Limits...
The relationship between renal function and plasma concentration of the cachectic factor zinc-alpha2-glycoprotein (ZAG) in adult patients with chronic kidney disease.

Pelletier CC, Koppe L, Alix PM, Kalbacher E, Croze ML, Hadj-Aissa A, Fouque D, Guebre-Egziabher F, Soulage CO - PLoS ONE (2014)

Bottom Line: An inverse relationship was found between ZAG levels and plasma protein (rs = -0.284; P<0.01), albumin (rs = -0.282, P<0.05), hemoglobin (rs = -0.267, P<0.05) and HDL-cholesterol (rs = -0.264, P<0.05) and a positive correlation were seen with plasma urea (rs = 0.283; P<0.01).In multiple regression analyses, plasma urea and HDL-cholesterol were the only variables associated with plasma ZAG (r2 = 0.406, P<0.001).In CKD-5 patients, plasma accumulation of ZAG was not correlated with protein energy wasting.

View Article: PubMed Central - PubMed

Affiliation: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France; Hospices Civils de Lyon, Service de Néphrologie, Hôpital E Herriot, Lyon, France.

ABSTRACT
Zinc-α2-glycoprotein (ZAG), a potent cachectic factor, is increased in patients undergoing maintenance dialysis. However, there is no data for patients before initiation of renal replacement therapy. The purpose of the present study was to assess the relationship between plasma ZAG concentration and renal function in patients with a large range of glomerular filtration rate (GFR). Plasma ZAG concentration and its relationship to GFR were investigated in 71 patients with a chronic kidney disease (CKD) stage 1 to 5, 17 chronic hemodialysis (HD), 8 peritoneal dialysis (PD) and 18 non-CKD patients. Plasma ZAG concentration was 2.3-fold higher in CKD stage 5 patients and 3-fold higher in HD and PD patients compared to non-CKD controls (P<0.01). The hemodialysis session further increased plasma ZAG concentration (+39%, P<0.01). An inverse relationship was found between ZAG levels and plasma protein (rs = -0.284; P<0.01), albumin (rs = -0.282, P<0.05), hemoglobin (rs = -0.267, P<0.05) and HDL-cholesterol (rs = -0.264, P<0.05) and a positive correlation were seen with plasma urea (rs = 0.283; P<0.01). In multiple regression analyses, plasma urea and HDL-cholesterol were the only variables associated with plasma ZAG (r2 = 0.406, P<0.001). In CKD-5 patients, plasma accumulation of ZAG was not correlated with protein energy wasting. Further prospective studies are however needed to better elucidate the potential role of ZAG in end-stage renal disease.

Show MeSH

Related in: MedlinePlus

Plasma ZAG concentration in CKD-5 patients with a diagnostic of protein-energy wasting.The boxes indicate the range (i.e. min to max) and the line indicate the median. Note that no difference was found to be significant at the P<0.05 level. Abbreviation: PEW, protein-energy wasting.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4116200&req=5

pone-0103475-g003: Plasma ZAG concentration in CKD-5 patients with a diagnostic of protein-energy wasting.The boxes indicate the range (i.e. min to max) and the line indicate the median. Note that no difference was found to be significant at the P<0.05 level. Abbreviation: PEW, protein-energy wasting.

Mentions: The results of the univariate correlation analysis are summarized in Table 3. In CKD patients stage 1 to 5, plasma ZAG concentrations negatively correlated with plasma protein concentration (rs = −0.284, P<0.01), albumin (rs = −0.282, P<0.05) hemoglobin (rs = −0.264, P<0.05), urea (rs = 0.283, P<0.01) and HDL-cholesterol (rs = −0.265, P<0.05). Multiple regression analysis (Table 4) including urea, protein, haemoglobin and HDL-cholesterol indicated that only urea (P<0.005) and HDL-cholesterol (P<0.05) were associated with ZAG plasma concentration. Urea, proteins, haemoglobin and HDL-cholesterol explained 41% of the variance of plasma ZAG concentration (P<0.001). Out of the 38 patients CKD-5, HD or PD, 11 (29%) presented PEW according to the criterions described in the method section (see patient characteristics in Table 5). We therefore re-analyzed the plasma ZAG concentrations of CKD-5, HD and PD patients presenting or not PEW. No significant difference in plasma ZAG concentration was noticed between these 2 sub-groups (Figure 3) suggesting that ZAG accumulates in CKD but does not have any relation with PEW. Since ZAG was described to exert potent lipolytic activity, plasma glycerol was measured in a subset of 39 patients (17 non CKD and 22 CKD) as an index of lipolysis. We did not observe any difference in plasma glycerol concentration between HV and CKD patients (Figure 4). Additionally, no significant correlation was found between ZAG and plasma glycerol concentration.


