The relationship between apelin and cardiac parameters in patients on peritoneal dialysis: is there a new cardiac marker?

BMC Nephrology

Rumeyza Kazancioglu⁴  Huseyin Oflaz²  Abdullah Sumnu¹  Sami Uzun¹  Zeki Aydin¹  Servet Yigit³  Filiz Basinoglu³  Ahmet Gurdal²  Meltem Gursu¹  Savas Ozturk¹  Serhat Karadag¹ 

[1] Department of Nephrology, Haseki Training and Research Hospital, Adivar Caddesi, Aksaray, Fatih, Istanbul, Turkey;Istanbul Medical Faculty, Department of Cardiology, Istanbul University, Istanbul, Turkey;Department of Biochemistry, Haseki Training and Research Hospital, Istanbul, Turkey;Medical Faculty, Department of Nephrology, Bezmialem Vakif University, Istanbul, Turkey

关键词: Peritoneal dialysis;    Hypervolemia;    Echocardiography;    Apelin;   

Others  :  1082741
DOI  :  10.1186/1471-2369-15-18

 received in 2012-07-08, accepted in 2013-11-25,  发布年份 2014

【 摘 要 】

Background

Many markers have been proposed for CVD risk assessment in dialysis population. Apelin is a peptide that has roles in cardiovascular functions and volume regulation namely vasodilation, decreased blood pressure (BP), positive inotropic effect and inhibition of antidiuretic hormone release. The aim of this study was to examine relationship of apelin levels with echocardiographic findings and laboratory parameters related with cardiovascular function and bone mineral metabolism among peritoneal dialysis (PD) patients.

Methods

This is a cross-sectional study in which chronic PD patients aged between 18 and 80 without active cardiac, infectious or malignant diseases and hypervolemia have been included. Apelin-36 levels and echocardiographic findings were recorded as well as clinical and laboratory data.

Results

Of the 53 patients, the mean age and female/male ratio was 52.8 ± 15.3 years and 30/23, respectively. Mean apelin level was 1.45 ± 0.37 ng/ml. Gender, drugs (renin-angiotensin-aldosteron inhibitors, statins), presence of left ventricular hypertrophy, diabetes mellitus, hypertension, hyperlipidemia and significant residual renal function did not affect apelin-36 levels. Apelin-36 was correlated negatively with age and left atrium diameter; and positively with diastolic BP, ejection fraction (EF), total cholesterol, LDL-cholesterol, HDL-cholesterol, parathyroid hormone and alkaline phosphatase (ALP) levels. Diastolic BP, LDL-cholesterol, ALP and EF were found to be the independent determinants of apelin-36 levels with linear regression analysis.

Conclusions

Apelinergic system has important roles in volume regulation, cardiovascular functions, lipid metabolism and bone mineral disorders in PD patients. Prospective studies with large population are required.

