Serum nitric oxide is associated with the risk of chronic kidney disease in women: Tehran lipid and glucose study

Abstract

Background and aim This study was conducted to investigate the association between serum nitric oxide metabolites (NOx) and the risk of chronic kidney disease (CKD). Methods We recruited 3462 and 2504 participants of the Tehran Lipid and Glucose Study (TLGS), for a cross-sectional and prospective analysis, respectively. Serum NOx concentrations were measured at baseline (2006–2008), and demographics, anthropometrics and biochemical variables were evaluated at baseline and again after 3 years (2009–2011). Estimated glomerular filtration rate (eGFR) and CKD were defined. Association between serum NOx and CKD in the cross-sectional phase and the predictability of NOx in CKD occurrence were assessed using multivariable logistic regression models with adjustment for confounders. Results Mean age of participants was 45.0 ± 15.9 years at baseline and 40.5% were male. The prevalence of CKD was 17.9% (13.4% in men, 21.0% in women) at baseline, at which point, marginally significant odds of CKD in the highest tertile of serum NOx in men (OR = 1.53, 95% CI = 0.96–2.45, p for trend = 0.047) and a significant odds of CKD in women (OR = 2.48, 95% CI = 1.76–3.49, p for trend = 0.001) were observed. After a 3-year follow-up, in women, risk of CKD was higher in the highest compared to the lowest NOx tertiles (OR = 1.86, 95% CI = 1.10–3.14, p for trend = 0.032) but no significant association was observed in men. Conclusion Serum NOx level was found to be an independent predictor of CKD in women; it could be a valuable surrogate for prediction of renal dysfunction in women and help to identify high-risk subjects.

KeyWords:

• Nitric oxide
• nitric oxide metabolites
• estimated glomerular filtration rate
• chronic kidney disease

Acknowledgements

We thank the Tehran Lipid and Glucose Study participants and the field investigators of the Tehran Lipid and Glucose Study for their cooperation and assistance in physical examinations, biochemical evaluation and database management. This study was supported by grant no. 121 from the National Research Council of the Islamic Republic of Iran and the Research Institute for Endocrine Sciences of Shahid Beheshti University of Medical Sciences. We thank Ms N. Shiva for critical editing of the English grammar and syntax of the manuscript.

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.