Evaluation of inflammation in obesity and chronic kidney disease with hemogram parameters

Yıl 2021, , 276 - 281, 31.12.2021

İlter Bozacı , Erhan Tatar

https://doi.org/10.30565/medalanya.943299

Öz

Aim: Chronic inflammation is involved in the pathogenesis of both obesity and chronic kidney disease (CKD). We aimed to evaluate the parameters derived from complete blood count (CBC) as inflammatory markers in obese patients and obese CKD patients.

Methods: Individuals enrolled in the study were divided into three groups. Group-1 was composed of obese patients; group-2 was composed of obese CKD patients and group-3 was composed of healthy individuals as the control group. This study was conducted at a training and research hospital over 6 months period.

Results: Forty-one patients were in group-1; 41 patients were in group-2 and 22 individuals were in group-3. White blood cell count (WBC) was significantly higher in group-1 and group-2 compared with group-3 (7,5±1,4 x10³/µL vs 8,4±2,4 x10³/µL vs 6,5±1,3 x10³/µL, respectively, p<0.001) and neutrophile to lymphocyte ratio (NLR) was significantly higher in group-1 and group-2 compared with group-3 (1,9±0,7 vs 2,5±1,5 vs 1,7±0,4, respectively, p<0.001). NLR and WBC was found positively correlated with systolic blood pressure, urea, creatinine, uric acid, whereas negatively correlated with estimated glomerular filtration rate.

Conclusion: It is important to determine significant results in CBC derived markers that are widely used in routine clinical practice as inflammatory markers.

Anahtar Kelimeler

Inflammation, Renal Insufficiency, Blood cell count.

Obezite ve Kronik Böbrek Hastalığındaki İnflamasyonun Hemogram Parametreleri ile Değerlendirilmesi

Öz

Amaç: Kronik inflamasyon hem obezitenin hem de kronik böbrek hastalığının patogenezi ile ilişkilidir. Çalışmamızda obez hastalarda ve obez kronik böbrek hastalarında inflamasyon belirteci olarak tam kan sayımı parametrelerinin değerlendirilmesini amaçladık.

Yöntemler: Çalışmada yer alan bireyler 3 ayrı gruba bölündü. Grup-1 obez hastalardan, grup-2 obez kronik böbrek hastalarından, grup-3 kontrol grubu olarak sağlıklı bireylerden oluşmakta idi. Çalışmamız, 6 aylık bir sürede bir eğitim ve araştırma hastanesinde gerçekleştirildi.

Bulgular: Kırkbir hasta grup-1’de; 41 hasta grup-2’de ve 22 sağlıklı birey grup-3’de yer aldı. Beyaz küre sayıları grup-3’e kıyasla grup-1 ve grup-2’de anlamlı düzeyde yüksek saptandı (7,5±1,4 x10³/µL vs 8,4±2,4 x10³/µL vs 6,5±1,3 x10³/µL, sırasıyla, p<0.001) ve nötrofil lenfosit oranı grup-3’e kıyasla grup-1 ve grup-2’de anlamlı düzeyde yüksek saptandı (1,9±0,7 vs 2,5±1,5 vs 1,7±0,4, sırasıyla, p<0.001). Nötrofil lenfosit oranı ve beyaz küre sayısının, sistolik kan basıncı, ürik asit, üre ve kreatinin arasında pozitif; glomerüler filtrasyon hızı ile negatif korelasyon saptandı.

Sonuç: Rutin klinik pratikte sıkça kullanılan hemogramdan elde edilen parametrelerin inflamasyon belirteçleri olarak anlamlı sonuçlanması önemlidir.

