Madhavi Bhatia, National Institute of Pharmaceutical Education and Research, Guwahati
Metabolic syndrome (MetS) is a group of cardiometabolic conditions that are leading contributors to an elevated risk for cardiovascular disease (CVD) and type II diabetes. Many consequences have been identified which occur due to MetS, an increased risk of fatty liver disease, renal disease, and low-grade chronic inflammation; this collectively leads to an increased risk of premature death. There are various molecular biomarkers such as liver enzymes –alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) serve as reliable indicators of past exposures and future adverse cardiometabolic abnormalities. Elevated kidney biomarkers may indicate vascular injury of the kidney and systemic endothelial dysfunction. Elevated liver enzymes may reflect liver dysfunction which is related to alcohol abuse, insulin resistance, or impaired perfusion that has been linked to venous congestion and renal dysfunction.
A U.S. National Health and Nutrition Examination Survey was conducted which revealed that one-third of all adults in the U.S. have MetS. This study aimed to identify the relationship between kidney and liver dysfunction with MetS, and all-cause, and CHD mortality.
MetS was more common in old age, in higher proportion in males, and smokers. Most biomarker ratios of liver and kidney function tend to be higher in individuals with MetS than individuals without MetS. Positive associations were observed between all-cause mortality and elevated levels of albuminuria, AST-ALT. Positive associations with CHD mortality were observed with elevated levels of UCAR, AST-ALT. But all-cause/CHD mortality was not associated with prevalent MetS.
Clinical applications-
The study of kidney and liver biomarkers helps us to understand all-cause and cardiovascular mortality. A UACR or BUN-CR test is used in the prediction of renal dysfunction or nephropathy. GGT-ALP levels help in determining whether the source of disease could be due to liver or bone pathology. The ratio of AST-ALT elevates in case of hepatitis, cirrhosis, necroinflammation.
Future prospects-
In the future, studies are required to understand the utility of kidney and liver biomarker ratios in the prediction of all-cause and cause-specific mortality. Further longitudinal studies should be done for in-depth tracking and analysis of the long-term impact of these biomarkers on high-risk adults to improve risk in chronic disease management.
Reference- Oye-Somefun, A., Kuk, J.L. & Ardern, C.I. Associations between elevated kidney and liver biomarker ratios, metabolic syndrome and all-cause and coronary heart disease (CHD) mortality: analysis of the U.S. National Health and Nutrition Examination Survey (NHANES). BMC Cardiovasc Disord 21, 352 (2021). https://doi.org/10.1186/s12872-021-02160-w
About the author
Madhavi Bhatia is currently pursuing a Master of Science in Pharmaceutical Biotechnology from NIPER, Guwahati. Her area of interest lies in understanding the role of gene mutation in the development of various diseases and developing a treatment for such diseases.
Publications-
1.https://bioxone.in/news/worldnews/mitotox-a-database-about-mitochondrial-toxicity/
2. https://bioxone.in/news/worldnews/mutation-prone-regions-of-the-human-dna-revealed/
3. https://bioxone.in/news/worldnews/the-recurrence-of-kidney-cancer-can-be-reduced/
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