The Potential Relationship Between Serum Irisin Concentration With Inflammatory Cytokines, Oxidative Stress Biomarkers, Glycemic Indices and Lipid Profiles in Obese Patients With Type 2 Diabetes Mellitus: A Pilot Study.

Objectives: Diabetes mellitus is a serious health-treated problem identified by disorders such as insulin resistance, dyslipidemia, and inflammation. Irisin, a newly discovered myokine/adipokine, is involved in metabolic homeostasis. The present study was carried out to investigate the potential relationship between serum irisin with inflammatory cytokines, oxidative stress biomarkers, glycemic indices, and lipid profiles in obese patients with type 2 diabetes mellitus. Methodology: This analytical cross-sectional study was conducted on 62 participants (n=32 obese participants with diabetes, n=30 participants with normal weight). The participants answered a demographic questionnaire. Serum irisin, glycemic indices, lipid profiles, inflammatory cytokines and oxidative stress biomarkers were measured using standard methods. The difference between groups was assessed by independent-sample t-test or by a non-parametric equivalent. For qualitative variables, the Chi-Square test was used. Pearson rho coefficient was used to determine the potential relationship between irisin and inflammatory cytokines, oxidative stress biomarkers, glycemic indices, and lipid profiles. A p<0.05 was defined as significant. Results: The median (IQR) age of the obese participants with diabetes was 54.0 years (52.2-60.7) and in the normal weight group was 38.0 years (30.0-47.2) (p<0.001). About 78% and 60% of participants in the obese with diabetes and the normal weight groups were females (p>0.05), respectively. Significant differences were observed in serum irisin levels between the two groups, with lower levels (218.74 ng/mL, [144.98-269.26]) noted in the obese with diabetes group compared to the normal weight group (266.68 ng/mL, [200.64-336.57]) with a p=0.024. There was a substantial difference between the two groups regarding IL-6, TNF-α, and hs-CRP (p<0.05). IL-6 had a moderate negative correlation with irisin in obese patients with T2DM (r=-0.478, p=0.006). Conclusion: Irisin concentration was detected to be lower in obese people with diabetes. A negative relationship was detected between irisin and IL-6. Considering emerging evidence about the beneficial functions of irisin in improving metabolic abnormalities, designing future studies with greater sample sizes that will validate these results is needed.

The impact of acute rejection in kidney transplantation on long-term allograft and patient outcome.

BACKGROUND: Patients with end stage renal disease (ESRD) can be sustained with dialysis therapy. OBJECTIVES: In this study, we followed up the effect of early acute and late acute rejections on survival rates of patients' grafts. PATIENTS AND METHODS: We investigated the timing and frequency of acute rejection episodes related to long-term patient-graft survival in Taleghani hospital between 1990 and 2011. Recipients were divided into three groups as Group-1 (no rejection), Group-2 (early acute rejection [EAR]: less than 3-months) and Group-3 (late acute rejection [LAR]: after 3 months of transplant). RESULTS: One and five-year patient's survival rates were 94.87% and 93.8%, and graft survival (GS) rates were 92.6% and 81.9%. EAR and LAR occurred in 125 (18.8%) and 77 (11.7%) patients, respectively. Graft and patient survival rates at one and five years were as follows; Group-1 (Graft 96.7% and 94.5% patient: 97.4% and 96.8%), Group-2 (Graft: 72% and 61%, patient: 85.6% and 84%), Group-3 (Graft: 84.4% and 36.8%, patient: 92.2% and 89.4%). Recipient age, type and length of dialysis, number of transplantations and the status of panel reactivity antibody (PRA) had no effect on the type of rejection. LAR was more commonly associated with males (P = 0.001) and donors' age was associated with rejection (P = 0.0002). Five-year GS rate among the three groups was lower in the LAR group (P < 0.0001). CONCLUSIONS: LAR had a negative impact on long-term renal allograft survival and the risk of chronic graft dysfunction increased in patients with a history of LAR.

Delayed graft function, allograft and patient srvival in kidney transplantation.

INTRODUCTION: Delayed Graft Function (DGF) is a common complication of renal transplants and the long-term relation between DGF and survival of patients and grafts is not well established. METHODS: This is a historical cohort study of transplanted patients in Taleghani Hospital of Shahid Beheshti University in Iran between 1994 and 2010. Patients who required dialysis during the first week after transplantation were considered to have DGF. The patients' conditions were updated to determine existing graft function, graft loss or patients' death at one year and five years post transplantation in relation to the presence or absence of DGF. RESULTS: DGF complicated 67/385 transplants (17.4%). Causes included acute tubular necrosis (58.2%), accelerated rejection (29.9%), transplant renal artery thrombosis (9%) and renal vein thrombosis (3%). More kidneys in the DGF group were procured from cadaveric donors (6% versus 0.9%, P = 0.02). At hospital discharge, patients with DGF had significantly higher mean creatinine level (4.4 ± 2.8 versus 2.0 ± 1.7; P = 0.001) compared to other patients. They also had more early acute rejection episodes and more late acute rejection episodes (34.3% versus 2% and 16.4% versus 3%, respectively; P = 0.0001) compared to other patients. The proportion of functioning grafts was significantly lower in the DGF group at 1-year (53.7% versus 95.3%, P = 0.0001) and 5-years (22.4% versus 61.6%, P = 0.001) compared to patients without DGF. CONCLUSION: The DGF group had a significantly higher acute rejection rate and an increased risk of graft loss at one and five years.