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

Sokolova A.V., Dragunov D.O., Klimova A.V., Stafeeva E.A., Stafeev A.N., Golubev Ya.V., Shmigol T.A., Negrebetsky V.V., Arutyunov G.P.

1) Pirogov Russian National Research Medical University, Moscow, Russia; 2) Research Institute for Healthcare Organization and Medical Management, Moscow, Russia; 3) Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

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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About the Authors

Anna V. Sokolova – Cand.Sci. (Med), Associate Professor, Department of Internal Medicine Propaedeutics No. 1, Institute of Clinical Medicine; Leading specialist, Organizational and Methodological Department for Therapy, Pirogov Russian National Research Medical University (Pirogov University). Address: 1 Ostrovityanov St., Moscow, 117513; e-mail: sokolova2211@gmail.com. ORCID: 0000-0003-0823-9190.
Dmitry O. Dragunov – 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, Pirogov Russian National Research Medical University (Pirogov University). Address: 1 Ostrovityanov St., Moscow, 117513.; e-mail: tamops2211@gmail.com. ORCID: 0000-0003-1059-8387.
Anastasia V. Klimova – Assistant Professor, Department of Propaedeutics of Internal Medicine No. 1, Institute of Clinical Medicine; Specialist, Organizational and Methodological Department for Therapy, Pirogov Russian National Research Medical University (Pirogov University). Address: 1 Ostrovityanov St., Moscow, 117513. ORCID: 0000-0002-3176-7699.
Elena A. Stafeeva – Cand.Sci. (Med), Assistant Professor, Department of Propaedeutics of Internal Medicine No. 1, Institute of Clinical Medicine, Pirogov Russian National Research Medical University (Pirogov University). Address: 1 Ostrovityanov St., Moscow, 117513; e-mail: alena.stafeeva16@yandex.ru.
Aleksandr N. Stafeev – Teaching Assistant at the Department of Hospital Therapy No. 2, Sechenov First Moscow State Medical University (Sechenov University).
Address: Bldg 2, 8 Trubetskaya, Moscow, 119048; e-mail: i@stafeev-pro.ru.
Yaroslav V. Golubev – Junior Researcher, Research and Testing Center, Department of Medical Chemistry and Toxicology, Institute of Pharmacy and Medical Chemistry. Address: Bldg 6 1 Ostrovityanov St., Moscow, 117513.
Tatyana A. Shmigol – 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. Address: Bldg 6 1 Ostrovityanov St., Moscow, 117513; ORCID: 0000-0002-5195-0845.
Vadim V. Negrebetsky – 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. Address: Bldg 6 1 Ostrovityanov St., Moscow, 117513; ORCID: 0000-0001-6852-8942.
Grigory P.Arutyunov – 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, Pirogov Russian National Research Medical University (Pirogov University).
Address: 1 Ostrovityanov St., Moscow, 117513; e-mail: arutyunov_gp@rsmu.ru. ORCID: 0000-0002-6645-2515.

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