The relationship between renal function and plasma concentration of the cachectic factor zinc-alpha2-glycoprotein (ZAG) in adult patients with chronic kidney disease.

Pelletier CC, Koppe L, Alix PM, Kalbacher E, Croze ML, Hadj-Aissa A, Fouque D, Guebre-Egziabher F, Soulage CO - PLoS ONE (2014)

Plasma ZAG concentration in CKD-5 patients with a diagnostic of protein-energy wasting.The boxes indicate the range (i.e. min to max) and the line indicate the median. Note that no difference was found to be significant at the P<0.05 level. Abbreviation: PEW, protein-energy wasting.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4116200&req=5

pone-0103475-g003: Plasma ZAG concentration in CKD-5 patients with a diagnostic of protein-energy wasting.The boxes indicate the range (i.e. min to max) and the line indicate the median. Note that no difference was found to be significant at the P<0.05 level. Abbreviation: PEW, protein-energy wasting.
Mentions: The results of the univariate correlation analysis are summarized in Table 3. In CKD patients stage 1 to 5, plasma ZAG concentrations negatively correlated with plasma protein concentration (rs = −0.284, P<0.01), albumin (rs = −0.282, P<0.05) hemoglobin (rs = −0.264, P<0.05), urea (rs = 0.283, P<0.01) and HDL-cholesterol (rs = −0.265, P<0.05). Multiple regression analysis (Table 4) including urea, protein, haemoglobin and HDL-cholesterol indicated that only urea (P<0.005) and HDL-cholesterol (P<0.05) were associated with ZAG plasma concentration. Urea, proteins, haemoglobin and HDL-cholesterol explained 41% of the variance of plasma ZAG concentration (P<0.001). Out of the 38 patients CKD-5, HD or PD, 11 (29%) presented PEW according to the criterions described in the method section (see patient characteristics in Table 5). We therefore re-analyzed the plasma ZAG concentrations of CKD-5, HD and PD patients presenting or not PEW. No significant difference in plasma ZAG concentration was noticed between these 2 sub-groups (Figure 3) suggesting that ZAG accumulates in CKD but does not have any relation with PEW. Since ZAG was described to exert potent lipolytic activity, plasma glycerol was measured in a subset of 39 patients (17 non CKD and 22 CKD) as an index of lipolysis. We did not observe any difference in plasma glycerol concentration between HV and CKD patients (Figure 4). Additionally, no significant correlation was found between ZAG and plasma glycerol concentration.

Bottom Line: An inverse relationship was found between ZAG levels and plasma protein (rs = -0.284; P<0.01), albumin (rs = -0.282, P<0.05), hemoglobin (rs = -0.267, P<0.05) and HDL-cholesterol (rs = -0.264, P<0.05) and a positive correlation were seen with plasma urea (rs = 0.283; P<0.01).In multiple regression analyses, plasma urea and HDL-cholesterol were the only variables associated with plasma ZAG (r2 = 0.406, P<0.001).In CKD-5 patients, plasma accumulation of ZAG was not correlated with protein energy wasting.

View Article: PubMed Central - PubMed

Affiliation: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France; Hospices Civils de Lyon, Service de Néphrologie, Hôpital E Herriot, Lyon, France.

ABSTRACT
Zinc-α2-glycoprotein (ZAG), a potent cachectic factor, is increased in patients undergoing maintenance dialysis. However, there is no data for patients before initiation of renal replacement therapy. The purpose of the present study was to assess the relationship between plasma ZAG concentration and renal function in patients with a large range of glomerular filtration rate (GFR). Plasma ZAG concentration and its relationship to GFR were investigated in 71 patients with a chronic kidney disease (CKD) stage 1 to 5, 17 chronic hemodialysis (HD), 8 peritoneal dialysis (PD) and 18 non-CKD patients. Plasma ZAG concentration was 2.3-fold higher in CKD stage 5 patients and 3-fold higher in HD and PD patients compared to non-CKD controls (P<0.01). The hemodialysis session further increased plasma ZAG concentration (+39%, P<0.01). An inverse relationship was found between ZAG levels and plasma protein (rs = -0.284; P<0.01), albumin (rs = -0.282, P<0.05), hemoglobin (rs = -0.267, P<0.05) and HDL-cholesterol (rs = -0.264, P<0.05) and a positive correlation were seen with plasma urea (rs = 0.283; P<0.01). In multiple regression analyses, plasma urea and HDL-cholesterol were the only variables associated with plasma ZAG (r2 = 0.406, P<0.001). In CKD-5 patients, plasma accumulation of ZAG was not correlated with protein energy wasting. Further prospective studies are however needed to better elucidate the potential role of ZAG in end-stage renal disease.

Show MeSH
Related in: MedlinePlus