Cyclophilin A is associated with peripheral artery disease and chronic kidney disease in geriatrics: The Tianliao Old People (TOP) study.

Meng-Chuan Liu,Yun-Lin Tai,Yen-Wei Lee,Po-Tseng Lee,Ling-Wei Hsu,Ping-Yen Liu,Chin-Sung Chang,Chi-Hsing Wu,Sheng-Hsiang Lin,Xiao-Ting Su,Jia-Rong Yu

doi:10.1038/srep09937

Abstract

Cyclophilin A (CyPA), secreted by vascular smooth muscle cells in response to oxidative stress, is important in the pathogenesis of progressive peripheral arterial occlusion disease (PAOD), which is common among chronic kidney disease. We explored the prevalence of PAOD in Taiwan’s elderly (≥ 65 years old) population and its association with CyPA and renal function. Residents of Tianliao District, a rural community in southern Taiwan, were surveyed. An ankle-brachial index (ABI) < 0.91 was defined as PAOD. Chronic kidney disease (CKD) was defined based on eGFR levels < 60 mL/min/1.73 m2. Serum CyPA was measured. Of the 473 participants, 68 (14.4%) had PAOD. Multiple logistic regression analysis showed PAOD was significantly associated with lower eGFR, lower BMI, higher glycated hemoglobin and higher pulse pressure. Serum CyPA levels in participants with PAOD were significantly higher than those with normal ABI values (47.3 ± 0.4 vs. 25.5 ± 0.2 ng/mL, p < 0.001). Moreover, eGFR inversely correlated with serum CyPA level (p < 0.05) in participants with CKD, but not in participants with normal renal function. In conclusion, with a prevalence of PAOD as high as 14.4% in an elderly community, CyPA might be the link between PAOD and advanced impaired renal function.

Highlights

Cyclophilin A is Associated with Peripheral Artery Disease and Chronic Kidney Disease in Geriatrics: The Tianliao Old People (TOP) Study
We found that participants with peripheral arterial occlusion disease (PAOD) had a higher hemoglobin A1c (HbA1c), which was an independent risk for PAOD, and that there was a similar result in the Atherosclerosis Risk in Communities study[27]
We found that the prevalence of PAOD in one Taiwan elderly population was similar to that reported in other studies, and that HbA1c, pulse pressure, and estimated glomerular filtration rate (eGFR) were significantly associated with PAOD

Summary

Introduction

Cyclophilin A is Associated with Peripheral Artery Disease and Chronic Kidney Disease in Geriatrics: The Tianliao Old People (TOP) Study. Serum CyPA levels in participants with PAOD were significantly higher than those with normal ABI values (47.3 6 0.4 vs 25.5 6 0.2 ng/mL, p , 0.001). Even though intermittent claudication is a classic symptom of PAOD, it was absent in most of our patients They manifested severe atherosclerotic changes when they were diagnosed[3]. The 1987–89 Atherosclerosis Risk in Communities (ARIC) study[6] reported that CKD was associated with a higher incidence of PAOD, and two other studies[7,8] reported that CKD was associated with both a high and a low ankle-brachial index (ABI), and that patients with CKD and a low ABI had a more rapid decline in renal function[8]

Methods

Results

Discussion

Conclusion