H decreasing inflammatorycytokines has been reported [13]. In our study, by using aspirin as positive control we confirmed these findings. Thus we conclude that aspirin may enhance the 10781694 insulin sensitivity by protecting IRS proteins from serine phosphorylation catalyzed by NF-kB and JNK. HLJDT, a combination of herbs used in traditional Chinese medicine, consists of four medicinal compositions. Coptidis rhizome is the principal drug in HLJDT and Berberine hydrochloride, a key component of coptidis rhizome, has shown inhibitory effect on Title Loaded From File inflammation [30]. Although the effects of HLJDT on anti-inflammation and IR have been reported [31,32], the underlying mechanism remains elusive. In our study, we found that HLJDT could reduce inflammatory mediators and improve IR, and this is associated with the inhibition of NF-kB activation induced by inflammatory cytokines. Compared with aspirin, the effects of HLJDT on reducing inflammation and increasing insulin-sensitivity were not significantly different. In conclusion, insulin resistance induced by inflammation in MS could impair cardiac structure and function. Thus, increasing insulin sensitivity could contribute to MS therapy. The traditional Chinese medicine such as HLJDT could be an effective strategy to improve IR and protect MS patients from IR-mediated cardiac injury.AcknowledgmentsWe thank Ming-xiang ZHANG, Fan JIANG, Hong JIANG and Xu-ping WANG for their excellent technical help.Author Title Loaded From File ContributionsConceived and designed the experiments: YGC XPJ. Performed the experiments: CBL XXL PLB. Analyzed the data: XXL. Contributed reagents/materials/analysis tools: HQG YZ. Wrote the paper: CBL.
Abdominal obesity (AO), known as an over-accumulation of visceral adiposity that can be estimated by waist circumference (WC), is prevalent in hemodialysis (HD) patients [1]. In the general population, AO is characterized by chronic low grade inflammation with increased serum inflammatory cytokine levels; it is considered to be a risk factor for atherosclerosis, cardiovascular disease, and increased mortality [2]. Postorino et al. have shown that high WC is associated with a high risk of cardiovascular mortality in patients with chronic kidney disease (CKD) as well as dialysis patients [3]. In addition, Witasp et al. [4] recently revealed increased proinflammatory gene expression in subcutaneous abdominal fat in patients with advanced CKD, providing a biological insight at the cellular level and linking obesity with inflammation in CKD patients. Recent available data suggest that peripheral artery disease (PAD) is prevalent in HD patients and is a strong predictor for subsequent cardiovascular and overall mortality [5?]. Althoughtraditional cardiovascular disease risk factors such as smoking and diabetes are strong risk factors for PAD [7], only AO, but not generalized obesity, has been shown to be associated with PAD in the general population [8?]. The association of AO and PAD in HD patients has not been elucidated thus far. The ankle brachial index (ABI) was reported to be a good marker for atherosclerosis and to be useful in the diagnosis of PAD [10]. Because prior findings demonstrated an association of AO with PAD in the general population, we hypothesized that HD patients with AO will have a higher prevalence of low ABI values and clinical PAD. In addition, we investigated the relationship between AO and various biochemical markers, which reflected the status of systemic inflammation and insulin resi.H decreasing inflammatorycytokines has been reported [13]. In our study, by using aspirin as positive control we confirmed these findings. Thus we conclude that aspirin may enhance the 10781694 insulin sensitivity by protecting IRS proteins from serine phosphorylation catalyzed by NF-kB and JNK. HLJDT, a combination of herbs used in traditional Chinese medicine, consists of four medicinal compositions. Coptidis rhizome is the principal drug in HLJDT and Berberine hydrochloride, a key component of coptidis rhizome, has shown inhibitory effect on inflammation [30]. Although the effects of HLJDT on anti-inflammation and IR have been reported [31,32], the underlying mechanism remains elusive. In our study, we found that HLJDT could reduce inflammatory mediators and improve IR, and this is associated with the inhibition of NF-kB activation induced by inflammatory cytokines. Compared with aspirin, the effects of HLJDT on reducing inflammation and increasing insulin-sensitivity were not significantly different. In conclusion, insulin resistance induced by inflammation in MS could impair cardiac structure and function. Thus, increasing insulin sensitivity could contribute to MS therapy. The traditional Chinese medicine such as HLJDT could be an effective strategy to improve IR and protect MS patients from IR-mediated cardiac injury.AcknowledgmentsWe thank Ming-xiang ZHANG, Fan JIANG, Hong JIANG and Xu-ping WANG for their excellent technical help.Author ContributionsConceived and designed the experiments: YGC XPJ. Performed the experiments: CBL XXL PLB. Analyzed the data: XXL. Contributed reagents/materials/analysis tools: HQG YZ. Wrote the paper: CBL.
Abdominal obesity (AO), known as an over-accumulation of visceral adiposity that can be estimated by waist circumference (WC), is prevalent in hemodialysis (HD) patients [1]. In the general population, AO is characterized by chronic low grade inflammation with increased serum inflammatory cytokine levels; it is considered to be a risk factor for atherosclerosis, cardiovascular disease, and increased mortality [2]. Postorino et al. have shown that high WC is associated with a high risk of cardiovascular mortality in patients with chronic kidney disease (CKD) as well as dialysis patients [3]. In addition, Witasp et al. [4] recently revealed increased proinflammatory gene expression in subcutaneous abdominal fat in patients with advanced CKD, providing a biological insight at the cellular level and linking obesity with inflammation in CKD patients. Recent available data suggest that peripheral artery disease (PAD) is prevalent in HD patients and is a strong predictor for subsequent cardiovascular and overall mortality [5?]. Althoughtraditional cardiovascular disease risk factors such as smoking and diabetes are strong risk factors for PAD [7], only AO, but not generalized obesity, has been shown to be associated with PAD in the general population [8?]. The association of AO and PAD in HD patients has not been elucidated thus far. The ankle brachial index (ABI) was reported to be a good marker for atherosclerosis and to be useful in the diagnosis of PAD [10]. Because prior findings demonstrated an association of AO with PAD in the general population, we hypothesized that HD patients with AO will have a higher prevalence of low ABI values and clinical PAD. In addition, we investigated the relationship between AO and various biochemical markers, which reflected the status of systemic inflammation and insulin resi.