Increased lipogenesis and impaired β-oxidation predict type 2 diabetic kidney disease progression in American Indians
Rajendiran, Thekkelnaycke M
Fort, Patrice E
Gardner, Thomas W
Looker, Helen C
Nelson, Robert G
Brosius, Frank C
Feldman, Eva L
AffiliationUniv Arizona, Dept Med, Div Nephrol, Coll Med
MetadataShow full item record
PublisherAMER SOC CLINICAL INVESTIGATION INC
CitationJCI Insight. 2019; 4(21): e130317. https://doi.org/10.1172/jci.insight.130317.
RightsCopyright © 2019, American Society for Clinical Investigation.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractBACKGROUND. In this study, we identified the lipidomic predictors of early type 2 diabetic kidney disease (DKD) progression, which are currently undefined. METHODS. This longitudinal study included 92 American Indians with type 2 diabetes. Serum lipids (406 from 18 classes) were quantified using mass spectrometry from baseline samples when iothalamate-based glomerular filtration rate (GFR) was at least 90 mL/min. Affymetrix GeneChip Array was used to measure renal transcript expression. DIM progression was defined as at least 40% decline in GFR during follow-up. RESULTS. Participants had a mean age of 45 +/- 9 years and median urine albumin/creatinine ratio of 43 (interquartile range 11-144). The 32 progressors had significantly higher relative abundance of polyunsaturated triacylglycerols (TAGs) and a lower abundance of C16-C 2 0 acylcarnitines (ACs) ( P< 0.001). In a Cox regression model, the main effect terms of unsaturated free fatty acids and phosphatidylethanolamines and the interaction terms of C16-C20 ACs and short-low-double-bond TAGs by categories of albuminuria independently predicted DKD progression. Renal expression of acetyl-CoA carboxylase-encoding gene (ACACIA) correlated with serum diacylglycerols in the glomerular compartment (r = 0.36, and P = 0.006) and with low-double-bond TAGs in the tubulointerstitial compartment (r = 0.52. and P < 0.001). CONCLUSION. Collectively, the findings reveal a previously unrecognized link between lipid markers of impaired mitochondria beta-oxidation and enhanced lipogenesis and DKD progression in individuals with preserved GFR. Renal acetyl-CoA carboxylase activation accompanies these lipidomic changes and suggests that it may be the underlying mechanism linking lipid abnormalities to DKD progression.
VersionFinal published version
SponsorsUnited States Department of Health & Human Services - National Institutes of Health (NIH) - USA [R24DK082841, K08DK106523, R03DK121941, P30DK089503, P30DK081943, P30DK020572]; Program for Neurology Research and Discovery at Michigan Medicine; Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases - United States Department of Health & Human Services - National Institutes of Health (NIH) - National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)