Serum Adiponectin as a Predictor for Cardiovascular Outcomes in Non-Diabetic End-Stage Renal Disease Patients.
- Author:
Hye Rim AN
1
;
Sung Jin MOON
;
Hyeong Cheon PARK
;
Yong Kyu LEE
;
Jwa Kyung KIM
;
Beom Seok KIM
;
Hyung Jong KIM
;
Dae Suk HAN
;
Sung Kyu HA
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. Hask1951@yuhs.ac
- Publication Type:Original Article
- Keywords:
Adiponectin;
End-stage renal disease;
Cardiovascular disease
- MeSH:
Adiponectin;
Cardiovascular Diseases;
Creatinine;
Dialysis;
Fasting;
Follow-Up Studies;
Humans;
Insulin;
Kaplan-Meier Estimate;
Kidney Failure, Chronic;
Linear Models;
Peritoneal Dialysis;
Proportional Hazards Models;
Renal Dialysis;
Survival Rate;
Waist-Hip Ratio
- From:Korean Journal of Nephrology
2010;29(4):465-473
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Adiponectin (ADPN) has been known to protect against cardiovascular disease (CVD) in metabolic syndrome with normal renal function for its anti-inflammatory and anti-atherogenic property. However, it is still unclear whether ADPN is associated with cardiovascular outcomes in end-stage renal disease (ESRD) patients. METHODS: This study included 80 non-diabetic ESRD patients [mean age, 52.8+/-13.7 years; dialysis duration, 67.1+/-52.0 months; hemodialysis (HD), 35 pts; peritoneal dialysis (PD), 45 pts] who survived for more than 3 months after the start of dialysis, and serum ADPN levels were measured at the beginning of the study. We conducted a longitudinal follow-up to evaluate the association of serum ADPN level with cardiovascular outcomes for 29.3+/-6.7 months. RESULTS: ADPN was inversely correlated with fasting serum insulin (r=-0.309, p=0.006) and HOMA-IR (r=-0.321, p=0.004) in ESRD patients. In a multiple linear regression analysis adjusted for age, gender, waist to hip ratio (WHR), and HDL-cholesterol, HOMA-IR (beta=-0.880, p=0.041) was an independent factor associated with serum ADPN level. Kaplan-Meier analysis revealed that patients with higher ADPN levels (> or =15.8 microgram/mL) had a significantly higher survival rate compared with lowers (<15.8 microgram/mL) (p=0.032). Cox proportional hazard model adjusted for age, WHR, creatinine, CRP, and previous CVD history revealed that serum ADPN level (HR, 0.899; 95% CI, 0.818-0.987; p=0.026) was an independent determinant of cardiovascular outcomes. CONCLUSION: These findings suggest that lower ADPN levels independently predict cardiovascular events in non-diabetic ESRD patients.
