Hormone released after exercise may predict cardiovascular events in patients with CKD

August 16, 2021

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Disclosure:
The study was supported by a grant from Shire Pharmaceutical. The authors do not report any other relevant financial information.

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Study results showed that in patients with chronic kidney disease, lower levels of the hormone serum irisin were associated with a higher likelihood of cardiovascular events during a 3-year follow-up period.

In addition, the serum irisin concentration in this patient group was significantly lower than in a cohort of healthy controls.

Hormone released after exercise can cause cardiovascular events in patients with CKD.  predict

The content of the infographic was adapted from Arcidiacono t, et al. J Ren Nutrit. 2021; doi: 10.1053 / j.jrn.2021.05.007.

“Irisin is a circulating myokin that is released from human skeletal muscles after physical exertion.” Teresa Archdeacon, MD, of the IRCCS San Raffaele Scientific Institute in Milan, and colleagues wrote. “… Irisin production decreases progressively in patients with CKD as a possible consequence of sarcopenia and physical inactivity, which is often observed in these patients. This decline can affect cardiovascular outcomes in patients with CKD who develop severe cardiovascular disease, which determines the majority of their mortality and morbidity.

In the present study, the association of serum irisin with cardiovascular risk was tested in a sample of elderly patients with CKD who were not on dialysis. This relationship can be viewed as an indirect assessment of the effect of skeletal muscle activity on cardiovascular risk. “

For the observational study, Arcidiacono and colleagues took blood samples from 79 patients with CRF who were continuing their usual medications and diets; physical activity was not taken into account. While serum irisin was similar in patients with different stages of CKD, the researchers found that it was significantly higher in patients with CKD stage 3 than in patients with stage 4 and 5 taken together (3.2 µg / ml vs. 2 , 8 µg / ml). Serum irisin was also higher in patients without diabetes than in patients with diabetes.

During the 3-year follow-up, 20 patients had a cardiovascular event, 17 of whom were in the middle or lowest tertiles of serum irisin.

The results of the Kaplan-Mayer survival analysis showed that patients in the highest irisine tertile developed fewer cardiovascular events than patients in the lower irisine tertile ratio = 10.8) tertile or lowest tertile (OR = 5).

The researchers also calculated cardiovascular risk using a score that includes serum irisin tertile, cardiovascular history, serum albumin, and FGF23; here they observed a 14% increase in cardiovascular risk for each point increase.

“Serum irisin could be a marker of cardiovascular health in patients with CKD,” concluded Arcidiacono and colleagues. “If our results [are] confirmed, Irisin could become a new therapeutic and diagnostic approach for cardiovascular disease. “

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