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  1. Article ; Online: Vitamin K and vascular calcification in chronic kidney disease: An update of current evidence.

    Lin, Yu-Li / Hsu, Bang-Gee

    Tzu chi medical journal

    2022  Volume 35, Issue 1, Page(s) 44–50

    Abstract: Vascular calcification, characterized by calcium deposition in the intimal and medial layers of the arterial wall, is frequently encountered in patients with chronic kidney disease (CKD) and leads to an enhanced risk of adverse cardiovascular (CV) ... ...

    Abstract Vascular calcification, characterized by calcium deposition in the intimal and medial layers of the arterial wall, is frequently encountered in patients with chronic kidney disease (CKD) and leads to an enhanced risk of adverse cardiovascular (CV) outcomes. However, the underlying complex pathophysiology remains incompletely understood. Recently, Vitamin K supplementation aimed at correcting Vitamin K deficiency highly prevalent in CKD holds great promise to mitigate the progression of vascular calcification. This article discusses the functional Vitamin K status in CKD, the pathophysiology linking Vitamin K deficiency and vascular calcification, and reviews current literature from animal models, observational studies, and clinical trials across the different spectrum of CKD. While favorable effects of Vitamin K on vascular calcification and CV outcomes are suggested in animal and observational studies, most recently published clinical trials investigating the effects of Vitamin K on vascular health failed to support the beneficial role of Vitamin K supplementation, despite improving the functional status of Vitamin K. We address the potential reasons for these discrepancies and provide further perspective on Vitamin K research in CKD.
    Language English
    Publishing date 2022-07-26
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2452925-4
    ISSN 2223-8956 ; 2223-8956
    ISSN (online) 2223-8956
    ISSN 2223-8956
    DOI 10.4103/tcmj.tcmj_100_22
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Serum Phenylacetylglutamine among Potential Risk Factors for Arterial Stiffness Measuring by Carotid-Femoral Pulse Wave Velocity in Patients with Kidney Transplantation.

    Yang, Hsiao-Hui / Chen, Yen-Cheng / Ho, Ching-Chun / Hsu, Bang-Gee

    Toxins

    2024  Volume 16, Issue 2

    Abstract: Phenylacetylglutamine (PAG), a gut microbiota metabolite, is associated with cardiovascular diseases. Arterial stiffness (AS), which is a marker of aging-associated vascular diseases, is an independent risk factor for cardiovascular morbidity and ... ...

    Abstract Phenylacetylglutamine (PAG), a gut microbiota metabolite, is associated with cardiovascular diseases. Arterial stiffness (AS), which is a marker of aging-associated vascular diseases, is an independent risk factor for cardiovascular morbidity and mortality. This study aimed to assess the correlation between serum PAG levels and AS in kidney transplantation (KT) patients, potentially uncovering new insights into the cardiovascular risks in this population. In this study, 100 KT patients were included. Carotid-femoral pulse wave velocity (cfPWV) was measured, and patients with cfPWV > 10 m/s were categorized as the AS group. Serum PAG levels were assessed using liquid chromatography-tandem mass spectrometry. Thirty KT patients (30.0%) exhibited AS, with higher percentages of diabetes mellitus, older age, and elevated levels of systolic blood pressure, serum fasting glucose, and PAG than the control group. After adjusting for factors significantly associated with AS by multivariate logistic regression analysis, serum PAG, age, fasting glucose levels, and systolic blood pressure were independent factors associated with AS. Furthermore, PAG levels had a negative correlation with the estimated glomerular filtration rate and a positive correlation with cfPWV values. Serum PAG levels are positively associated with cfPWV values and are a biomarker of AS in KT patients.
    MeSH term(s) Humans ; Carotid-Femoral Pulse Wave Velocity ; Pulse Wave Analysis/methods ; Vascular Stiffness ; Kidney Transplantation/adverse effects ; Risk Factors ; Blood Pressure ; Glucose ; Glutamine/analogs & derivatives
    Chemical Substances phenylacetylglutamine (92358I79RG) ; Glucose (IY9XDZ35W2) ; Glutamine (0RH81L854J)
    Language English
    Publishing date 2024-02-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2518395-3
    ISSN 2072-6651 ; 2072-6651
    ISSN (online) 2072-6651
    ISSN 2072-6651
    DOI 10.3390/toxins16020111
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Serum Leptin Level is Positively Correlated with Aortic Stiffness in Patients with Type 2 Diabetes Mellitus.