Anahtar Kelimeler

Enflamasyon, Böbrek Yetmezliği, Kan Hücre Sayımı

Kaynakça

• 1. McGarry T, Biniecka M, Veale DJ, Fearon U. Hypoxia, oxidative stress and inflammation. Free Radic Biol Med. 2018;125:15-24. doi: 10.1016/j.freeadbiomed.2018.03.042.
• 2. Krzysztoszek J, Wierzejska E, Zielińska A. Obesity. An analysis of epidemiological and prognostic research. Arch Med Sci. 2015;11(1):24–33. doi: 10.5114/aoms.2013.37343.
• 3. Kawai T, Autieri MV, Scalia R. Adipose tissue inflammation and metabolic dysfunction in obesity. Am J Physiol Cell Physiol. 2021;320(3):375-91. doi:10.1152/ajpcell.00379.2020.
• 4. Verma S, Singh P, Khurana S, Ganguly NK, Kukreti R, Saso L, et al. Implications of oxidative stress in chronic kidney disease: a review on current concepts and therapies. Kidney Res Clin Pract. 2021;40(2):183-93. doi: 10.23876/j.krcp.20.163.
• 5. Cheng W, Wang H, Zhang J, Bai G, Han W, Chen J, et al. Lymphocyte subset counts as diagnostic and prognostic markers for carbapenem-resistant Enterobacteriaceae (CRE) infection in critically ill patients. Int J Infect Dis. 2020;96:315-22. doi: 10.1016/j.ijid.2020.04.072.
• 6. Rehman FU, Khan A, Aziz A, Iqbal M, Mahmood SBZ, Ali N. Neutrophils to Lymphocyte Ratio: Earliest and Efficacious Markers of Sepsis. Cureus. 2020;12(10):e10851. doi:10.7759/cureus.10851.
• 7. Titan SM, Venturini G, Padilha K, Goulart AC, Lotufo PA, Bensenor IJ et al. Metabolomics biomarkers and the risk of overall mortality and ESRD in CKD: Results from the Progredir Cohort. PLoS One. 2019;14(3):e0213764. doi: 10.1371/journal.pone.0213764.
• 8. Pottel H, Björk J, Courbebaisse M, Couzi L, Ebert N, Eriksen BO et al. Development and validation of a modified full age spectrum creatinine-based equation to estimate glomerular filtration rate: A cross sectional analysis of pooled data. Ann Intern Med. 2021;174(2):183-91. doi: 10.7326/M20-4366.
• 9. Andrassy KM. Improving global outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2013;84(3):622-3. doi: 10.1038/ki.2013.243.
• 10. Berghöfer A, Pıschon T, Reinhold T, Apovian CM, Sharma AM, Willlich SN. Obesity prevalence from a European perspective: a systematic review. BMC Public Health. 2008;8:200. doi: 10.1186/1471-2458-8-200.
• 11. Garofallo SB, Portal VL, Markoski MM, Dias LD, de Quadrosa AS, Marcadenti A. Correlations between Traditional and Nontraditional Indicators of Adiposity, Inflammation, and Monocyte Subtypes in Patients with Stable Coronary Artery Disease. J Obes. 2019;2019:3139278. doi: 10.1155/2019/3139278.
• 12. Johnson RJ, Nakagawa T, Jalal D, Sanchez-Lozada LG, Kangh DH, Ritz E. Uric acid and chronic kidney disease: which is chasing which? Nephrol Dial Transplant. 2013;28(9):2221-8. doi: 10.1093/ndt/gft029.
• 13. Richette P, Perez-Ruiz F, Doherty M, Jansen TL, Nuki G, Pascual E et al. Improving cardiovascular and renal outcomes in gout: what should we target? Nat Rev Rheumatol. 2014;10(11):654–61. doi: 10.1038/nrrheum.2014.124.
• 14. Ali N, Perveen R, Rahman S, Mahmood S, Rahman S, Islam S, et al. Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: a study on Bangladeshi adults. PLoS One. 2018;13(11):e0206850. doi:10.371/journal.pone.0206850.
• 15. Chaudhary NS, Bridges SL Jr, Saag KG, Rahn EJ, Curtis JR, Gaffo A, et al. Severity of Hypertension Mediates the Association of Hyperuricemia With Stroke in the REGARDS Case Cohort Study. Hypertension. 2020;75(1):246-56. doi: 10.1161/HYPERTENSIONAHA.119.13580.
• 16. Russo E, Viazzi F, Pontremoli R, Barbagallo CM, Michele Bombelli M, Casiglia E, et al. Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) project. J Nephrol. 2021. doi: 10.1007/s40620-021-00985-4. Online ahead of print.
• 17. Nakayama S, Satoh M, Tatsumi Y, Murakami T, Muroya T, Hirose T et al. Detailed association between serum uric acid levels and the incidence of chronic kidney disease stratified by sex in middle-aged adults. Atherosclerosis. 2021;330:107-13. doi: 10.1016/j.atherosclerosis.2021.06.908.
• 18. Sharaf El Din UAA, Salem MM, Abdulazim DO. Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: a review. J Adv Res. 2017;8(5):537–48. doi: 10.1016/j.jare.2016.11.004.
• 19. Sato Y, Feig DI, Stack AG, Kang DH, Lanaspa MA, Ejaz AA, et al. The case for uric acid-lowering treatment in patients with hyperuricaemia and CKD. Nat Rev Nephrol. 2019;15(12):767–75. doi:10.1038/s41581-019-0174-z.
• 20. Spiga R, Marin MA, Mancuso E, Fatta CD, Fuoco A, Perticone F, et al. Uric Acid Is Associated With Inflammatory Biomarkers and Induces Inflammation Via Activating the NF-κB Signaling Pathway in HepG2 Cells. Arterioscler Thromb Vasc Biol. 2017;37(6):1241–9. doi: 10.1161/ATVBAHA:117.309128.
• 21. Neuschwander-Tetri BA. Non-alcoholic fatty liver disease. BMC Med. 2017;15(1):45. doi: 10.1186/s12916-017-0806-8.
• 22. Valent Morić B, Jelaković B, Vidatić I, Trutin I, Jelaković A, Stipančić G. Ambulatory blood pressure profile in office normotensive obese children: prevalence of masked hypertension and impact of parental hypertension. J Pediatr Endocrinol Metab. 2020;33(10):1313-20. doi: 10.1515/jpem-2020-0269.
• 23. Pioli MR, de Faria AP. Pro-inflammatory Cytokines and Resistant Hypertension: Potential for Novel Treatments? Curr Hypertens Rep. 2019;21(12):95. doi: 10.1007/s11906-019-1003-2.