The Role of Immune Cells in DKD: Mechanisms and Targeted Therapies.

Diabetic kidney disease (DKD), is a common microvascular complication and a major cause of death in patients with diabetes. Disorders of immune cells and immune cytokines can accelerate DKD development of in a number of ways. As the kidney is composed of complex and highly differentiated cells, the interactions among different cell types and immune cells play important regulatory roles in disease development. Here, we summarize the latest research into the molecular mechanisms underlying the interactions among various immune and renal cells in DKD. In addition, we discuss the most recent studies related to single cell technology and bioinformatics analysis in the field of DKD. The aims of our review were to explore immune cells as potential therapeutic targets in DKD and provide some guidance for future clinical treatments.

Novel and traditional anthropometric indices for identifying arterial stiffness in overweight and obese adults.

BACKGROUND: Obesity and arterial stiffness are both independently associated with cardiovascular risk. New anthropometric indices can better reflect abdominal obesity than traditional anthropometric indices. Thus, we hypothesized that compared with conventional parameters, these newly developed anthropometric parameters were more accurate to identify arterial stiffness among overweight and obesity population. METHODS: Cross-sectional data on socio-demographic, lifestyle, clinical characteristics and biochemical measurements were collected for 1442 Chinese obese and overweight adults. Six anthropometric indices including a body shape index (ABSI), body mass index (BMI), ABSI combined with BMI, body roundness index (BRI), waist circumference and waist-to-hip ratio were calculated. Carotid-femoral pulse wave velocity (cf-PWV) was detected in all subjects. Meanwhile, visceral fat area (VFA) was quantificationally measured by CT. Partial Spearman correlation coefficients were used to clarify the association between anthropometric measures with cf-PWV. Logistic regression analyses were used to identify to the association between anthropometric measures and arterial stiffness. RESULTS: After adjusting for covariates, BRI had the strongest correlation with cf-PWV and VFA in all anthropometric indices. Multivariate regression analysis showed VFA (ß = 0.322, p < 0.001) and BRI (ß = 0.307, p < 0.001) remained independently associated with cf-PWV. BRI had a highest odds ratios in all anthropometric indices (OR = 1.543, p < 0.001). ABSI only displayed a weak correlation with arterial stiffness. Meanwhile, BRI had the highest area under curve for abnormal cf-PWV, and the optimum cutoff value was a BRI ≥5.4. CONCLUSION: BRI was found to have a close relationship with arterial stiffness in overweight and obesity people. However, ABSI was weakly correlated with arterial stiffness, but not better than traditional anthropometric indices.

The feasibility of two anthropometric indices to identify metabolic syndrome, insulin resistance and inflammatory factors in obese and overweight adults.

OBJECTIVES: A body shape index (ABSI) and body roundness index (BRI) were reported to predict diabetes and hypertension in general population, but their validity was regularly questioned. The aim of this study was to evaluate whether ABSI and BRI are the best anthropometric indices to reflect metabolic syndrome (MetS), insulin resistance (IR), and inflammatory factors in obese and overweight Chinese adults. METHODS: Cross-sectional data on sociodemographic, lifestyle, anthropometric indices, clinical characteristics, and biochemical measurements were collected for 1442 Chinese obese and overweight adults. Logistic regression analysis examined the associations between anthropometric indices with incidences of MetS and IR in both sexes. Furthermore, the correlation between anthropometric indices and inflammatory factors was assessed. RESULTS: Multivariate regression analysis depicting BRI and waist circumference (WC) were associated significantly with MetS and IR. BRI had the highest odds ratios (ORs) for IR and WC had the highest ORs for MetS in all anthropometric indices. However, ABSI did not exhibit any association between the MetS and IR. The ABSI adjusted regression coefficients (ß values) were 0.403 for high-sensitivity C reactive protein, 0.077 for tumor necrosis factor-α, and 0.022 for interleukin-6. BRI and WC were also significantly associated with three inflammatory factors. Comparing the lowest with the highest quintile, BRI had the largest ORs for MetS (OR, 5.778; 95% confidence interval [CI], 2.954-11.303; P < 0.01) and IR (OR, 6.212; 95% CI, 2.912-13.250; P < 0.01). CONCLUSION: Only BRI and WC, not ABSI, can significantly determine the presence of MetS and IR. BRI showed the optimal capability to identify IR in obese and overweight population.