneal Dialysis Patients. International Journal of Hypertension. 2021; 2021 ():1-8.
Chicago/Turabian StyleCheng-Hao Sung; Bang-Gee Hsu; Jen-Pi Tasi; Chih-Hsien Wang; Chiu-Huang Kuo. 2021. "Positive Associations between Adipocyte Fatty Acid-Binding Protein Level and Central Arterial Stiffness in Peritoneal Dialysis Patients." International Journal of Hypertension 2021, no. : 1-8.
Sarcopenia is common in patients undergoing chronic hemodialysis, which leads to poor outcomes. SARC-F (sluggishness, assistance in walking, rising from a chair, climb stairs, falls), a self-report questionnaire, is recommended as an easily applied tool for screening sarcopenia in older people. However, there are limited data regarding its use in patients undergoing chronic hemodialysis. Therefore, we aimed to evaluate the association between SARC-F and mortality in these patients. SARC-F questionnaire was applied in 271 hemodialysis patients (mean age 64.4 ± 14.3 years) at baseline. The association between SARC-F and mortality during a 24-month follow-up was analyzed. During this follow-up period, 40 patients (14.8%) died. The discriminative power of SARC-F score for predicting mortality was 0.716 (95% confidence interval (CI) = 0.659–0.769; p < 0.001). The best cut-off was a score ≥ 1, which provided 85.0% sensitivity, 47.2% specificity, 21.8% positive predictive value, and 94.8% negative predictive value. Kaplan–Meier curves showed that patients with SARC-F ≥ 1 exhibited a higher risk of mortality than those with SARC-F < 1 (p < 0.001). Moreover, a stepwise decline in survival with higher SARC-F scores was also observed. After full adjustments, SARC-F ≥ 1 was independently associated with increased mortality (hazard ratio = 2.87, 95% CI = 1.11–7.38; p = 0.029). In conclusion, SARC-F applied for sarcopenia screening predicted mortality in patients undergoing chronic hemodialysis.
Yu-Li Lin; Jia-Sian Hou; Yu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Hung-Hsiang Liou; Bang-Gee Hsu. Association of SARC-F Questionnaire and Mortality in Prevalent Hemodialysis Patients. Diagnostics 2020, 10, 890 .
AMA StyleYu-Li Lin, Jia-Sian Hou, Yu-Hsien Lai, Chih-Hsien Wang, Chiu-Huang Kuo, Hung-Hsiang Liou, Bang-Gee Hsu. Association of SARC-F Questionnaire and Mortality in Prevalent Hemodialysis Patients. Diagnostics. 2020; 10 (11):890.
Chicago/Turabian StyleYu-Li Lin; Jia-Sian Hou; Yu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Hung-Hsiang Liou; Bang-Gee Hsu. 2020. "Association of SARC-F Questionnaire and Mortality in Prevalent Hemodialysis Patients." Diagnostics 10, no. 11: 890.
L-carnitine (LC) is a co-factor in fatty acid metabolism; its role with respect to aortic stiffness (AS) associated with chronic kidney disease (CKD) was unclear. Our aim was to investigate associations between serum LC levels and AS in patients with non-dialysis CKD stage 3–5. The AS patients were those with carotid-femoral pulse wave velocities (cfPWV) >10 m/s; those with cfPWV ≤10 m/s were included as controls. Serum LC was measured by liquid chromatography and mass spectrometry. Of 136 CKD patients, the 44 (32.4%) with AS were older, exhibited higher rates of diabetes, and had elevated diastolic and systolic blood pressures (SBP), elevated fasting glucose levels and lower levels of serum LC compared to controls. Multivariable logistic regression revealed that serum LC (odds ratio [OR] = 0.949, 95% confidence interval [CI] 0.911–0.988, p = 0.011) and age (OR = 1.055, 95% CI 1.013–1.099, p = 0.009) were independent predictors of AS. Multivariable stepwise linear regression revealed significant positive (age and SBP) and negative (serum LC) correlations with cfPWV. The area under the curve of serum LC as a means to predict AS in CKD patients was 0.657 (95% CI 0.571–0.736, p = 0.0009). We concluded that low serum LC is a significant predictor of AS in patients diagnosed with CKD.
Yi-Jen Hsieh; Bang-Gee Hsu; Yu-Hsien Lai; Chih-Hsien Wang; Yu-Li Lin; Chiu-Huang Kuo; Jen-Pi Tsai. Association of Low Serum l-Carnitine Levels with Aortic Stiffness in Patients with Non-Dialysis Chronic Kidney Disease. Nutrients 2020, 12, 2918 .
