Short-chain fatty acids as predictors of renal function decline in patients with sarcopenia and CHF

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Аннотация

Objective. Evaluation of the relationship between the blood short-chain fatty acid (SCFA) levels and renal function in patients with sarcopenia and chronic heart failure (CHF).

Material and methods. The study included patients with CHF and sarcopenia who were treated at City Clinical Hospital No. 4 of the Moscow Healthcare Department (2019–2021). Sarcopenia was assessed using bioimpedance analysis, dynamometry, and the SPPB test, renal function was assessed using creatinine levels and the calculated glomerular filtration rate (SCF CKD-EPI), and plasma SCFA levels (C3–C6, including branched acids) were determined by HPLC-MS/MS. Statistical analysis was performed using the R 4.4.2 programming language in the RStudio environment (version 2024.12.0.467).

Results. The study included 74 patients with CHF and sarcopenia (mean age 68.3±5.7 years), who were characterized by high comorbidity: arterial hypertension was observed in 81٪ of patients, coronary artery disease - in 67٪, type 2 diabetes mellitus - in 36٪. Patients were characterized by reduced muscle strength, reduced skeletal muscle mass and limited physical performance. All examined patients showed an increase in SCFA levels compared to reference values. According to the univariate logistic regression data, significant predictors of a decrease in GFR <60 ml/min/1,73 m2 were isovaleric acid (50th percentile, OR=8,93; p<0.001), isobutyric acid (50th percentile, OR=6,69; p<0,001), 2-methylbutyric acid (50th percentile, OR=6,69; p<0,001) and caproic acid (25th percentile, OR=4,11; p=0,0072; 50th percentile, OR=4,60; p=0,0032). Caproic acid was of particular importance: an increase in its level by 25٪ was accompanied by a decrease in GFR by -2,26 ml/min/1,73 m2.

Conclusion. The study showed that in patients with sarcopenia and CHF, increased blood SCFA concentrations, in particular caproic, isovaleric, isobutyric and 2-methylbutyric, are associated with a significant decrease in GFR.

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Авторлар туралы

Anna Sokolova

Pirogov Russian National Research Medical University; Research Institute for Healthcare Organization and Medical Management

Хат алмасуға жауапты Автор.
Email: sokolova2211@gmail.com
ORCID iD: 0000-0003-0823-9190

Cand.Sci. (Med), Associate Professor, Department of Internal Medicine Propaedeutics No. 1, Institute of Clinical Medicine, Leading specialist, Organizational and Methodological Department for Therapy

Ресей, Moscow; Moscow

Dmitry Dragunov

Pirogov Russian National Research Medical University; Research Institute for Healthcare Organization and Medical Management

Email: tamops2211@gmail.com
ORCID iD: 0000-0003-1059-8387

Cand.Sci. (Med), Associate Professor, Department of Propaedeutics of Internal Medicine No. 1, Institute of Clinical Medicine, Head of the Organizational and Methodological Department for Therapy

Ресей, Moscow; Moscow

Anastasia Klimova

Pirogov Russian National Research Medical University; Research Institute for Healthcare Organization and Medical Management

Email: sokolova2211@gmail.com
ORCID iD: 0000-0002-3176-7699

Assistant Professor, Department of Propaedeutics of Internal Medicine No. 1, Institute of Clinical Medicine, Specialist, Organizational and Methodological Department for Therapy

Ресей, Moscow; Moscow

Elena Stafeeva

Pirogov Russian National Research Medical University

Email: alena.stafeeva16@yandex.ru

Cand.Sci. (Med), Assistant Professor, Department of Propaedeutics of Internal Medicine No. 1, Institute of Clinical Medicine

Ресей, Moscow

Aleksandr Stafeev

Pirogov Russian National Research Medical University; Sechenov First Moscow State Medical University (Sechenov University)

Email: i@stafeev-pro.ru

Teaching Assistant at the Department of Hospital Therapy No. 2

Ресей, Moscow; Moscow

Yaroslav Golubev

Pirogov Russian National Research Medical University

Email: sokolova2211@gmail.com

Junior Researcher, Research and Testing Center, Department of Medical Chemistry and Toxicology, Institute of Pharmacy and Medical Chemistry

Ресей, Moscow

Tatyana Shmigol

Pirogov Russian National Research Medical University

Email: sokolova2211@gmail.com
ORCID iD: 0000-0002-5195-0845

Cand.Sci. (Biol.), Head of the Department of Medical Chemistry and Toxicology, Associate Professor at the Department of Chemistry, Institute of Pharmacy and Medical Chemistry

Ресей, Moscow

Vadim Negrebetsky

Pirogov Russian National Research Medical University

Email: sokolova2211@gmail.com
ORCID iD: 0000-0001-6852-8942

Dr.Sci. (Chem.), Professor of the Russian Academy of Sciences, Associate Professor, Director of the Institute of Pharmacy and Medical Chemistry, Director of the Research and Testing Center of the Institute of Pharmacy and Medical Chemistry, Head of the Department of Chemistry, Institute of Pharmacy and Medical Chemistry

Ресей, Moscow

Grigory Arutyunov

Pirogov Russian National Research Medical University

Email: arutyunov_gp@rsmu.ru
ORCID iD: 0000-0002-6645-2515

Dr.Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Director of the Institute of Clinical Medicine, Head of the Department of Propaedeutics of Internal Medicine No. 1, Institute of Clinical Medicine

Ресей, Moscow

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2. Fig. Univariate logistic regression: outcome - decrease in GFR less than 60 ml/min. Green dots p<0.05; red dots p>0.05.

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