Korean J Nephrol.  2010 Jul;29(4):465-473.

Serum Adiponectin as a Predictor for Cardiovascular Outcomes in Non-Diabetic End-Stage Renal Disease Patients

• An HR
• Moon SJ
• Park HC
• Lee YK
• Kim JK
• Kim BS
• Kim HJ
• Han DS
• Ha SK

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.

Keyword

Adiponectin; End-stage renal disease; Cardiovascular disease

MeSH Terms

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
Adiponectin
Creatinine
Insulin