Race modifies the association between adiposity and inflammation in patients with chronic kidney disease: findings from the chronic renal insufficiency cohort study

Maria R Wing, Wei Yang, Valerie Teal, Sankar Navaneethan, Kaixiang Tao, Akinlolu Ojo, Nicolas N Guzman, Muredach Reilly, Melanie Wolman, Sylvia E Rosas, Magda Cuevas, Michael Fischer, Eva Lustigova, Stephen R Master, Dawei Xie, Dina Appleby, Marshall Joffe, John Kusek, Harold I Feldman, Dominic S Raj, Chronic Renal Insufficiency Cohort (CRIC) Study, Maria R Wing, Wei Yang, Valerie Teal, Sankar Navaneethan, Kaixiang Tao, Akinlolu Ojo, Nicolas N Guzman, Muredach Reilly, Melanie Wolman, Sylvia E Rosas, Magda Cuevas, Michael Fischer, Eva Lustigova, Stephen R Master, Dawei Xie, Dina Appleby, Marshall Joffe, John Kusek, Harold I Feldman, Dominic S Raj, Chronic Renal Insufficiency Cohort (CRIC) Study

Abstract

Objective: The race-specific association of inflammation with adiposity and muscle mass in subjects with chronic kidney disease (CKD) was examined.

Methods: Plasma concentration of interleukin (IL)-1β, IL-1 receptor antagonist (IL-1RA), IL-6, IL-10, tumor necrosis factor (TNF)-α, TGF-β, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, and serum albumin was measured in 3,939 Chronic Renal Insufficiency Cohort study participants. Bioelectric impedance analysis was used to determine body fat mass (BFM) and fat-free mass (FFM).

Results: Plasma levels of hs-CRP, fibrinogen, IL-1RA, IL-6, and TNF-α increased and serum albumin decreased across the quartiles of body mass index. In multivariable analysis, BFM and FFM were positively associated with hs-CRP, fibrinogen, IL-1β, IL-1RA, and IL-6. One standard deviation (SD) increase in BFM and FFM was associated with 0.36 (95% confidence interval [CI] = 0.33, 0.39) and 0.26 (95% CI = 0.22, 0.30) SD increase in log-transformed hs-CRP, respectively (P < 0.001). Race stratified analysis showed that the association between biomarkers and BFM and FFM differed by race, with Caucasians, demonstrating a stronger association with markers of inflammation than African Americans.

Conclusions: BFA and FFM are positively associated with markers of inflammation in patients with CKD. Race stratified analysis showed that Caucasians have a stronger association with markers of inflammation compared to African Americans.

Copyright © 2014 The Obesity Society.

Figures

Figure 1
Figure 1
Association between inflammation score and body mass index, body fat mass, and fat free mass in CRIC Study participants. All anthropometric measures were higher in CRIC study participants with higher inflammation score (p

Figure 2

Multivariable adjusted association between body…

Figure 2

Multivariable adjusted association between body fat mass and biomarkers of inflammation in Caucasians…

Figure 2
Multivariable adjusted association between body fat mass and biomarkers of inflammation in Caucasians and African Americans. A significant interaction between race and BFM was noted for IL-6, IL-1RA, and the inflammation score.

Figure 3

Multivariable adjusted association between fat…

Figure 3

Multivariable adjusted association between fat free mass and biomarkers of inflammation in Caucasians…

Figure 3
Multivariable adjusted association between fat free mass and biomarkers of inflammation in Caucasians and African Americans. A significant interaction between race and FFM was evident for IL-1RA.
Figure 2
Figure 2
Multivariable adjusted association between body fat mass and biomarkers of inflammation in Caucasians and African Americans. A significant interaction between race and BFM was noted for IL-6, IL-1RA, and the inflammation score.
Figure 3
Figure 3
Multivariable adjusted association between fat free mass and biomarkers of inflammation in Caucasians and African Americans. A significant interaction between race and FFM was evident for IL-1RA.