    Wu, Tsung-Jui / Wu, Du-An / Hsu, Bang-Gee

    Frontiers in bioscience (Landmark edition)

    2023  Volume 28, Issue 6, Page(s) 128

    Abstract: Background: The global number of people living with diabetes mellitus (DM) continues to grow. Obesity, smoking, hypercholesterolemia, and hypertension are independently correlated with the risk of cardiovascular disease (CVD) in diabetic patients ... ...

    Abstract Background: The global number of people living with diabetes mellitus (DM) continues to grow. Obesity, smoking, hypercholesterolemia, and hypertension are independently correlated with the risk of cardiovascular disease (CVD) in diabetic patients regardless of differences in race or ethnicity. We aimed to investigate the relationship between serum leptin levels and aortic stiffness in patients with type 2 DM to identify cardiovascular risk at the early stage.
    Methods: A total of 128 diabetic patients were enrolled after screening for eligibility at a medical center in Eastern Taiwan. Aortic stiffness was defined as having a carotid-femoral pulse wave velocity (cfPWV) of >10 m/s using applanation tonometry. Fasting serum levels of leptin and other associated biomarkers were determined by enzyme immunoassay or biochemical analyses.
    Results: Forty-six diabetic patients with a cfPWV of >10 m/s were included in the aortic stiffness group. Compared with the control group (n = 82), our aortic stiffness group was significantly older (
    Conclusions: The results suggested that serum leptin is positively associated with aortic stiffness in patients with type 2 DM.
    MeSH term(s) Humans ; Diabetes Mellitus, Type 2/complications ; Pulse Wave Analysis ; Leptin ; Vascular Stiffness/physiology ; Biomarkers ; Risk Factors
    Chemical Substances Leptin ; Biomarkers
    Language English
    Publishing date 2023-06-06
    Publishing country Singapore
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2704569-9
    ISSN 2768-6698 ; 2768-6698
    ISSN (online) 2768-6698
    ISSN 2768-6698
    DOI 10.31083/j.fbl2806128
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Assessment of uremic sarcopenia in dialysis patients: An update.

    Lin, Yu-Li / Hsu, Bang-Gee

    Tzu chi medical journal

    2021  Volume 34, Issue 2, Page(s) 182–191

    Abstract: Uremic sarcopenia, which is highly prevalent in dialysis patients, leads to an increased risk of adverse outcomes, such as poor quality of life, falls, fracture, hospitalization, and even mortality. Therefore, early detection of uremic sarcopenia is ... ...

    Abstract Uremic sarcopenia, which is highly prevalent in dialysis patients, leads to an increased risk of adverse outcomes, such as poor quality of life, falls, fracture, hospitalization, and even mortality. Therefore, early detection of uremic sarcopenia is crucial for administering quick and adequate multidisciplinary therapy to improve clinical outcomes. This review updates the current information about uremic sarcopenia assessment in chronic dialysis patients. We discuss the methods of assessing skeletal muscle mass, strength, and physical performance. We also discuss surrogate markers derived from serum and dialysate creatinine, in addition to emerging screening tools. The prevalence, clinical relevance, and impact of uremic sarcopenia on survival are reviewed and we discuss the limitations and challenges in applying the current working definition of sarcopenia based on the senior population to dialysis patients. The review shows that dialysis patients with skeletal muscle weakness or poor physical performance, either with or without low skeletal muscle mass, should undergo multidisciplinary therapy, included nutritional counseling, lifestyle modification, and exercise intervention, to mitigate the detrimental effects of uremic sarcopenia.
    Language English
    Publishing date 2021-07-16
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2452925-4
    ISSN 2223-8956 ; 2223-8956
    ISSN (online) 2223-8956
    ISSN 2223-8956
    DOI 10.4103/tcmj.tcmj_254_20
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Association of endothelial dysfunction and peripheral arterial disease with sarcopenia in chronic kidney disease.

    Hsu, Bang-Gee / Wang, Chih-Hsien / Lai, Yu-Hsien / Kuo, Chiu-Huang / Lin, Yu-Li

    Journal of cachexia, sarcopenia and muscle

    2024  

    Abstract: Background: Endothelial dysfunction and peripheral arterial disease (PAD), which disturb skeletal muscle microperfusion, are highly prevalent in patients with chronic kidney disease (CKD). We evaluated the association of endothelial dysfunction and PAD ... ...

