Distribution of serum adiponectin isoforms in pediatric patients with steroid-sensitive nephrotic syndrome

Abstract

Background Serum adiponectin circulates in three multimeric isoforms: high-molecular-weight (HMW), middle-molecular-weight (MMW), and low-molecular-weight (LMW) isoforms. Potential change in the circulating adiponectin levels in patients with nephrotic syndrome (NS) remain unknown. This study aimed to assess the levels of total adiponectin and the distribution of its isoforms in pediatric patients with NS. Methods We sequentially measured total adiponectin and each adiponectin isoform levels at the onset of NS, initial remission, and during the remission period of the disease in 31 NS patients. We also calculated the ratios of HMW (%HMW), MMW (%MMW), and LMW (%LMW) to total adiponectin incuding 51 control subjects. Results The median of total serum adiponectin levels in patients were 36.7, 36.7, and 20.2 μg/mL at the onset, at initial remission, and during the remission period of NS, respectively. These values were significantly higher than those in control subjects. The median values of %HMW, %MMW, and %LMW values were 56.9/27.0/14.1 at the onset, 62.0/21.8/13.4 at the initial remission, and 58.1/21.7/17.5 at during the remission period of NS, respectively. Compared with control subjects, %HMW at initial remission and %MMW at the onset were high, and the %LMW values at the onset and at initial remission were low. Conclusions In patients with NS, total serum adiponectin levels increase at the onset of the disease, and the ratio of adiponectin isoforms changes during the course of the disease. Further studies are needed to delineate the mechanisms between proteinuria and adiponectin isoforms change.

Tiopronin-nephropathy in a female adolescent patient with cystinuria

“…Although urinary excretion of protein and selectivity index were not assessed, the patient s proteinuria was accompanied by 2.2 g/dL of hypoalbuminemia (≤2.5 g/dL), hyperlipidemia, and high level of adiponectin (24.9 µg/mL). It has previously been shown that the serum adiponectin level is elevated in pediatric patients of steroid sensitive nephrotic syndrome (SSNS), especially minimal change nephrotic syndrome (MCNS), which is most frequent among pediatric patients with SSNS 20) . The above-mentioned findings in our patient were consistent with nephrotic syndrome.…”

Biomarkers to predict steroid resistance in idiopathic nephrotic syndrome: a systematic review

“…Elevated levels of serum adiponectin have been reported in patients with FSGS, chronic kidney disease, end-stage renal disease, those on dialysis and transplant recipients [44][45][46]. Total serum levels of adiponectin rise following the onset of nephrotic syndrome with notable changes in the ratios of the three adiponectin isoforms [47]. A recent study noticed that levels start lower and show a significant decrease following steroid treatment in children with SSNS whereas in children with SRNS levels start higher and increase following treatment [20].…”