References

    1. Gupta J, Mitra N, Kanetsky PA, Devaney J, Wing MR, Reilly M, et al. Association between Albuminuria, Kidney Function, and Inflammatory Biomarker Profile. Clin J Am Soc Nephrol. 2012;7:1938–1946.
    1. Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity. Annu Rev Immunol. 2011;29:415–445.
    1. Ejerblad E, Fored CM, Lindblad P, Fryzek J, McLaughlin JK, Nyren O. Obesity and risk for chronic renal failure. J Am Soc Nephrol. 2006;17(6):1695–1702.
    1. Kramer HJ, Saranathan A, Luke A, Durazo-Arvizu RA, Guichan C, Hou S, et al. Increasing body mass index and obesity in the incident ESRD population. J Am Soc Nephrol. 2006;17(5):1453–1459.
    1. Mak RH, Cheung W. Cachexia in chronic kidney disease: role of inflammation and neuropeptide signaling. Curr Opin Nephrol Hypertens. 2007;16(1):27–31.
    1. Kimmel PL, Phillips TM, Phillips E, Bosch JP. Effect of renal replacement therapy on cellular cytokine production in patients with renal disease. Kidney Int. 1990;38(1):129–135.
    1. Raj DSC, Dominic EA, Pai A, Osman F, Morgan M, Pickett G, et al. Skeletal muscle, cytokines and oxidative stress in End-stage renal disease. Kidney Int. 2005;68:2338–2344.
    1. Raj DS, Shah H, Shah VO, Ferrando A, Bankhurst A, Wolfe R, et al. Markers of inflammation, proteolysis, and apoptosis in ESRD. Am J Kidney Dis. 2003;42(6):1212–1220.
    1. Cheung WW, Paik KH, Mak RH. Inflammation and cachexia in chronic kidney disease. Pediatr Nephrol. 2010;25(4):711–724.
    1. Raj DS, Moseley P, Dominic EA, Onime A, Tzamaloukas AH, Boyd A, et al. Interleukin-6 modulates hepatic and muscle protein synthesis during hemodialysis. Kidney Int. 2008;73(9):1054–1061.
    1. Fried SK, Bunkin DA, Greenberg AS. Omental and subcutaneous adipose tissues of obese subjects release interleukin-6: depot difference and regulation by glucocorticoid. J Clin Endocrinol Metab. 1998;83(3):847–850.
    1. Feldman HI, Appel LJ, Chertow GM, Cifelli D, Cizman B, Daugirdas J, et al. The Chronic Renal Insufficiency Cohort (CRIC) Study: Design and Methods. J Am Soc Nephrol. 2003;14(7 Suppl 2):S148–S153.
    1. Anderson AH, Yang W, Hsu CY, Joffe MM, Leonard MB, Xie D, et al. Estimating GFR Among Participants in the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis. 2012;60(2):250–261.
    1. Bellizzi V, Scalfi L, Terracciano V, De NL, Minutolo R, Marra M, et al. Early changes in bioelectrical estimates of body composition in chronic kidney disease. J Am Soc Nephrol. 2006;17(5):1481–1487.
    1. Janssen I, Heymsfield SB, Baumgartner RN, Ross R. Estimation of skeletal muscle mass by bioelectrical impedance analysis. J Appl Physiol. 2000;89(2):465–471.
    1. Garg AX, Blake PG, Clark WF, Clase CM, Haynes RB, Moist LM. Association between renal insufficiency and malnutrition in older adults: results from the NHANES III. Kidney Int. 2001;60(5):1867–1874.
    1. Chertow GM, Lowrie EG, Wilmore DW, Gonzalez J, Lew NL, Ling J, et al. Nutritional assessment with bioelectrical impedance analysis in maintenance hemodialysis patients. Journal of the American Society of Nephrology. 1995;6(1):75–81.
    1. National Institute of Health. Clinical guidelines on the identification, Evaluation and Treatment of Overweight and Obesity in Adults. Bethesda, MD: NIH; 1998.
    1. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004;291(7):844–850.
    1. Muntner P, Winston J, Uribarri J, Mann D, Fox CS. Overweight, obesity, and elevated serum cystatin C levels in adults in the United States. Am J Med. 2008;121(4):341–348.
    1. World Health Organisation. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. 2000 Report No.: World Health Organ Tech Rep Ser 894.
    1. Balakrishnan VS, Jaber BL, Natov SN, Cendoroglo M, King AJ, Schmid CH, et al. Interleukin-1 receptor antagonist synthesis by peripheral blood mononuclear cells in hemodialysis patients. Kidney Int. 1998;54(6):2106–2112.
    1. Roubenoff R. Applications of bioelectrical impedance analysis for body composition to epidemiologic studies. Am J Clin Nutr. 1996;64(3 Suppl):459S–462S.
    1. Mohamed-Ali V, Goodrick S, Rawesh A, Katz DR, Miles JM, Yudkin JS, et al. Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab. 1997;82(12):4196–4200.
    1. Fain JN, Madan AK, Hiler ML, Cheema P, Bahouth SW. Comparison of the release of adipokines by adipose tissue, adipose tissue matrix, and adipocytes from visceral and subcutaneous abdominal adipose tissues of obese humans. Endocrinology. 2004;145(5):2273–2282.
    1. Serrano AL, Baeza-Raja B, Perdiguero E, Jardi M, Munoz-Canoves P. Interleukin-6 is an essential regulator of satellite cell-mediated skeletal muscle hypertrophy. Cell Metab. 2008;7(1):33–44.
    1. Boivin MA, Battah SI, Dominic EA, Kalantar-Zadeh K, Ferrando A, Tzamaloukas AH, et al. Activation of caspase-3 in the skeletal muscle during haemodialysis. Eur J Clin Invest. 2010;40(10):903–910.
    1. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW., Jr Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999;341(15):1097–1105.
    1. Lovejoy JC, de la Bretonne JA, Klemperer M, Tulley R. Abdominal fat distribution and metabolic risk factors: effects of race. Metabolism. 1996;45(9):1119–1124.
    1. Carroll JF, Chiapa AL, Rodriquez M, Phelps DR, Cardarelli KM, Vishwanatha JK, et al. Visceral fat, waist circumference, and BMI: impact of race/ethnicity. Obesity (Silver Spring) 2008;16(3):600–607.
    1. Maury E, Brichard SM. Adipokine dysregulation, adipose tissue inflammation and metabolic syndrome. Mol Cell Endocrinol. 2010;314(1):1–16.
    1. Hull HR, Thornton J, Wang J, Pierson RN, Jr, Kaleem Z, Pi-Sunyer X, et al. Fat-free mass index: changes and race/ethnic differences in adulthood. Int J Obes (Lond) 2011;35(1):121–127.
    1. Nascimento MM, Pecoits-Filho R, Qureshi AR, Hayashi SY, Manfro RC, Pachaly MA, et al. The prognostic impact of fluctuating levels of C-reactive protein in Brazilian haemodialysis patients: a prospective study. Nephrol Dial Transplant. 2004;19(11):2803–2809.
    1. Kushner RF, Gudivaka R, Schoeller DA. Clinical characteristics influencing bioelectrical impedance analysis measurements. Am J Clin Nutr. 1996;64(3 Suppl):423S–427S.
    1. Beasley LE, Koster A, Newman AB, Javaid MK, Ferrucci L, Kritchevsky SB, et al. Inflammation and race and gender differences in computerized tomography-measured adipose depots. Obesity (Silver Spring) 2009;17(5):1062–1069.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren