Lower serum irisin levels are associated with the increasing mortality of cardiovascular and cerebrovascular diseases in hemodialysis patients

Abstract

Background: Irisin is a recently discovered myokine/adipokine and lower levels of irisin were proved to be associated with adverse outcomes of cardiovascular and cerebrovascular diseases (CCVD) in general population. A significant decrease of irisin concentrations were also detected in patients with chronic kidney disease (CKD). In the present study, we investigated whether the serum irisin levels were associated with cardiovascular and cerebrovascular mortality in hemodialysis (HD) patients.Methods: This retrospective cohort study enrolled 152 HD patients. Kaplan-Meier analysis was used to estimate the cumulative mortality of CCVD. The differences between the survival curves were compared by log-rank test. A multivariable Cox regression analysis was employed to identify the predictors of CCVD related deaths.Results: Among 152 HD patients, 55 patients died and 18 of them died of CCVD, 97 HD patients survived. Compared with the survival group, patients died of CCVD had significantly lower serum irisin levels [23.6 (2.2, 319.4) vs. 45.7 (2.1, 367.8) ng/mL, P<0.05]. The Kaplan-Meier survival curves showed that patients with lower levels of irisin had higher CCVD mortality. The Cox regression analysis indicated lower irisin level as an independent risk factor for CCVD mortality in HD patients but not for all-cause mortality.Conclusions: Our results provided an association between lower irisin level and CCVD mortality in HD patients. Lower levels of irisin increased the mortality of CCVD in HD patients.

Irisin protects against vascular calcification by activating autophagy and inhibiting NLRP3-mediated vascular smooth muscle cell pyroptosis in chronic kidney disease

“…Irisin treatment reduced the degree of aortic atherosclerotic plaques in Apolipoprotein E -deficient mice [ 32 , 51 ]. Our study recently reported that the plasma levels of Irisin are lower in uremic patients with VC than in those without VC [ 18 , 19 ]. Moreover, lower Irisin levels are associated with increased cardiovascular and cerebrovascular disease mortality in CKD patients [ 19 ].…”

“…Our study recently reported that the plasma levels of Irisin are lower in uremic patients with VC than in those without VC [ 18 , 19 ]. Moreover, lower Irisin levels are associated with increased cardiovascular and cerebrovascular disease mortality in CKD patients [ 19 ]. In the present study, our results from in vitro, ex vivo and in vivo experiments indicated that Irisin has an inhibitory effect on VC.…”

“…Some of its beneficial properties have been attributed to autophagy induction, suggesting that irisin is an important regulator of autophagy [ 17 ]. Our previous study showed that lower serum Irisin levels were associated with an increased risk of VC in peritoneal dialysis patients [ 18 ] and hemodialysis patients [ 19 ], indicating a potential relationship between the circulating Irisin concentration and VC in CKD patients. However, the role of Irisin in CKD‐associated VC has not yet been studied.…”

Relationship between Serum Irisin Level, All-Cause Mortality, and Cardiovascular Mortality in Peritoneal Dialysis Patients

“…Low serum irisin levels were predictive of poor functional outcomes in patients with ischemic stroke [8,9]. Dong et al [10] found that low serum irisin levels were associated with increased CV mortality in patients undergoing hemodialysis. However, the significance of serum irisin level in the clinical outcomes of PD patients had never been studied.…”