Association between biomarkers of inflammation and left ventricular hypertrophy in moderate chronic kidney disease

• Published in: Clinical nephrology Vol. 67; no. 4; p. 209
• Main Authors: Cottone, S, Nardi, E, Mulè, G, Vadalà, A, Lorito, M C, Riccobene, R, Palermo, A, Arsena, R, Guarneri, M, Cerasola, G
• Format: Journal Article
• Language: English
• Published: Germany 01-04-2007
• Subjects: Adult; alpha-Fetoproteins - metabolism; Analysis of Variance; Biomarkers - blood; C-Reactive Protein - metabolism; Case-Control Studies; Cytokines - blood; Echocardiography; Enzyme-Linked Immunosorbent Assay; Female; Humans; Hypertrophy, Left Ventricular - blood; Hypertrophy, Left Ventricular - diagnostic imaging; Inflammation - blood; Kidney Failure, Chronic - blood; Male; Middle Aged; Phosphopeptides - blood; Procollagen - blood; Regression Analysis; Tumor Necrosis Factor-alpha - blood
• ISSN: 0301-0430
• DOI: 10.5414/cnp67209

Left ventricular hypertrophy (LVH) is a predictor for cardiovascular mortality, and it is considered to be a surrogate marker of preclinical cardiovascular disease. This study aimed at evaluating whether fetuin-A plasma levels are decreased in patients with moderate chronic kidney disease (CKD) and their linkage to plasma concentrations of hs-C-reactive protein (CRP), cardiotrophyn-1 (CT-1), tumor necrosis factor-ac (TNF-alpha), propeptide of collagen Type I (PIP) and to LVH.
We enrolled 64 moderate CKD and 55 essential hypertensives (EH) with normal renal function as controls. All the patients underwent an echocardiographic examination; plasma samples were obtained to measure routine clinical parameters and the molecules listed above (measured by ELISA).
Among CKD there were 30/64 patients with LVH, and in EH group 14/55 subjects had LVH. Fetuin A was reduced in CKD when compared with EH (p < 0.0001). The comparison between CKD having LVH with those without LVH showed significant differences in plasma levels of fetuin-A (p < 0.002), TNF-alpha (p < 0.01) and hs-CRP (p < 0.001), CT-1 and PIP (p < 0.002). CKD with LVH had lower values of fetuin-A (p < 0.001), and higher values of hs-CRP (p < 0.001) TNF-alpha (p < 0.001), CT-1 (p < 0.001) and PIP (p < 0.001) than EH with LVH. The multivariate analysis of correlation demonstrated that in CKD patients hs-CRP (beta 0.42, p < 0.00006), and systolic blood pressure (beta 0.29, p < 0.02) were independent predictors of LV mass index. The relationship between LV mass index and fetuin-A did not reach statistical significance.
For the first time in moderate CKD patients, we demonstrate that fetuin-A is decreased and relates to LVH depending on C-reactive protein.