AMA StyleYi-Jen Hsieh, Bang-Gee Hsu, Yu-Hsien Lai, Chih-Hsien Wang, Yu-Li Lin, Chiu-Huang Kuo, Jen-Pi Tsai. Association of Low Serum l-Carnitine Levels with Aortic Stiffness in Patients with Non-Dialysis Chronic Kidney Disease. Nutrients. 2020; 12 (10):2918.
Chicago/Turabian StyleYi-Jen Hsieh; Bang-Gee Hsu; Yu-Hsien Lai; Chih-Hsien Wang; Yu-Li Lin; Chiu-Huang Kuo; Jen-Pi Tsai. 2020. "Association of Low Serum l-Carnitine Levels with Aortic Stiffness in Patients with Non-Dialysis Chronic Kidney Disease." Nutrients 12, no. 10: 2918.
Circulating malondialdehyde-modified low-density lipoprotein (MDA-LDL) acts as a marker of oxidative stress and is associated with atherosclerotic cardiovascular disease. The relationship between serum MDA-LDL levels and aortic stiffness (AS) in patients with hemodialysis (HD) was evaluated. There were 155 HD patients enrolled in this study. Carotid-femoral pulse wave velocity (cfPWV) was measured by a validated tonometry system. Patients with cfPWV >10 m/s were used to define the AS group, while those with values of ≤10 m/s were regarded as the control group. Serum MDA-LDL levels were measured using a commercial enzyme-linked immunosorbent assay. Sixty-eight patients (43.9%) who were defined as AS sufferers, and were older, had a higher percentage of diabetes and hypertension and higher systolic blood pressure and serum MDA-LDL level compared to subjects in the control group. After adjusting for factors significantly associated with AS by multivariable logistic regression analysis, it was revealed that serum MDA-LDL levels, diabetes, and hypertension were independent predictors of AS in HD patients. Multivariable forward stepwise linear regression analysis also showed that a logarithmically transformed MDA-LDL level was significantly correlated with cfPWV values in HD patients. In HD patients, a high serum MDA-LDL level was positively associated with cfPWV values and was a significant predictor of the development of high AS.
Jia-Sian Hou; Chih-Hsien Wang; Yu-Hsien Lai; Chiu-Huang Kuo; Yu-Li Lin; Bang-Gee Hsu; Jen-Pi Tsai. Serum Malondialdehyde-Modified Low-Density Lipoprotein Is a Risk Factor for Central Arterial Stiffness in Maintenance Hemodialysis Patients. Nutrients 2020, 12, 2160 .
AMA StyleJia-Sian Hou, Chih-Hsien Wang, Yu-Hsien Lai, Chiu-Huang Kuo, Yu-Li Lin, Bang-Gee Hsu, Jen-Pi Tsai. Serum Malondialdehyde-Modified Low-Density Lipoprotein Is a Risk Factor for Central Arterial Stiffness in Maintenance Hemodialysis Patients. Nutrients. 2020; 12 (7):2160.
Chicago/Turabian StyleJia-Sian Hou; Chih-Hsien Wang; Yu-Hsien Lai; Chiu-Huang Kuo; Yu-Li Lin; Bang-Gee Hsu; Jen-Pi Tsai. 2020. "Serum Malondialdehyde-Modified Low-Density Lipoprotein Is a Risk Factor for Central Arterial Stiffness in Maintenance Hemodialysis Patients." Nutrients 12, no. 7: 2160.
Sarcopenia is highly prevalent in patients undergoing chronic hemodialysis (HD). This study investigated the relationship among serum indoxyl sulfate (IS) levels, muscle mass, and strength in HD patients. A total of 108 HD patients were enrolled. Skeletal muscle mass and handgrip strength (HGS) were assessed, using bioimpedance analysis and a hand-held dynamometer, respectively. Skeletal muscle index (SMI) was defined as skeletal muscle mass/height2 (kg/m2). Serum IS, p-cresol sulfate (PCS), and trimethylamine N-oxide (TMAO) levels were determined using liquid chromatography–mass spectrometry. Patients were classified into two groups based on median serum IS values. HGS measurement was repeated after 2 years. Patients in the high IS group had longer HD duration and higher serum TMAO levels than those in the low IS group. Log-normalized IS level was negatively correlated with SMI (r = − 0.227; p = 0.018), but PCS and TMAO levels were not. Among 78 patients who completed 2-year follow-up, those in the high IS group (n = 41) showed greater absolute (− 2.48 kg versus − 0.25 kg, p = 0.035) and relative HGS loss (− 9.1% versus 1.4%, p = 0.036) than those in the low IS group, after adjustment for potential confounders. Indoxyl sulfate (IS) may play a significant role in uremic sarcopenia. Further large-scale studies are needed to confirm our preliminary findings.
