Serum Irisin May Predict Cardiovascular Events in Elderly Patients With Chronic Kidney Disease Stage 3-5
Irisin is a circulating myokine released from skeletal muscles after physical exercise. Irisin production decreases during the course of chronic kidney disease (CKD) as a potential consequence of sarcopenia and physical inactivity. In the light of the potential role of irisin in cardiovascular disease of CKD patients, we studied the relationship of serum irisin with cardiovascular risk in a sample of patients at different stages of CKD not undergoing dialysis (n=79). Our findings suggest that serum irisin may be a marker of cardiovascular outcome in CKD patients. doi: 10.1053/j.jrn.2021.05.007 PMID: 34294556
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Seventy-nine consecutive patients with stage 3-5 CKD were recruited from the patients of the Nephrology outpatient clinic at the San Raffaele Hospital in Milan from 2010 to 2014. Irisin serum concentrations were measured using a competitive ELISA kit (AdipoGen, Liestal, Switzerland; intra- and inter-assay coefficient of variations of the method were 5.2% and 6.5%, respectively). As its normal range was not defined, serum irisin was measured in 20 healthy controls matched for gender, age and body weight with CKD patients participating in the study; they were the first participants in an epidemiological survey on aging in general population (FRASNET) performed by our research Unit. These subjects had eGFR > 60 ml/min and normal stick urine analysis and did not suffer from chronic or acute disorders. Incident cardiovascular events were recorded during a 3-year follow-up. They included myocardial infarction, angina pectoris, coronary revascularization, hospitalization caused by congestive heart failure, hemorrhagic or thromboembolic stroke, transient ischemic attack and cardiovascular death. Cardiovascular event risk was explored with Cox regression using two models: the first model considered age, body weight, presence of diabetes mellitus, gender, Kauppila calcification score, serum values of FGF23 (as logarithm), phosphate, sclerostin, albumin and cholesterol, eGFR and serum irisin tertiles as covariates; the other model added history of cardiovascular events to these covariates.