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NDT Advance Access originally published online on September 2, 2006
Nephrology Dialysis Transplantation 2006 21(12):3475-3480; doi:10.1093/ndt/gfl423
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Steroid pulse therapy impaired endothelial function while increasing plasma high molecule adiponectin concentration in patients with IgA nephropathy

Haruhito Adam Uchida1, Yoshio Nakamura2, Masanobu Kaihara1, Hisanao Norii1, Yoshihisa Hanayama1, Hitoshi Sugiyama1, Yohei Maeshima1, Yasushi Yamasaki1 and Hirofumi Makino1

1Department of Medicine and Clinical Science and 2Department of Laboratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

Correspondence and offprint requests to: Yoshio Nakamura, MD, Department of Laboratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Email: yoshin2{at}md.okayama-u.ac.jp

Background. Decreased plasma adiponectin is associated with impaired endothelial function and, thereby, increased risk for cardiovascular events. Glucocorticoid (GC) affects vascular endothelial cells either favourably or harmfully depending upon the dosages and duration. We examined the effect of GC pulse therapy on vascular endothelial function.

Methods. Fourteen young patients with IgA nephropathy were evaluated for flow-mediated vasodilation (FMD), plasma levels of adiponectin both in high molecular weight (HMW adiponectin) form and in single molecular form (total adiponectin), hepatocyte growth factor (HGF), asymmetric dimethylarginine (ADMA), and high-sensitive C-reactive protein, before and after a course of GC pulse therapy.

Results. GC pulse therapy significantly decreased FMD (from 7.2 ± 2.6 to 5.7 ± 2.5%, P < 0.01). Meanwhile, plasma adiponectin levels were significantly augmented (total adiponectin: from 10.2 ± 4.0 to 12.1 ± 6.3 µg/ml, P < 0.05; HMW: from 6.5 ± 3.2 to 7.7 ± 3.3 µg/ml, P < 0.05). In parallel, elevated concentrations of serum HGF (from 0.28 ± 0.12 to 0.63 ± 0.38 ng/ml, P < 0.01) and plasma ADMA (from 0.45 ± 0.07 to 0.53 ± 0.04 nmol/ml, P < 0.05) were observed.

Conclusions. GC pulse therapy impaired endothelial function while increasing plasma adiponectin levels, which may in turn restore the endothelial function in patients with IgA nephropathy.

Keywords: asymmetric dimethylarginine; endothelial dysfunction; glucocorticoid; hepatocyte growth factor; high molecular weight adiponectin; IgA nephropathy


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