Yu-Li Lin; Chin-Hung Liu; Yu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Hung-Hsiang Liou; Bang-Gee Hsu. Association of Serum Indoxyl Sulfate Levels with Skeletal Muscle Mass and Strength in Chronic Hemodialysis Patients: A 2-year Longitudinal Analysis. Calcified Tissue International 2020, 107, 257 -265.
AMA StyleYu-Li Lin, Chin-Hung Liu, Yu-Hsien Lai, Chih-Hsien Wang, Chiu-Huang Kuo, Hung-Hsiang Liou, Bang-Gee Hsu. Association of Serum Indoxyl Sulfate Levels with Skeletal Muscle Mass and Strength in Chronic Hemodialysis Patients: A 2-year Longitudinal Analysis. Calcified Tissue International. 2020; 107 (3):257-265.
Chicago/Turabian StyleYu-Li Lin; Chin-Hung Liu; Yu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Hung-Hsiang Liou; Bang-Gee Hsu. 2020. "Association of Serum Indoxyl Sulfate Levels with Skeletal Muscle Mass and Strength in Chronic Hemodialysis Patients: A 2-year Longitudinal Analysis." Calcified Tissue International 107, no. 3: 257-265.
Recent evidence has indicated that fibroblast growth factor 21 (FGF21) regulates longitudinal bone growth, with increased FGF21 levels leading to bone loss. The present study evaluated the relationship between bone mineral density (BMD) and serum FGF21 levels in patients undergoing hemodialysis (HD). We analyzed blood samples from 95 patients undergoing HD and measured BMD using dual-energy X-ray absorptiometry of the lumbar vertebrae (L2–L4). Serum FGF21 concentrations were determined using a commercially available enzyme-linked immunosorbent assay kit. Thirteen (11.6%) patients were found to have osteoporosis, 27 (28.4%) osteopenia, and 57 patients had normal BMD. Advanced age and decreased body mass index, height, body weight, waist circumference, and triglyceride level were associated with lower lumbar T-scores, as were increased alkaline phosphatase, urea reduction rate, fractional clearance index for urea, and FGF21 levels. Low log-FGF21, increased body mass index, increased pre-HD body weight, and increased logarithmically transformed triglycerides (log-TG) were found to be significantly and independently associated with lumbar BMD by multivariate forward stepwise linear regression analysis with adjustment for significant confounders. We conclude that high serum FGF21 level is negatively associated with BMD in patients undergoing HD.
Yin-Ting Wu; Bang-Gee Hsu; Chih-Hsien Wang; Yu-Li Lin; Yu-Hsien Lai; Chiu-Huang Kuo. Lower Serum Fibroblast Growth Factor 21 Levels are Associated with Normal Lumbar Spine Bone Mineral Density in Hemodialysis Patients. International Journal of Environmental Research and Public Health 2020, 17, 1938 .
AMA StyleYin-Ting Wu, Bang-Gee Hsu, Chih-Hsien Wang, Yu-Li Lin, Yu-Hsien Lai, Chiu-Huang Kuo. Lower Serum Fibroblast Growth Factor 21 Levels are Associated with Normal Lumbar Spine Bone Mineral Density in Hemodialysis Patients. International Journal of Environmental Research and Public Health. 2020; 17 (6):1938.
Chicago/Turabian StyleYin-Ting Wu; Bang-Gee Hsu; Chih-Hsien Wang; Yu-Li Lin; Yu-Hsien Lai; Chiu-Huang Kuo. 2020. "Lower Serum Fibroblast Growth Factor 21 Levels are Associated with Normal Lumbar Spine Bone Mineral Density in Hemodialysis Patients." International Journal of Environmental Research and Public Health 17, no. 6: 1938.
