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Purpose <p>Oxidative stress (OS) and endothelial dysfunction are major drivers of cardiovascular disease (CVD) in peritoneal dialysis (PD). MOTS-c, a mitochondria-derived peptide, is emerging as a key regulator of skeletal muscle health, metabolic homeostasis, and vascular function, yet its role in the uremic environment remains unexplored. We investigated the relationship between MOTS-c levels, OS markers, and vascular stiffness in PD patients.</p> Methods <p>This pilot, clinical study included 32 stable PD patients (mean age 60.7 ± 1.2&#xa0;years, 62.5% male). MOTS-c levels were quantified in serum (sMOTS-c), urine (uMOTS-c), and peritoneal dialysate (dMOTS-c). Systemic oxidative status was assessed via plasma Advanced Oxidation Protein Products (AOPPs). Vascular function was evaluated by carotid-femoral Pulse Wave Velocity (PWV), and left ventricular systolic function was assessed echocardiographically<b>.</b></p> Results <p>Urinary MOTS-c (uMOTS-c) levels were inversely correlated with serum AOPPs (R = − 0.592, <i>p</i> = <i>0.012)</i> and a positive association with PWV (R = 0.708, <i>p</i> = 0.001) and left ventricular systolic function (R = 0.440, <i>p</i> = <i>0.04</i>). Conversely, dialysate MOTS-c (dMOTS-c) were strongly and inversely correlated with PWV (R = − 0.717, <i>p</i> = 0.019) as well as systolic and diastolic blood pressure (R = -0.5, <i>p</i> &lt; <i>0.01)</i>.</p> Conclusion <p>Ηigher urinary MOTS-c was linked to lower systemic oxidative stress, suggesting a potential protective role, and associated with greater arterial stiffness, potentially reflecting a compensatory response to vascular injury. In contrast, higher peritoneal MOTS-c levels were associated with an improved vascular profile. These findings suggest a novel ‘Mitochondrial-Vascular Axis’ in uremia, highlighting MOTS-c as a potential biomarker.</p>

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MOTS-c is associated with oxidative stress and arterial stiffness in peritoneal dialysis patients: a pilot study

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Michela Musolino,
  • Athanasios Roumeliotis,
  • Stefanos Roumeliotis,
  • Mariateresa Zicarelli,
  • Federico Ruosi,
  • Marta Greco,
  • Roberta Misiti,
  • Daniela Patrizia Foti,
  • Vasiliki Sgouropoulou,
  • Gordana Kocic,
  • Andrej Veljkovic,
  • Ioannis E. Neofytou,
  • Ioannis Alekos,
  • Efthymios Papas,
  • Anila Duni,
  • Davide Bolignano,
  • Evangelia Dounousi,
  • Vassilios Liakopoulos

摘要

Purpose

Oxidative stress (OS) and endothelial dysfunction are major drivers of cardiovascular disease (CVD) in peritoneal dialysis (PD). MOTS-c, a mitochondria-derived peptide, is emerging as a key regulator of skeletal muscle health, metabolic homeostasis, and vascular function, yet its role in the uremic environment remains unexplored. We investigated the relationship between MOTS-c levels, OS markers, and vascular stiffness in PD patients.

Methods

This pilot, clinical study included 32 stable PD patients (mean age 60.7 ± 1.2 years, 62.5% male). MOTS-c levels were quantified in serum (sMOTS-c), urine (uMOTS-c), and peritoneal dialysate (dMOTS-c). Systemic oxidative status was assessed via plasma Advanced Oxidation Protein Products (AOPPs). Vascular function was evaluated by carotid-femoral Pulse Wave Velocity (PWV), and left ventricular systolic function was assessed echocardiographically.

Results

Urinary MOTS-c (uMOTS-c) levels were inversely correlated with serum AOPPs (R = − 0.592, p = 0.012) and a positive association with PWV (R = 0.708, p = 0.001) and left ventricular systolic function (R = 0.440, p = 0.04). Conversely, dialysate MOTS-c (dMOTS-c) were strongly and inversely correlated with PWV (R = − 0.717, p = 0.019) as well as systolic and diastolic blood pressure (R = -0.5, p < 0.01).

Conclusion

Ηigher urinary MOTS-c was linked to lower systemic oxidative stress, suggesting a potential protective role, and associated with greater arterial stiffness, potentially reflecting a compensatory response to vascular injury. In contrast, higher peritoneal MOTS-c levels were associated with an improved vascular profile. These findings suggest a novel ‘Mitochondrial-Vascular Axis’ in uremia, highlighting MOTS-c as a potential biomarker.