    Abstract Background: Endothelial dysfunction and peripheral arterial disease (PAD), which disturb skeletal muscle microperfusion, are highly prevalent in patients with chronic kidney disease (CKD). We evaluated the association of endothelial dysfunction and PAD with sarcopenia in patients with non-dialysis CKD.
    Methods: This cross-sectional study included 420 patients with stages 3-5 non-dialysis CKD aged 69.0 ± 11.8 years. Skeletal muscle index (skeletal muscle mass/height
    Results: Among the participants, 103 (24.5%) were classified as having sarcopenia. Compared with patients without sarcopenia, those with sarcopenia had significantly lower ABI (1.04 ± 0.16 vs. 1.08 ± 0.15, P = 0.028 for the right ABI; 1.01 ± 0.16 vs. 1.06 ± 0.16, P = 0.002 for the left ABI) and VRI (0.83 ± 0.57 vs. 1.08 ± 0.56, P < 0.001) and had higher serum levels of ICAM-1 (P < 0.001), VCAM-1 (P = 0.003) and ET-1 (P = 0.037). Multivariate logistic regression revealed that, beyond age and body mass index, the average ABI (odds ratio [OR]: 0.81/0.1 increase; 95% confidence interval [CI]: 0.67-0.98; P = 0.032) and VRI (OR: 0.93/0.1 increase; 95% CI: 0.88-0.98; P = 0.010) were independently associated with sarcopenia. Among the endothelial biomarkers measured, ICAM-1 (OR: 2.47/1-SD increase; 95% CI: 1.62-3.75) and VCAM-1 (OR: 1.91/1-SD increase; 95% CI: 1.27-2.87) were independent predictors of sarcopenia. Group stratification based on the cut-offs of VRI and ABI showed that those with both poor VRI and ABI had the greatest risk for sarcopenia (OR: 4.22; 95% CI: 1.69-10.49), compared with those with normal VRI and ABI.
    Conclusions: Endothelial dysfunction and PAD are independently associated with sarcopenia in patients with stages 3-5 CKD, suggesting the dominant role of vascular dysfunction in sarcopenia.
    Language English
    Publishing date 2024-04-21
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2586864-0
    ISSN 2190-6009 ; 2190-5991
    ISSN (online) 2190-6009
    ISSN 2190-5991
    DOI 10.1002/jcsm.13471
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  6. Article ; Online: Novel equations incorporating the sarcopenia index based on serum creatinine and cystatin C to predict appendicular skeletal muscle mass in patients with nondialysis CKD.

    Hsu, Bang-Gee / Wang, Chih-Hsien / Lai, Yu-Hsien / Kuo, Chiu-Huang / Lin, Yu-Li

    Clinical nutrition (Edinburgh, Scotland)

    2024  Volume 43, Issue 3, Page(s) 765–772

    Abstract: Background & aims: Skeletal muscle mass measurements are important for customizing nutritional strategies for patients with chronic kidney disease (CKD). The serum creatinine-to-cystatin C ratio (Cr/CysC) is a potential indicator of sarcopenia. We ... ...

    Abstract Background & aims: Skeletal muscle mass measurements are important for customizing nutritional strategies for patients with chronic kidney disease (CKD). The serum creatinine-to-cystatin C ratio (Cr/CysC) is a potential indicator of sarcopenia. We developed simple equations to predict the appendicular skeletal muscle mass (ASM) of patients with CKD using readily available parameters and Cr/CysC.
    Methods: Overall, 573 patients with nondialysis CKD stages 3-5 were included for developing and validating the equations. The participants were randomly divided into development and validation groups in a 2:1 ratio. ASM was measured using the Body Composition Monitor (BCM), a multifrequency bioelectrical impedance spectroscopy device. The height, weight, anthropometric data, and handgrip strength (HGS) of the participants were obtained. Equations were generated using stepwise multiple linear regression models. The prognostic significance of the predicted ASM was evaluated in a CKD registry comprising 1043 patients.
    Results: The optimal equation without anthropometric data and HGS (Equation 1) was as follows: ASM (kg) = -7.949 - 0.049 × Age (years) - 2.213 × Woman + 0.090 × Height (cm) + 0.210 × Weight (kg) + 1.141 × Cr/CysC. The modified equation (Equation 2) with anthropometric data and HGS was as follows: ASM (kg) = -4.468 - 0.050 × Age (years) - 2.285 × Woman+ 0.079 × Height (cm) + 0.228 × Weight (kg) - 0.127 × Mid-arm muscular circumference (cm) + 1.127 × Cr/CysC. Both equations exhibited strong correlations with the ASM measured via BCM in the validation cohort (r = 0.944 and 0.943 for Equations 1 and 2, respectively) with minimal bias. When Equation 1 was applied to the CKD registry, the estimated ASM index (ASM/Height
    Conclusions: Novel ASM equations offer a simple method for predicting skeletal muscle mass and can provide valuable prognostic information regarding patients with nondialysis CKD.
    MeSH term(s) Female ; Humans ; Cystatin C ; Creatinine ; Hand Strength ; Sarcopenia/diagnosis ; Renal Insufficiency, Chronic ; Muscle, Skeletal
    Chemical Substances Cystatin C ; Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2024-02-01
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2024.01.029
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  7. Article: Carotid-Femoral Pulse Wave Velocity Could Be a Marker to Predict Cardiovascular and All-Cause Mortality of Hemodialysis Patients.