Sclerostin and dickkopf-1 (DKK1) played a role in the development of cardiovascular diseases and arterial stiffness in chronic kidney disease (CKD) patients but with controversial results of patients in end-stage renal disease (ESRD) including hemodialysis (HD) and peritoneal dialysis (PD). This study aimed to examine the association between the mode of dialysis or the values of sclerostin or DKK1 and carotid-femoral pulse wave velocity (cfPWV) in ESRD patients. There were 122 HD and 72 PD patients enrolled in this study. By a validated tonometry system, cfPWV was measured and then segregated patients into values of >10 m/s as the high central arterial stiffness (AS) group and values ≤ 10 m/s as the control group. Serum levels of sclerostin and DKK1 were measured using a commercial enzyme-linked immunosorbent assay kit. Possible risk factors for the development of AS were analyzed by logistic regression analysis. There were 21 (29.2%) of PD and 53 (43.4%) of HD in the high AS group. Compared to patients in the control group, those in the high AS group were older, had more comorbidities, had higher systolic blood pressure, and had higher serum levels of fasting glucose, C-reactive protein, and sclerostin. Levels of sclerostin (adjusted OR 1.012, 95% CI. 1.006–1.017, p = 0.0001) was found to be an independent predictor of high AS in ESRD patients by multivariate logistic regression analysis. Furthermore, receiver operating characteristic curve analysis showed the optimal cut-off values of sclerostin for predicting AS was 208.64 pmol/L (Area under the curve 0.673, 95% CI: 0.603–0.739, p < 0.001). This study showed that serum levels of sclerostin, but not DKK1 or mode of dialysis, to be a predictor for high central AS in ESRD patients.
Chun-Feng Wu; Jia-Sian Hou; Chih-Hsien Wang; Yu-Li Lin; Yu-Hsien Lai; Chiu-Huang Kuo; Hung-Hsiang Liou; Jen-Pi Tsai; Bang-Gee Hsu. Serum Sclerostin But Not DKK-1 Correlated with Central Arterial Stiffness in End Stage Renal Disease Patients. International Journal of Environmental Research and Public Health 2020, 17, 1230 .
AMA StyleChun-Feng Wu, Jia-Sian Hou, Chih-Hsien Wang, Yu-Li Lin, Yu-Hsien Lai, Chiu-Huang Kuo, Hung-Hsiang Liou, Jen-Pi Tsai, Bang-Gee Hsu. Serum Sclerostin But Not DKK-1 Correlated with Central Arterial Stiffness in End Stage Renal Disease Patients. International Journal of Environmental Research and Public Health. 2020; 17 (4):1230.
Chicago/Turabian StyleChun-Feng Wu; Jia-Sian Hou; Chih-Hsien Wang; Yu-Li Lin; Yu-Hsien Lai; Chiu-Huang Kuo; Hung-Hsiang Liou; Jen-Pi Tsai; Bang-Gee Hsu. 2020. "Serum Sclerostin But Not DKK-1 Correlated with Central Arterial Stiffness in End Stage Renal Disease Patients." International Journal of Environmental Research and Public Health 17, no. 4: 1230.
Arterial stiffness (AS) has an important impact on the outcomes of patients on hemodialysis (HD), and p-cresyl sulfate (PC) can mediate the process of vascular damage. We aimed to investigate the relationship between carotid–femoral pulse wave velocity (cfPWV) and the level of PCs in HD patients. Serum PCs were quantified using liquid chromatography mass spectrometry. Patients who were on standard HD for more than 3 months were enrolled and categorized according to the cfPWV into the high AS (>10 m/s) and control (≤10 m/s) groups. Forty-nine (41.5%) patients belonged to the high AS group and had a higher incidence of diabetes mellitus (DM) and increased systolic blood pressure, serum C-reactive protein, and PC levels but had lower creatinine, compared with those in the control group. In HD patients, the risk for developing high AS increased in the presence of DM (OR 4.147, 95% confidence interval (CI) 1.497–11.491) and high PCs (OR 1.067, 95% CI 1.002–1.136). Having DM (r = 0.446) and high PC level (r = 0.174) were positively associated with cfPWV. The most optimal cutoff value of PC for predicting AS was 18.99 mg/L (area under the curve 0.661, 95% CI 0.568–0.746). We concluded that DM and PCs were promising predictors of high AS in patients on maintenance HD.
Yu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Yu-Li Lin; Jen-Pi Tsai; Bang-Gee Hsu. Serum P-Cresyl Sulfate Is a Predictor of Central Arterial Stiffness in Patients on Maintenance Hemodialysis. Toxins 2019, 12, 10 .
