Hypoadiponectinemia and the presence of metabolic syndrome in patients with chronic kidney disease: results from the KNOW-CKD study

Diabetology & Metabolic Syndrome, Nov 2016

Background In patients with chronic kidney disease, metabolic syndrome has been demonstrated to be the culprit behind diverse complications. Adiponectin is known to have anti-atherogenic and cardio-protective effects. Meanwhile, the relationship between adiponectin and metabolic syndrome in patients with chronic kidney disease has not been clarified. The aim of this study was to elucidate the relationship between adiponectin level and metabolic syndrome in patients with chronic kidney disease. Methods The KoreaN Cohort Study for Outcome in Patients with Chronic Kidney Disease is a cohort study that enrolled subjects with chronic kidney disease throughout South Korea. From February 2011 to July 2014, data were collected from 1332 patients with chronic kidney disease. Results The mean age of the patients was 53.5 years and 803 patients (60.7%) were men. The median adiponectin level was 10.7 μg/mL and 585 (44.3%) patients had metabolic syndrome. In multiple linear regression analysis, log adiponectin was positively associated with high-density lipoprotein cholesterol levels (β = 0.006), whereas it was negatively associated with serum albumin (β = −0.284), triglyceride (log β = −0.288), high sensitivity C-reactive protein (log β = −0.058) levels and estimated glomerular filtration rate (β = −0.005). Multiple logistic regression analysis indicated that low adiponectin level was independently associated with a higher risk of metabolic syndrome (per 1 μg/mL increase; odds ratio = 0.953, 95% confidence interval = 0.898–0.970, P < 0.001) after adjustment for multiple confounding factors. Conclusions Hypoadiponectinemia is independently associated with the presence of metabolic syndrome in patients with chronic kidney disease.

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Hypoadiponectinemia and the presence of metabolic syndrome in patients with chronic kidney disease: results from the KNOW-CKD study

Yoon et al. Diabetol Metab Syndr Hypoadiponectinemia and the presence of metabolic syndrome in patients with chronic kidney disease: results from the KNOW-CKD study ChangY‑un Yoon 0 3 Yung Ly Kim 0 3 Seung Hyeok Han 0 3 Tae‑Hyun Yoo 0 3 Su‑Ah Sung 2 Woo‑kyung Chung 1 DongW‑an Chae 6 Yong‑Soo Kim 5 Curie Ahn 4 Kyu Hun Choi 0 3 0 Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University , 50 Yonsei‐ro, Seodaemun‐gu, Seoul 120‐752 , Republic of Korea 1 Department of Internal Medicine, Gachon University School of Medicine , Incheon , Republic of Korea 2 Department of Internal Medicine, Eulji General Hospital , Seoul , Republic of Korea 3 Department of Internal Medicine, College of Medicine, Institute of Kid‐ ney Disease Research, Yonsei University , 50 Yonsei‐ro, Seodaemun‐gu, Seoul 120‐752 , Republic of Korea 4 Department of Internal Medicine, Seoul National University Hospital , Seoul , Republic of Korea 5 Department of Internal Medicine , Seoul St. Mary Hospital, Catholic University of Korea , Seoul , Republic of Korea 6 Depart‐ ment of Internal Medicine, Seoul National University Bundang Hospital , Gyeo‐ nggi‐do, Seongnam , Republic of Korea Background: In patients with chronic kidney disease, metabolic syndrome has been demonstrated to be the culprit behind diverse complications. Adiponectin is known to have anti‑ atherogenic and cardio‑ protective effects. Meanwhile, the relationship between adiponectin and metabolic syndrome in patients with chronic kidney disease has not been clarified. The aim of this study was to elucidate the relationship between adiponectin level and metabolic syndrome in patients with chronic kidney disease. Methods: The KoreaN Cohort Study for Outcome in Patients with Chronic Kidney Disease is a cohort study that enrolled subjects with chronic kidney disease throughout South Korea. From February 2011 to July 2014, data were collected from 1332 patients with chronic kidney disease. Results: The mean age of the patients was 53.5 years and 803 patients (60.7%) were men. The median adiponectin level was 10.7 μg/mL and 585 (44.3%) patients had metabolic syndrome. In multiple linear regression analysis, log adiponectin was positively associated with high‑ density lipoprotein cholesterol levels (β = 0.006), whereas it was negatively associated with serum albumin (β = −0.284), triglyceride (log β = −0.288), high sensitivity C‑ reactive protein (log β = −0.058) levels and estimated glomerular filtration rate (β = −0.005). Multiple logistic regression analysis indicated that low adiponectin level was independently associated with a higher risk of metabolic syndrome (per 1 μg/mL increase; odds ratio = 0.953, 95% confidence interval = 0.898-0.970, P < 0.001) after adjustment for multiple confounding factors. Conclusions: Hypoadiponectinemia is independently associated with the presence of metabolic syndrome in patients with chronic kidney disease. Adiponectin; Chronic kidney disease; Metabolic syndrome - Metabolic syndrome is defined as the aggregation of non-traditional risk factors, including central obesity, hypertension, hyperglycemia, hypertriglyceridemia, and decreased high-density lipoprotein cholesterol (HDL-C) [1]. The clinical significance of metabolic syndrome is its association with endocrinologic derangement, cardiovascular events [2], and renal impairment [3] in the general population. In addition, unfavorable clinical relationships were also reported in patients with chronic kidney disease on maintenance dialysis [4]. Adiponectin, which is released from adipocytes [5], is known to have anti-atherogenic and cardio-protective effects. It is chiefly related to insulin resistance and © The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. systemic inflammation, which are important factors for non-traditional risks of adverse outcome in chronic kidney disease [6]. Hypoadiponectinemia is related to metabolic syndrome [7] and increased intima-media thickness, which is a well-known early indicator of atherosclerosis in the general population [8] and in patients with chronic kidney disease [9]. However, the relationship between adiponectin level and metabolic syndrome in patients with chronic kidney disease has not been definitely clarified [10]. Decreased estimated glomerular filtration rate (eGFR), which is a well-known risk factor of metabolic syndrome, is significantly and independently relate (...truncated)


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Chang-Yun Yoon, Yung Kim, Seung Han, Tae-Hyun Yoo, Su-Ah Sung, Woo-kyung Chung, Dong-Wan Chae, Yong-Soo Kim, Curie Ahn, Kyu Choi. Hypoadiponectinemia and the presence of metabolic syndrome in patients with chronic kidney disease: results from the KNOW-CKD study, Diabetology & Metabolic Syndrome, 2016, pp. 75, 8, DOI: 10.1186/s13098-016-0191-z