【 授权许可】

   
2014 Karadag et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Miller LM, Sood MM, Sood AR, Reslerova M, Komenda P, Rigatto C, Bueti J: Cardiovascular disease in end-stage renal disease: the challenge of assessing and managing cardiac disease in dialysis patients. Int Urol Nephrol 2010, 42:1007-1014.
• [2]Krediet RT, Balafa O: Cardiovascular risk in the peritoneal dialysis patient. Nat Rev Nephrol 2010, 6:451-460.
• [3]Enia G, Mallamaci F, Benedetto FA, Panuccio V, Parlongo S, Cutrupi S, Giacone G, Cottini E, Tripepi G, Malatino LS, Zoccali C: Long-term CAPD patients are volume expanded and display more severe left ventricular hypertrophy than haemodialysis patients. Nephrol Dial Transplant 2001, 16:1459-1464.
• [4]US Renal Data System: USRDS 2007 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Volume II. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disease; 2007. http://www.usrds.org webcite
• [5]Jansen MA, Termorshuizen F, Korevaar JC, Dekker FW, Boeschoten E, Krediet RT: Predictors of survival in anuric peritoneal dialysis patients. Kidney Int 2005, 68:1199-1205.
• [6]Prinsen B: A broad-based metabolic approach to study VLDL apoB-100 metabolism in patients with ESRD and patients treated with peritoneal dialysis. Kidney Int 2004, 65:1064-1075.
• [7]O’Dowd BF, Heiber M, Chan A, Heng HH, Tsui LC, Kennedy JL, Shi X, Petronis A, George SR, Nguyen T: A human gene that shows identity with the gene encoding the angiotensin receptor is located on chromosome 11. Gene 1993, 136:355-360.
• [8]Tatemoto K, Hosoya M, Habata Y, Fujii R, Kakegawa T, Zou MX, Kawamata Y, Fukusumi S, Hinuma S, Kitada C, Kurokawa T, Onda H, Fujino M: Isolation and characterization of a novel endogenous peptide ligand for the human APJ receptor. Biochem Biophys Res Commun 1998, 251:471-476.
• [9]Ladeiras-Lopes R, Ferreira-Martins J, Leite-Moreira AF: The apelinergic system: the role played in human physiology and pathology and potential therapeutic applications. Arq Bras Cardiol 2008, 90:343-349.
• [10]Kleinz MJ, Skepper JN, Davenport AP: Immunocytochemical localization of the apelin receptor, APJ, to human cardiomyocytes, vascular smooth muscle and endothelial cells. Regul Pept 2005, 126:233-240.
• [11]Falcao-Pires I, Leite-Moreira AF: Apelin: a novel neurohumoral modulator of the cardiovascular system: pathophysiologic importance and potential use as a therapeutic target. Rev Port Cardiol 2005, 24:1263-1276.
• [12]Tatemoto K, Takayama K, Zou MX, Kumaki I, Zhang W, Kumano K, Fujiyama M: The novel peptide apelin lowers blood pressure via a nitric oxide-dependent mechanism. Regul Pept 2001, 99:87-92.
• [13]Katugampola SD, Maguire JJ, Matthewson SR, Davenport AP: [(125)I]-(Pyr(1))Apelin-13 is a novel radioligand for localizing the APJ orphan receptor in human and rat tissues with evidence for a vasoconstrictor role in man. Br J Pharmacol 2001, 132:1255-1260.
• [14]Szakodi I, Tavi P, Foldes G, Voutilainen-Myllylä S, Ilves M, Tokola H, Pikkarainen S, Piuhola J, Rysä J, Tóth M, Ruskoaho H: Apelin, the novel endogenous ligand of the orphan receptor APJ, regulates cardiac contractility. Circ Res 2002, 91:434-440.
• [15]Taheri S, Murphy K, Cohen M, Sujkovic E, Kennedy A, Dhillo W, Dakin C, Sajedi A, Ghatei M, Bloom S: The effects of centrally administered apelin-13 on food intake, water intake and pituitary hormone release in rats. Biochem Biophys Res Commun 2002, 291:1208-1212.
• [16]Hus-Citharel A, Bouby N, Frugière A, Bodineau L, Gasc JM, Llorens-Cortes C: Effect of apelin on glomerular hemodynamic function in the rat kidney. Kidney Int 2008, 74:486-494.
