CLINICAL RESEARCH

Oxidative Stress and Inflammation Are Associated with Adiposity in Moderate to Severe CKD

Luis F. Ramos, Ayumi Shintani, T. Alp Ikizler and Jonathan Himmelfarb
JASN March 2008, 19 (3) 593-599; DOI: https://doi.org/10.1681/ASN.2007030355

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Relationship between BMI and biomarkers of inflammation and oxidative stress in 184 patients with CKD and 43 control subjects. The effect of BMI on F2-isoprostanes (P = 0.21 for interaction) and protein thiols (P = 0.75 for interaction) was similar in CKD and control groups. There may be a potential effect modification by disease status on the effect of BMI and CRP (P = 0.10 for interaction).

Tables

  • Table 1.

    Baseline characteristics between CKD and control groups

    CharacteristicControl (n = 43)CKD (n = 184)
    Male gender (n [%])20 (47)107 (58)
    Black race (n [%])6 (14)24 (13)
    Age (yr; mean ± SD)59.1 ± 10.066.6 ± 12.4a
    Diabetes (n [%])–82 (45)
    Weight (kg; mean ± SD)83.2 ± 18.487.4 ± 21.9
    BMI (kg/m2; mean ± SD)28.9 ± 4.230.6 ± 7.6
    Body fat (%; mean ± SD)31.5 ± 11.430.5 ± 13.1
    Blood urea nitrogen (mg/dl; mean ± SD)16.7 ± 4.239.1 ± 16.9a
    Serum creatinine (mg/dl; mean ± SD)1.0 ± 0.242.1 ± 0.67a
    eGFR (ml/min; mean ± SD)79.9 ± 16.634.1 ± 10.9a
    Serum albumin (g/dl; mean ± SD)4.4 ± 0.224.3 ± 0.38

    • ↵a P < 0.001 between patients with CKD and control subjects.

  • Table 2.

    Cardiovascular history in 184 patients with stages 3 and 4 CKD

    ParameterStage 3 CKD (n [%]; n = 112)Stage 4 CKD (n [%]; n = 72)Combined CKD Stages (n [%]; n = 184)
    Unstable angina25 (22.3)16 (22.2)41 (22.3)
    Acute myocardial infarction25 (22.3)10 (13.9)35 (19.0)
    Cerebrovascular accident14 (12.5)11 (15.3)25 (13.6)
    Congestive heart failure10 (8.9)9 (12.5)19 (10.3)
    Peripheral artery disease22 (19.6)15 (20.8)37 (20.1)
    Percutaneous coronary intervention8 (7.1)9 (12.5)17 (9.2)
    Coronary artery bypass graft surgery18 (16.1)11 (15.3)29 (15.8)
    Carotid endarterectomy9 (8.0)4 (5.6)13 (7.1)
    Peripheral artery disease surgery9 (8.0)8 (11.1)17 (9.2)
  • Table 3.

    Differences in Markers of Oxidative Stress and Inflammation Between CKD and Controls Group

    Inflammatory/Oxidative BiomarkersControl (mean ± SD; n = 43)CKD (mean ± SD; n = 184)Unadjusted PaAdjusted Pb
    Plasma F2-isoprostanes (ng/ml)c0.050 ± 0.0330.081 ± 0.049<0.001<0.001
    Protein thiols (μ mol/L)c328.4 ± 33.3304.0 ± 55.2<0.0010.050
    CRP (mg/L)c2.2 ± 1.95.5 ± 7.6<0.0010.010

    • ↵a Mann-Whitney U test for unadjusted analysis between groups.

    • ↵b P values were obtained using multivariable linear regression adjusted for age, gender, race, BMI, eGFR, history of diabetes, systolic BP, history of smoking, total cholesterol, and serum albumin.

    • ↵c Log10 transformed dependent variable in multivariable linear regression model.

  • Table 4.

    Unadjusted and adjusted correlation of BMI versus markers of oxidative stress and inflammation

    ParameterCKD (n = 184)Controls (n = 43)
    rsPaAdjusted PbrsPaAdjusted Pb
    F2-isoprostanesc0.30<0.001<0.0010.450.0200.600
    Protein thiols−0.180.0200.003−0.180.2700.040
    CRPc0.240.001<0.0010.470.0020.010

    • ↵a Spearman rank correlation for unadjusted analysis between BMI and markers of oxidative stress and inflammation.

    • ↵b Multivariable linear regression was used to control for age, eGFR, and history of diabetes.

    • ↵c Log10 transformed dependent variable in multivariable linear regression model.

  • Table 5.

    Unadjusted and adjusted correlation of body fat percentage versus markers of oxidative stress and inflammation

    ParameterCKD (n = 184)Controls (n = 43)
    rsPaAdjusted PbrsPaAdjusted Pb
    F2-isoprostanesc0.45<0.001<0.0010.66<0.0010.002
    Protein thiols−0.090.2300.060−0.060.7000.640
    CRPc0.190.0100.0030.360.0200.090

    • ↵a Spearman rank correlation coefficients for unadjusted analysis between body fat percentage and markers of oxidative stress and inflammation.

    • ↵b Multivariable linear regression was used to control for age, eGFR, and history of diabetes.

    • ↵c Log10 transformed dependent variable in multivariable linear regression model.

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Oxidative Stress and Inflammation Are Associated with Adiposity in Moderate to Severe CKD
Luis F. Ramos, Ayumi Shintani, T. Alp Ikizler, Jonathan Himmelfarb
JASN Mar 2008, 19 (3) 593-599; DOI: 10.1681/ASN.2007030355
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