AMA StyleYu-Hsien Lai, Chih-Hsien Wang, Chiu-Huang Kuo, Yu-Li Lin, Jen-Pi Tsai, Bang-Gee Hsu. Serum P-Cresyl Sulfate Is a Predictor of Central Arterial Stiffness in Patients on Maintenance Hemodialysis. Toxins. 2019; 12 (1):10.
Chicago/Turabian StyleYu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Yu-Li Lin; Jen-Pi Tsai; Bang-Gee Hsu. 2019. "Serum P-Cresyl Sulfate Is a Predictor of Central Arterial Stiffness in Patients on Maintenance Hemodialysis." Toxins 12, no. 1: 10.
Sarcopenia is prevalent in chronic hemodialysis patients. This prospective cohort study evaluated the impact of sarcopenia and its diagnostic criteria on hospitalization and mortality in 126 chronic hemodialysis patients. Skeletal muscle mass, handgrip strength (HGS), gait speed, and blood parameters were assessed. Sarcopenia was evaluated using the criteria of the European Working Group on Sarcopenia in Older People and the Taiwanese criteria for Sarcopenia. Muscle quality was defined as HGS divided by mid-arm muscle circumference. Prevalences of uremic sarcopenia were 8.7% and 13.5% according to Taiwanese and European criteria, respectively. Low HGS and gait speed were much more prevalent than low muscle mass. Within 3 years, 79 (62.7%) patients were hospitalized and 26 (20.6%) died. Low HGS and slow gait speed were associated with hospitalization and mortality, while sarcopenia was associated with mortality but not with hospitalization. Notably, in our patients without sarcopenia, close associations between increased hospitalization and mortality risk with low HGS and slow gait speed remained unchanged. In Cox proportional hazard analysis, muscle quality [hazard ratio (HR) = 0.42, 95% confidence interval (CI) = 0.19–0.93, p = 0.032] and serum creatinine (HR = 0.82, 95% CI = 0.71–0.95, p = 0.009) were independently associated with composite outcome of hospitalization or death. Muscle functionality and quality can predict hospitalization and overall survival in chronic hemodialysis patients, better than muscle mass.
Yu-Li Lin; Hung-Hsiang Liou; Chih-Hsien Wang; Yu-Hsien Lai; Chiu-Huang Kuo; Shu-Yuan Chen; Bang-Gee Hsu. Impact of sarcopenia and its diagnostic criteria on hospitalization and mortality in chronic hemodialysis patients: A 3-year longitudinal study. Journal of the Formosan Medical Association 2019, 119, 1 .
AMA StyleYu-Li Lin, Hung-Hsiang Liou, Chih-Hsien Wang, Yu-Hsien Lai, Chiu-Huang Kuo, Shu-Yuan Chen, Bang-Gee Hsu. Impact of sarcopenia and its diagnostic criteria on hospitalization and mortality in chronic hemodialysis patients: A 3-year longitudinal study. Journal of the Formosan Medical Association. 2019; 119 (7):1.
Chicago/Turabian StyleYu-Li Lin; Hung-Hsiang Liou; Chih-Hsien Wang; Yu-Hsien Lai; Chiu-Huang Kuo; Shu-Yuan Chen; Bang-Gee Hsu. 2019. "Impact of sarcopenia and its diagnostic criteria on hospitalization and mortality in chronic hemodialysis patients: A 3-year longitudinal study." Journal of the Formosan Medical Association 119, no. 7: 1.
Summary Background & aims Muscle wasting is highly prevalent in patients with chronic kidney disease (CKD). However, the assessment of skeletal muscle mass and strength in clinical settings is not commonly available. We aimed to evaluate the feasibility of serum creatinine/cystatin C (Cr/CysC) ratio in the assessment of muscle wasting. Methods In 272 patients with CKD aged 66.5 ± 15.1 years, skeletal muscle mass and handgrip strength (HGS) were assessed. Skeletal muscle index (SMI) was calculated as skeletal muscle mass/height2. Low muscle mass was defined as SMI below the sex-specific 10th percentile of study population and low handgrip strength as less than 26 Kg for men and 18 Kg for women. Results The Cr/CysC ratio was significantly lower in both the low SMI and low HGS groups. Moreover, the Cr/CysC ratio correlated with SMI (r = .306, p < .001) and HGS (r = .341, p < .001). After adjusting for confounding factors, age, sex, waist circumference, body fat mass, and Cr/CysC ratio were independently associated with SMI, whereas age, sex, diabetes, hemoglobin, estimated glomerular filtration rate, urine protein/creatinine ratio, SMI, and Cr/CysC ratio were independently associated with HGS. Conclusions Cr/CysC ratio appears to be a promising surrogate marker for detecting muscle wasting in patients with CKD. Further studies are needed to extend our findings.