    Ng, Xin-Ning / Tsai, Jen-Pi / Wang, Chih-Hsien / Hsu, Bang-Gee

    Journal of clinical medicine

    2023  Volume 12, Issue 7

    Abstract: Among hemodialysis (HD) patients, cardiovascular disease (CVD) is recognized as a major contributor to the high risk of mortality, and emerging evidence has ascertained arterial stiffness as an independent predictor of adverse cardiovascular (CV) ... ...

    Abstract Among hemodialysis (HD) patients, cardiovascular disease (CVD) is recognized as a major contributor to the high risk of mortality, and emerging evidence has ascertained arterial stiffness as an independent predictor of adverse cardiovascular (CV) outcomes. We aimed to investigate the efficacy of arterial stiffness measurement in predicting CV and all-cause mortality in patients on HD (
    Language English
    Publishing date 2023-03-26
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12072509
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  8. Article: Endocan as a Potential Marker for Predicting All-Cause Mortality in Hemodialysis Patients.

    Lin, Jia-Hong / Hsu, Bang-Gee / Wang, Chih-Hsien / Tsai, Jen-Pi

    Journal of clinical medicine

    2023  Volume 12, Issue 23

    Abstract: Endocan, a pro-inflammatory cytokine and pro-angiogenic factor, is a marker of endothelial dysfunction and has been proven to correlate with cardiovascular disease. In hemodialysis (HD) patients, cardiovascular disease is the major cause of mortality. ... ...

    Abstract Endocan, a pro-inflammatory cytokine and pro-angiogenic factor, is a marker of endothelial dysfunction and has been proven to correlate with cardiovascular disease. In hemodialysis (HD) patients, cardiovascular disease is the major cause of mortality. Our study aimed to investigate the relationship between serum endocan and all causes of mortality in HD patients. A total of 103 patients, aged over 20 years old and undergoing HD for more than 3 months, were included and followed for 36 months. Mortality events, serum endocan, biochemical data, body mass index, systolic and diastolic blood pressure, baseline characteristics, and the use of antihypertensive and lipid-lowering drugs were recorded. In our study, a total of 26 deaths (25.2%) occurred. Hemodialysis patients with diabetes mellitus, older age, higher serum endocan, and lower creatinine and albumin levels had a higher risk of mortality. Adjusting for prognostic variables, HD patients with higher serum endocan (
    Language English
    Publishing date 2023-11-30
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12237427
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  9. Article ; Online: Empagliflozin Attenuates Vascular Calcification in Mice with Chronic Kidney Disease by Regulating the NFR2/HO-1 Anti-Inflammatory Pathway through AMPK Activation.

    Lu, Chia-Wen / Lee, Chung-Jen / Hsieh, Yi-Jen / Hsu, Bang-Gee

    International journal of molecular sciences

    2023  Volume 24, Issue 12

    Abstract: Vascular calcification (VC) is associated with increased cardiovascular risks in patients with chronic kidney disease (CKD). Sodium-glucose cotransporter 2 inhibitors, such as empagliflozin, can improve cardiovascular and renal outcomes. We assessed the ... ...