• [17]Chong KS, Gardner RS, Morton JJ, Ashley EA, McDonagh TA: Plasma concentrations of the novel peptide apelin are decreased in patients with chronic heart failure. Eur J Heart Fail 2006, 8:355-360.
• [18]Chen MM, Ashley EA, Deng DX, Tsalenko A, Deng A, Tabibiazar R, Ben-Dor A, Fenster B, Yang E, King JY, Fowler M, Robbins R, Johnson FL, Bruhn L, McDonagh T, Dargie H, Yakhini Z, Tsao PS, Quertermous T: Novel role for the potent endogenous inotrope apelin in human cardiac dysfunction. Circulation 2003, 108:1432-1439.
• [19]Xie H, Tang SY, Cui RR, Huang J, Ren XH, Yuan LQ, Lu Y, Yang M, Zhou HD, Wu XP, Luo XH, Liao EY: Apelin and its receptor are expressed in human osteoblasts. Regul Pept 2006, 134:118-125.
• [20]Xie H, Yuan LQ, Luo XH, Huang J, Cui RR, Guo LJ, Zhou HD, Wu XP, Liao EY: Apelin suppresses apoptosis of human osteoblasts. Apoptosis 2007, 12:247-254.
• [21]Shan PF, Lu Y, Cui RR, Jiang Y, Yuan LQ, Liao EY: Apelin attenuates the osteoblastic differentiation of vascular smooth muscle cells. PLoS One 2011, 18:17938.
• [22]Ronkainen VP, Ronkainen JJ, Hanninen SL, Leskinen H, Ruas JL, Pereira T, Poellinger L, Vuolteenaho O, Tavi P: Hypoxia inducible factor regulates the cardiac expression and secretion of apelin. FASEB J 2007, 21:1821-1830.
• [23]Foldes G, Horkay F, Szokodi I, Vuolteenaho O, Ilves M, Lindstedt KA, Mäyränpää M, Sármán B, Seres L, Skoumal R, Lakó-Futó Z, de Châtel R, Ruskoaho H, Tóth M: Circulating and cardiac levels of apelin, the novel ligand of the orphan receptor APJ, in patients with heart failure. Biochem Biophys Res Commun 2003, 308:480-485.
• [24]Malyszko J, Malyszko JS, Kozminski P, Mysliwiec M: Apelin and cardiac function in hemodialyzed patients: possible relations? Am J Nephrol 2006, 26:121-126.
• [25]Codognotto M, Piccoli A, Zaninotta M, Mion M, Vertolli U, Tona F, Boffa GM: Evidence for decreased circulating apelin beyond heart involvement in uremic cardiomyopathy. Am J Nephrol 2007, 27:1-6.
• [26]Ellinor PT, Low AF, Macrae CA: Reduced apelin levels in lone atrial fibrillation. Eur Heart J 2006, 27:222-226.
• [27]Li Z, Bai Y, Jian H: Reduced apelin levels in stable angina. Intern Med 2008, 47:1951-1955.
• [28]El-Mesallamy HO, Hamdy NM, Rizk HH, El-Zayadi AR: Apelin serum level in Egyptian patients with chronic hepatitis C. Mediators Inflamm 2011, 2011:703031. Epub
• [29]Malyszko J, Kozminski P, Malyszko J, Mysliwiec M: Type of arteriovenous fistula, NYHA class and apelin in hemodialyzed patients. Int Urol Nephrol 2011, 43:185-190.
• [30]Japp AG, Cruden NL, Barnes G, van Gemeren N, Mathews J, Adamson J, Johnston NR, Denvir MA, Megson IL, Flapan AD, Newby DE: Acute cardiovascular effects of apelin in humans: potential role in patients with chronic heart failure. Circulation 2010, 121:1818-1827.
• [31]Chandrasekaran B, Dar O, McDonagh T: The role of apelin in cardiovascular function and heart failure. Eur J Heart Fail 2008, 10:725-732.
• [32]García-Diaz D, Campión J, Milagro FI, Martínez JA: Adiposity dependent apelin gene expression: relationship with oxidative and inflammation markers. Mol Cell Biochem 2007, 305:87-94.
• [33]Malyszko J, Malyszko JS, Pawlak K, Wolczynski S, Mysliwiec M: Apelin, a novel adipocytokine, in relation to endothelial function and inflammation in kidney allograft recipients. Transplant Proc 2008, 40:3466-3469.
• [34]El-Shehaby AM, El-Khatib MM, Battah AA, Roshdy AR: Apelin: a potential link between inflammation and cardiovascular disease in end stage renal disease patients. Scand J Clin Lab Invest 2010, 70:421-427.
• [35]Zhang H, Xie H, Zhao Q, Xie GQ, Wu XP, Liao EY, Luo XH: Relationships between serum adiponectin, apelin, leptin, resistin, visfatin levels and bone mineral density, and bone biochemical markers in post-menopausal Chinese women. Endocrinol Invest 2010, 33:707-711.