title: Irisin, a novel myokine is an independent predictor for sarcopenia and carotid atherosclerosis in dialysis patients.
abstract: OBJECTIVE
  In end-stage renal disease, deleterious effect of sarcopenia on cardiovascular disease has been explained mainly by chronic inflammation. However, evidence emerged that skeletal muscles mediate their protective effect against sarcopenia by secreting myokines. Therefore, we sought to investigate the effect of irisin, a recently introduced myokine, on the association between sarcopenia and cardiovascular disease in peritoneal dialysis (PD) patients.
  
  
  METHODS
  Serum irisin concentrations were assessed by enzyme-linked immunosorbent assay in 102 prevalent PD patients and 35 age- and sex-matched controls. To determine sarcopenia and cardiovascular disease, anthropometric indices including mid-arm muscle circumference (MAMC) and carotid intima-media thickness (cIMT) were measured.
  
  
  RESULTS
  Serum irisin concentrations were significantly lower in PD patients than in controls (184.2 ± 88.0 vs. 457.2 ± 105.5 ng/mL, P < 0.001). In PD patients, univariate linear regression analysis showed that serum irisin was positively correlated with MAMC and thigh circumference, but negatively correlated with residual renal function and cIMT. Multivariate analysis revealed that MAMC (per 1 cm increase, B = 8.78, 95% confidence interval [CI] = 0.77-16.79, P = 0.03) had an independent association with serum irisin. In addition, serum irisin was a significant independent predictor for carotid atherosclerosis even after adjustment for high-sensitivity C-reactive protein in PD patients (per 1 g/mL increase, odds ratio = 0.990, 95% CI = 0.982-0.997, P = 0.007).
  
  
  CONCLUSIONS
  This study demonstrated that serum irisin was significantly associated with sarcopenia and carotid atherosclerosis in PD patients. Additional studies to provide a confirmation and examine possible mechanisms are warranted.
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors: Mi Jung
authors: MJ
authors: Lee
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors: Sul A
authors: SA
authors: Lee
authors: Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Republic of Korea.
authors: Bo Young
authors: BY
authors: Nam
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Cardiovascular Genome Center, Yonsei University Health System, Seoul, Republic of Korea.
authors: Sungha
authors: S
authors: Park
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Cardiovascular Genome Center, Yonsei University Health System, Seoul, Republic of Korea.
authors: Sang-Hak
authors: SH
authors: Lee
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors: Han Jak
authors: HJ
authors: Ryu
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors: Young Eun
authors: YE
authors: Kwon
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors: Yung Ly
authors: YL
authors: Kim
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors: Kyoung Sook
authors: KS
authors: Park
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors: Hyung Jung
authors: HJ
authors: Oh
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors: Jung Tak
authors: JT
authors: Park
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors: Seung Hyeok
authors: SH
authors: Han
authors: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors: Dong-Ryeol
authors: DR
authors: Ryu
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Republic of Korea.
authors: Shin-Wook
authors: SW
authors: Kang
authors: Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Republic of Korea. Electronic address: yoosy0316@yuhs.ac.
authors: Tae-Hyun
authors: TH
authors: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D001132:Arm / Q000502:physiology; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005353:Fibronectins / Q000097:blood*; D006801:Humans; D007249:Inflammation; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D055948:Sarcopenia / Q000097:blood / Q000175:diagnosis*
chemical_list: C577593:FNDC5 protein, human; D005353:Fibronectins
keywords: Carotid atherosclerosis; Irisin; Myokine; Peritoneal dialysis; Sarcopenia