    Abstract Vascular calcification (VC) is associated with increased cardiovascular risks in patients with chronic kidney disease (CKD). Sodium-glucose cotransporter 2 inhibitors, such as empagliflozin, can improve cardiovascular and renal outcomes. We assessed the expression of Runt-related transcription factor 2 (Runx2), interleukin (IL)-1β, IL-6, AMP-activated protein kinase (AMPK), nuclear factor erythroid-2-related factor (Nrf2), and heme oxygenase 1 (HO-1) in inorganic phosphate-induced VC in mouse vascular smooth muscle cells (VSMCs) to investigate the mechanisms underlying empagliflozin's therapeutic effects. We evaluated biochemical parameters, mean artery pressure (MAP), pulse wave velocity (PWV), transcutaneous glomerular filtration rate (GFR), and histology in an in vivo mouse model with VC induced by an oral high-phosphorus diet following a 5/6 nephrectomy in ApoE
    MeSH term(s) Mice ; Animals ; AMP-Activated Protein Kinases/metabolism ; Heme Oxygenase-1/metabolism ; NF-E2-Related Factor 2/metabolism ; Pulse Wave Analysis ; Vascular Calcification/etiology ; Vascular Calcification/complications ; Renal Insufficiency, Chronic/metabolism ; Phosphates/metabolism ; Anti-Inflammatory Agents/pharmacology ; Myocytes, Smooth Muscle/metabolism
    Chemical Substances AMP-Activated Protein Kinases (EC 2.7.11.31) ; empagliflozin (HDC1R2M35U) ; Heme Oxygenase-1 (EC 1.14.14.18) ; NF-E2-Related Factor 2 ; Phosphates ; Anti-Inflammatory Agents
    Language English
    Publishing date 2023-06-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms241210016
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  10. Article ; Online: Serum sclerostin level is positively associated with endothelial dysfunction measured by digital thermal monitoring in patients with type 2 diabetes: A prospective cross-sectional study.

    Hsu, Bang-Gee / Wu, Du-An / Yang, Hsin-Yu / Chen, Ming-Chun

    Medicine

    2023  Volume 102, Issue 36, Page(s) e34649

    Abstract: Sclerostin and dickkopf-1 (DKK1), extracellular inhibitors of the canonical Wnt/β-catenin signaling pathway, have been associated with vascular aging and atherosclerosis. This study aimed to assess the correlation of sclerostin and DKK1 concentrations ... ...

    Abstract Sclerostin and dickkopf-1 (DKK1), extracellular inhibitors of the canonical Wnt/β-catenin signaling pathway, have been associated with vascular aging and atherosclerosis. This study aimed to assess the correlation of sclerostin and DKK1 concentrations with endothelial function measured using vascular reactivity index (VRI) in patients with type 2 diabetes mellitus (T2DM). Fasting blood samples were collected from 100 patients with T2DM. Endothelial function and VRI were measured using digital thermal monitoring and circulating sclerostin and DKK1 levels by enzyme-linked immunosorbent assays. VRI values < 1.0, 1.0-1.9, and > 2.0 indicated poor, intermediate, and good vascular reactivity, respectively. Overall, 30, 38, and 32 patients had poor, intermediate, and good vascular reactivity, respectively. Older age, higher serum glycated hemoglobulin, urinary albumin-to-creatinine ratio, and sclerostin as well as lower hypertension prevalence, systolic blood pressure, and diastolic blood pressure (DBP) were associated with poor VRI. Multivariable forward stepwise linear regression analysis showed that DBP (β = 0.294, adjusted R2 change = 0.098, P < .001), log-glycated hemoglobin (β = -0.235, adjusted R2 change = 0.050, P = .002), log-urine albumin-to-creatinine ratio (β = -0.342, adjusted R2 change = 0.227, P < .001), and log-sclerostin level (β = -0.327, adjusted R2 change = 0.101, P < .001) were independently associated with VRI. Serum sclerostin, along with glycated hemoglobin and albumin-to-creatinine ratio, exhibited a negative correlation with VRI, while DBP showed a positive correlation with VRI. These factors can independently predict endothelial dysfunction in patients with T2DM.
    MeSH term(s) Humans ; Diabetes Mellitus, Type 2 ; Cross-Sectional Studies ; Creatinine ; Glycated Hemoglobin ; Prospective Studies ; Hypertension ; Albumins
    Chemical Substances Creatinine (AYI8EX34EU) ; Glycated Hemoglobin ; Albumins
    Language English
    Publishing date 2023-03-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000034649
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