Epicardial Adipose Tissue and Renal Disease

Aeddula, Narothama Reddy; Cheungpasitporn, Wisit; Pathireddy, Samata

doi:10.3390/jcm8030299

Cited by 15 publications

(8 citation statements)

References 106 publications

(143 reference statements)

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“…Emerging evidence suggest that SLT2-i could exert beneficial effects on CV system through a significant reduction in epicardial adipose tissue, a novel, early, non-invasive biomarker and indicator of CV outcome (Table 3) [46,47,48,49,50]. This favorable effect could probably be due to the SGLT2-i-dependent loss of body fat and reduced production of pro-inflammatory chemokines.…”

Section: Sglt2 Inhibitors For Cardio-renal Protection In Dm2: Randmentioning

confidence: 99%

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SGLT2 Inhibitors: Nephroprotective Efficacy and Side Effects

et al. 2019

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The burden of diabetic kidney disease (DKD) has increased worldwide in the last two decades. Besides the growth of diabetic population, the main contributors to this phenomenon are the absence of novel nephroprotective drugs and the limited efficacy of those currently available, that is, the inhibitors of renin-angiotensin system. Nephroprotection in DKD therefore remains a major unmet need. Three recent trials testing effectiveness of sodium-glucose cotransporter 2 inhibitors (SGLT2-i) have produced great expectations on this therapy by consistently evidencing positive effects on hyperglycemia control, and more importantly, on the cardiovascular outcome of type 2 diabetes mellitus. Notably, these trials also disclosed nephroprotective effects when renal outcomes (glomerular filtration rate and albuminuria) were analyzed as secondary endpoints. On the other hand, the use of SGLT2-i can be potentially associated with some adverse effects. However, the balance between positive and negative effects is in favor of the former. The recent results of Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation Study and of other trials specifically testing these drugs in the population with chronic kidney disease, either diabetic or non-diabetic, do contribute to further improving our knowledge of these antihyperglycemic drugs. Here, we review the current state of the art of SGLT2-i by addressing all aspects of therapy, from the pathophysiological basis to clinical effectiveness.

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Section: Sglt2 Inhibitors For Cardio-renal Protection In Dm2: Randmentioning

confidence: 99%

“…CREDENCE trial adds knowledge of the safety of canaglifozin in the CKD setting [46]. A novel finding related to occurrence of adverse events.…”

Section: Adverse Effects Of Sglt2 Inhibitorsmentioning

confidence: 99%

SGLT2 Inhibitors: Nephroprotective Efficacy and Side Effects

et al. 2019

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“…Due to its proximity to the coronary arteries PAT influences cardiac structure and myocardial microcirculation [ 14 , 15 ]. An increase in PAT volume is therefore linked to an accelerated inflammation [ 12 , 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Increased Pericardial Adipose Tissue in Smokers

Zimmermann

Ruether

Ziegler

et al. 2021

JCM

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Background: Pericardial adipose tissue (PAT), a visceral fat depot directly located to the heart, is associated with atherosclerotic and inflammatory processes. The extent of PAT is related to the prevalence of coronary heart disease and might be used for cardiovascular risk prediction. This study aimed to determine the effect of smoking on the extent of PAT. Methods: We retrospectively examined 1217 asymptomatic patients (490 females, age 58.3 ± 8.3 years, smoker n = 573, non-smoker n = 644) with a multislice CT scanner and determined the PAT volume. Coronary risk factors were determined at inclusion, and a multivariate analysis was performed to evaluate the influence of smoking on PAT independent from accompanying risk factors. Results: The mean PAT volume was 215 ± 107 mL in all patients. The PAT volume in smokers was significantly higher compared to PAT volume in non-smokers (231 ± 104 mL vs. 201 ± 99 mL, p = 0.03). Patients without cardiovascular risk factors showed a significantly lower PAT volume (153 ± 155 mL, p < 0.05) compared to patients with more than 1 risk factor. Odds ratio was 2.92 [2.31, 3.61; p < 0.001] for elevated PAT in smokers. Conclusion: PAT as an individual marker of atherosclerotic activity and inflammatory burden was elevated in smokers. The finding was independent from metabolic risk factors and might therefore illustrate the increased inflammatory activity in smokers in comparison to non-smokers.

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“…High adiponectin levels are related to CV events and all-cause mortality in stage 3–4 CKD or HD patients [6, 21, 22], whereas some studies have found that the association is only dependent on BMI or waist circumference[7, 23]. Besides, as epicardial adipose tissue (EAT) thickness increases in CKD, secretion of adiponectin from EAT also plays the emerging role in cardiac metabolism regulating CV outcomes[24]. Moreover, the largest cohort study showed no significant association between longitudinal changes in adiponectin and mortality in HD patients[25].…”

Section: Introductionmentioning

confidence: 99%

The association of adiponectin with metabolic syndrome and clinical outcome in patients with non-diabetic chronic kidney disease

Kuo

Lin

et al. 2019

PLoS ONE

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Adiponectin is the most abundant circulating adipokine, and it has insulin-sensitizing and anti-inflammatory properties. Although it has been speculated that kidney function decline associated with elevated adiponectin is attributable to decreased renal clearance and compensatory responses to adiponectin resistance, it is unclear how elevated adiponectin affects clinical outcomes in chronic kidney disease (CKD) patients and whether the effects are the same as those in the general population. Therefore, the aim of this study is to examine whether the association between serum adiponectin levels and clinical outcomes in non-diabetic CKD patients is independent of adiposity and metabolic syndrome. We enrolled 196 non-diabetic CKD patients with eGFR ranging between 10 and 60 mL/min/1.73 m 2 , these patients were divided into two groups based on the presence of metabolic syndrome. The primary endpoint was all-cause mortality or renal events (renal failure requiring renal replacement therapy [RRT] or 50% reduction in eGFR). During the mean follow-up period of 5 years, 48 (24.5%) incident cases of end-stage renal disease (ESRD) were observed, and 33 (16.8%) deaths occurred. The mean eGFR was 29.8 ± 12.8 mL/min/1.73m 2 . The baseline median adiponectin concentration in the cohort was 29.4(interquartile range, 13.3–108.7) μg/ml. Adiponectin levels were inversely related to body mass index (BMI) ( r = −0.29; P < 0.001) and waist circumference ( r = −0.35; P < 0.001). In the fully adjusted Cox regression model, the hazard ratios (HRs) were 2.08 (95% confidence interval [CI], 1.08–4.02; P = 0.03) for RRT and 1.66 (95% CI, 1.03–2.65; P = 0.04) for composite renal outcome. The risks remained consistent within different subgroups. However, no association was observed with mortality risk. In conclusion, higher adiponectin levels are associated with a higher risk of ESRD independent of conventional risk factors, BMI, and metabolic syndrome components.

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Epicardial Adipose Tissue and Renal Disease

Cited by 15 publications

References 106 publications

SGLT2 Inhibitors: Nephroprotective Efficacy and Side Effects

SGLT2 Inhibitors: Nephroprotective Efficacy and Side Effects

Increased Pericardial Adipose Tissue in Smokers

The association of adiponectin with metabolic syndrome and clinical outcome in patients with non-diabetic chronic kidney disease

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