Yu-Li Lin; Shu-Yuan Chen; Yu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Hung-Hsiang Liou; Bang-Gee Hsu. Serum creatinine to cystatin C ratio predicts skeletal muscle mass and strength in patients with non-dialysis chronic kidney disease. Clinical Nutrition 2019, 39, 2435 -2441.
AMA StyleYu-Li Lin, Shu-Yuan Chen, Yu-Hsien Lai, Chih-Hsien Wang, Chiu-Huang Kuo, Hung-Hsiang Liou, Bang-Gee Hsu. Serum creatinine to cystatin C ratio predicts skeletal muscle mass and strength in patients with non-dialysis chronic kidney disease. Clinical Nutrition. 2019; 39 (8):2435-2441.
Chicago/Turabian StyleYu-Li Lin; Shu-Yuan Chen; Yu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Hung-Hsiang Liou; Bang-Gee Hsu. 2019. "Serum creatinine to cystatin C ratio predicts skeletal muscle mass and strength in patients with non-dialysis chronic kidney disease." Clinical Nutrition 39, no. 8: 2435-2441.
Indoxyl sulfate (IS), a product metabolized from tryptophan, is negatively correlated with renal function and cardiovascular diseases in patients with chronic kidney disease (CKD). We investigated the association between serum IS levels and endothelial function in patients with CKD. Fasting blood samples were obtained from 110 patients with stages 3–5 CKD. The endothelial function, represented by vascular reactivity index (VRI), was measured non-invasively using digital thermal monitoring. Serum IS levels were determined using liquid chromatography–mass spectrometry. Twenty-one (19.1%), 36 (32.7%), and 53 (48.2%) patients had poor (VRI < 1.0), intermediate (1.0 ≤ VRI < 2.0), and good (VRI ≥ 2.0) vascular reactivity. By univariate linear regression analysis, a higher prevalence of smoking, advanced age, higher systolic, and diastolic blood pressure (DBP), elevated levels of serum phosphorus, blood urea nitrogen, creatinine, and IS were negatively correlated with VRI values, but estimated glomerular filtration rate negatively associated with VRI values. After being adjusted by using multivariate stepwise linear regression analysis, DBP and IS levels were significantly negatively associated with VRI values in CKD patients. We concluded that IS level associated inversely with VRI values and had a modulating role in endothelial function in patients with stages 3–5 CKD.
Chih-Hsien Wang; Yu-Hsien Lai; Chiu-Huang Kuo; Yu-Li Lin; Jen-Pi Tsai; Bang-Gee Hsu. Association between Serum Indoxyl Sulfate Levels and Endothelial Function in Non-Dialysis Chronic Kidney Disease. Toxins 2019, 11, 589 .
AMA StyleChih-Hsien Wang, Yu-Hsien Lai, Chiu-Huang Kuo, Yu-Li Lin, Jen-Pi Tsai, Bang-Gee Hsu. Association between Serum Indoxyl Sulfate Levels and Endothelial Function in Non-Dialysis Chronic Kidney Disease. Toxins. 2019; 11 (10):589.
Chicago/Turabian StyleChih-Hsien Wang; Yu-Hsien Lai; Chiu-Huang Kuo; Yu-Li Lin; Jen-Pi Tsai; Bang-Gee Hsu. 2019. "Association between Serum Indoxyl Sulfate Levels and Endothelial Function in Non-Dialysis Chronic Kidney Disease." Toxins 11, no. 10: 589.
Cardiovascular morbidity and mortality are highly prevalent in patients with end-stage renal disease, and osteoprotegerin (OPG) may be an important link between bone loss and vascular calcification. This study was conducted to evaluate the relationship between central arterial stiffness and serum OPG levels in hemodialysis (HD) patients. Blood samples were collected from 120 HD patients, and the carotid-femoral pulse wave velocity (cfPWV) value was measured using a validated tonometry system. The cfPWV value of > 10 m/s was used to define the high artery stiffness group. Serum OPG levels were analyzed categorically into tertiles. Of the 120 HD patients, 53 (44.2%) were defined as the high arterial stiffness group, who had higher values of systolic blood pressure (p = 0.038), serum calcium (p = 0.007), and OPG (p < 0.001) levels and a higher prevalence of diabetes mellitus (DM, p = 0.001). Increasing tertiles of serum OPG levels were significantly associated with greater height (p = 0.011), male gender (p = 0.008), higher cfPWV values (p = 0.020), and lower intact parathyroid hormone (iPTH, p = 0.049) levels. Multivariable linear regression analysis showed that cfPWV value was independently associated with DM (β = 1.83, p = 0.008) and increasing tertiles of serum OPG levels (β = 0.89 and 1.63 for tertile 2 and tertile 3, respectively, p for trend = 0.035) in HD patients. Multivariable logistic regression analysis revealed that, in addition to age, DM, low iPTH levels, and high serum calcium levels, increasing tertiles of serum OPG levels (OR = 5.34 for tertile 2; OR = 7.06 for tertile 3; p for trend = 0.002) were an independent predictor of high arterial stiffness in HD patients. Serum calcium levels positively correlated with cfPWV value only in the highest OPG tertile group (r = 0.408, p = 0.009). A positive association was detected between serum OPG levels and central arterial stiffness in HD patients, and patients with high serum OPG levels may have greater influence of calcium load on central arterial stiffening.
Jia-Sian Hou; Yu-Li Lin; Chih-Hsien Wang; Yu-Hsien Lai; Chiu-Huang Kuo; Yi-Maun Subeq; Bang-Gee Hsu. Serum osteoprotegerin is an independent marker of central arterial stiffness as assessed using carotid–femoral pulse wave velocity in hemodialysis patients: a cross sectional study. BMC Nephrology 2019, 20, 184 .
AMA StyleJia-Sian Hou, Yu-Li Lin, Chih-Hsien Wang, Yu-Hsien Lai, Chiu-Huang Kuo, Yi-Maun Subeq, Bang-Gee Hsu. Serum osteoprotegerin is an independent marker of central arterial stiffness as assessed using carotid–femoral pulse wave velocity in hemodialysis patients: a cross sectional study. BMC Nephrology. 2019; 20 (1):184.
Chicago/Turabian StyleJia-Sian Hou; Yu-Li Lin; Chih-Hsien Wang; Yu-Hsien Lai; Chiu-Huang Kuo; Yi-Maun Subeq; Bang-Gee Hsu. 2019. "Serum osteoprotegerin is an independent marker of central arterial stiffness as assessed using carotid–femoral pulse wave velocity in hemodialysis patients: a cross sectional study." BMC Nephrology 20, no. 1: 184.
Sarcopenia, defined as low muscle mass and strength, is highly prevalent in patients undergoing chronic hemodialysis (HD). However, muscle function and muscle mass do not share the same clinical relevance. In fact, muscle strength was more closely associated with the risk of mortality in chronic HD patients than was muscle mass. Therefore, to identify the risk factors of muscle weakness is vital. Angiotensin II overexpression had been recognized to impair skeletal muscle strength. Accordingly, angiotensin II receptor blockers (ARBs) potentially possess a muscle protective effect. This cross-sectional study aimed to identify the factors associated with low muscle strength and to explore the relationship between ARB use and muscle strength in chronic HD patients. A total of 120 chronic HD patients, aged 63.3 ± 13.2 years, were included in this study. Basic characteristics, handgrip strength (HGS), body composition, and nutritional status were assessed, and blood samples for biochemical tests were obtained. We divided these participants into normal- and low HGS groups according to the consensus of the European Working Group on Sarcopenia in Older People (EWGSOP). We observed that 78 (65.0%) patients had low HGS. In our cohort, we found that height (r = 0.653; P < 0.001), weight (r = 0.496; P < 0.001), body mass index (r = 0.215; P = 0.020), skeletal muscle index (r = 0.562; P < 0.001), albumin (r = 0.197; P = 0.032), and serum creatinine (r = 0.544; P < 0.001) were positively and age (r = − 0.506; P < 0.001), subjective global assessment (SGA) score (r = − 0.392; P < 0.001), fractional clearance index for urea (Kt/V) (r = − 0.404; P < 0.001) and urea reduction ratio (URR) (r = − 0.459; P < 0.001) were negatively correlated with HGS. According to our analysis, age (Odds ratio, OR = 1.11, 95% confidence interval, 95% CI = 1.05–1.17, P < 0.001), HD duration (OR = 1.01, 95% CI = 1.00–1.02, P = 0.010), diabetes (OR = 13.33, 95% CI = 3.45–51.53, P < 0.001), Kt/V (OR = 1.61, 95% CI = 1.06–2.46, P = 0.027), and SGA score (OR = 1.19, 95% CI = 1.03–1.38, P = 0.017) were regarded as independent predictors of low HGS. In contrast, ARB use (OR = 0.25, 95% CI = 0.07–0.93, P = 0.039) was independently associated with preserved HGS in chronic HD patients, after adjustment for multiple confounding factors. Our study is the first report in chronic HD patients to indicate a potentially protective effect of ARB on muscle strength. However, further longitudinal follow-up and intervention studies are needed to confirm this finding.
Yu-Li Lin; Shu-Yuan Chen; Yu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Hung-Hsiang Liou; Bang-Gee Hsu. Angiotensin II receptor blockade is associated with preserved muscle strength in chronic hemodialysis patients. BMC Nephrology 2019, 20, 54 .
AMA StyleYu-Li Lin, Shu-Yuan Chen, Yu-Hsien Lai, Chih-Hsien Wang, Chiu-Huang Kuo, Hung-Hsiang Liou, Bang-Gee Hsu. Angiotensin II receptor blockade is associated with preserved muscle strength in chronic hemodialysis patients. BMC Nephrology. 2019; 20 (1):54.
Chicago/Turabian StyleYu-Li Lin; Shu-Yuan Chen; Yu-Hsien Lai; Chih-Hsien Wang; Chiu-Huang Kuo; Hung-Hsiang Liou; Bang-Gee Hsu. 2019. "Angiotensin II receptor blockade is associated with preserved muscle strength in chronic hemodialysis patients." BMC Nephrology 20, no. 1: 54.
Leptin plays a role in stimulating vascular inflammation, vascular smooth muscle hypertrophy, and augmenting blood pressure, which contributes to the pathogenesis of atherosclerosis and leads to arterial stiffness. This vascular damage, measured by carotid-femoral pulse wave velocity (cfPWV), is recognized as an independent predictor of cardiovascular mortality in hemodialysis (HD) patients. The aim of this study was to evaluate the relationship between serum leptin and arterial stiffness in HD patients. In 112 of the 126 HD patients were eligible and their biochemical data were collected for analysis. Serum leptin level was measured using a commercial enzyme-linked immunosorbent assay kit. Carotid-femoral pulse wave velocity was measured by a validated tonometry system (SphygmoCor). Those have cfPWV values above 10 m/s are defined as the high arterial stiffness group. Among the participants, thirty-eight of them who were in the high arterial stiffness group, had a higher prevalence of diabetes mellitus (p = 0.002), age (p = 0.029), body mass index (BMI, p = 0.018), body fat mass (p = 0.001), hemoglobin (p = 0.040), and serum leptin levels (P<0.001). Multivariable logistic regression analysis showed that leptin (odds ratio [OR] 1.09; 95% confidence interval [CI] 1.04–1.14; p <0.001), diabetes (OR 7.17; CI 1.39–37.00; p = 0.019), body fat mass (OR 1.16; CI 1.02–1.33; p = 0.027); and hemoglobin (OR 2.11; CI 1.15–3.87; p = 0.015) were independently associated with arterial stiffness in HD patients. In our study, hyperleptinemia was positively correlated to the high cfPWV and thus was related to high arterial stiffness in HD patients.
Chiu-Huang Kuo; Yu-Li Lin; Chung-Jen Lee; Chih-Hsien Wang; Yu-Hsien Lai; Hung-Hsiang Liou; Bang-Gee Hsu. Hyperleptinemia positively associated with central arterial stiffness in hemodialysis patients. PLOS ONE 2018, 13, e0190694 .
AMA StyleChiu-Huang Kuo, Yu-Li Lin, Chung-Jen Lee, Chih-Hsien Wang, Yu-Hsien Lai, Hung-Hsiang Liou, Bang-Gee Hsu. Hyperleptinemia positively associated with central arterial stiffness in hemodialysis patients. PLOS ONE. 2018; 13 (1):e0190694.
Chicago/Turabian StyleChiu-Huang Kuo; Yu-Li Lin; Chung-Jen Lee; Chih-Hsien Wang; Yu-Hsien Lai; Hung-Hsiang Liou; Bang-Gee Hsu. 2018. "Hyperleptinemia positively associated with central arterial stiffness in hemodialysis patients." PLOS ONE 13, no. 1: e0190694.