Obesity and chronic kidney disease progression—the role of a new adipocytokine: C1q/tumour necrosis factor-related protein-1

Abstract

Background Obesity is a risk factor for incident chronic kidney disease (CKD) in the general population. C1q/tumour necrosis factor-related protein 1 (CTRP1) is a new adipokine with multiple vascular and metabolic effects and may modulate the association between obesity and vascular diseases. The aim of the study is to explore potential links between obesity, CTRP1 levels and CKD progression. Methods Patients with Stages 3 and 4 CKD without previous cardiovascular events were enrolled and divided into two groups according to body mass index (BMI). Demographic, clinical and analytical data and CTRP1 levels were collected at baseline. During follow-up, renal events [defined as dialysis initiation, serum creatinine doubling or a 50% decrease in estimated glomerular filtration rate (Modification of Diet in Renal Disease)] were registered. Results A total of 71 patients with CKD were divided into two groups: 25 obese (BMI >30 kg/m 2 ) and 46 non-obese. CTRP1 in plasma at baseline was higher in obese patients [median (interquartile range) 360 (148) versus 288 (188) ng/mL, P = 0.041]. No significant association was found between CTRP1 levels and CKD stage, presence of diabetes, aldosterone and renin levels, or blood pressure. Obese patients had higher systolic blood pressure (P = 0.018) and higher high-sensitivity C-reactive protein (P = 0.019) and uric acid (P = 0.003) levels, without significant differences in the percentage of diabetic patients or albuminuria. During a mean follow-up of 65 months, 14 patients had a renal event. Patients with CTRP1 in the lowest tertile had more renal events, both in the overall sample (log rank: 5.810, P = 0.016) and among obese patients (log rank: 5.405, P = 0.020). Higher CTRP1 levels were associated with slower renal progression (hazard ratio 0.992, 95% confidence interval 0.986–0.998; P = 0.001) in a model adjusted for obesity, aspirin, albuminuria and renal function. Conclusions CTRP1 levels are higher in obese than in non-obese patients with CKD. High CTRP1 levels may have a renal protective role since they were associated with slower kidney disease progression. Interventional studies are needed to explore this hypothesis.

Circulating levels of C1q/TNF‐α‐related protein 6 (CTRP6) in polycystic ovary syndrome

“…For instance, CTRP1 forms an oligo‐heterotrimer with CTRP6, and is known to enhance glucose uptake and insulin sensitivity . Elevated levels of CTRP1 have been associated with BMI, T2DM, nonalcoholic fatty liver disease (NAFLD), congestive heart failure (CHF), and chronic kidney disease progression . CTRP3, also known as cartonectin, regulates glucose homeostasis and exhibits anti‐inflammatory immunomodulatory role .…”

The circulating levels of CTRP5 and the ratio of CTRP1 to CTRP5 plasma levels are significant predictors for cIMT value in patients with type 2 diabetes

“…One possible explanation regarding elevation of CTRP1 concentrations in T2D patients might be a self-protective or compensatory mechanism in response to abnormal glucose metabolism. Inconsistent with the above results, it was reported that CTRP1 levels did not significantly higher in diabetic subjects (33). The main reason for this discrepancy could be due to different samples as human and animal models (DIO or ob/ob mice) investigated.…”

The circulating levels of CTRP5 and the ratio of CTRP1 to CTRP5 plasma levels are significant predictors for cIMT value in patients with type 2 diabetes: A case-control study

“…One possible explanation regarding the elevation of CTRP1 concentrations in T2D patients might be a self-protective or compensatory mechanism in response to abnormal glucose metabolism. Inconsistent with the above results, it was reported that CTRP1 levels did not significantly higher in diabetic subjects (33). The main reason for this discrepancy could be due to different samples as human and animal models (DIO or ob/ob mice) investigated.…”