Hormone released after exercise may predict cardiovascular events in patients with CKD
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For patients with chronic kidney disease, lower values of the hormone serum irisin were associated with a greater likelihood of experiencing cardiovascular events during a follow-up of 3 years, study results showed.
In addition, serum irisin was significantly lower in this patient group than in a cohort of healthy controls.
“Irisin is a circulating myokine released from human skeletal muscles after physical exercise,” Teresa Arcidiacono, MD, of the IRCCS San Raffaele Scientific Institute in Milan, and colleagues wrote. “ ... Irisin production progressively decreases in patients with CKD as a potential consequence of sarcopenia and physical inactivity frequently detected in these patients. This decline may influence cardiovascular outcome in patients with CKD who develop a severe cardiovascular disease determining most of their mortality and morbidity.
The present study tested the relationship of serum irisin with cardiovascular risk in a sample of elderly patients with CKD not undergoing dialysis. This relationship may be considered as an indirect assessment of the effect of skeletal muscle activity on the cardiovascular risk.”
For the observational study, Arcidiacono and colleagues sampled the blood of 79 patients with CKD who continued their usual medications and diets; physical activity levels were not considered. While serum irisin was similar between patients at varying stages of CKD, researchers found it was significantly higher in patients with CKD stage 3 than in patients with stage 4 and 5 taken together (3.2 ug/mL vs. 2.8 ug/mL). Serum irisin was also higher in patients without diabetes than in those with diabetes.
During the 3-year follow-up, 20 patients experienced a cardiovascular event, 17 of which were in the middle or lowest tertiles of serum irisin.
Results of the Kaplan-Mayer survival analysis showed patients in the highest irisin tertile developed fewer cardiovascular events than patients in the lower irisin tertiles, with the Cox regression model demonstrating patients in the highest tertile had a lower cardiovascular risk than patients in the middle (odds ratio = 10.8) tertile or lowest tertile (OR =5).
Researchers also calculated cardiovascular risk with a score including serum irisin tertiles, cardiovascular history, serum albumin and FGF23; here, they observed a 14% increase in cardiovascular risk for each point increase.
“Serum irisin could be a marker of cardiovascular health in patients with CKD,” Arcidiacono and colleagues concluded. “If our findings [are] confirmed, irisin could become a new therapeutic and diagnostic approach for the cardiovascular disease.”
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