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
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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
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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)