Low serum adiponectin level is associated with better physical health-related quality of life in chronic kidney disease

Abstract

Hyperadiponectemia is paradoxically associated with renal disease progression and mortality in chronic kidney disease (CKD). Its association with health-related quality of life (HR-QOL) is unknown. This study aimed to verify the association between adiponectin and HR-QOL in Korean pre-dialysis CKD cohort. This cross-sectional study analyzed 1551 pre-dialysis CKD patients from KNOW-CKD (KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease). Participants were categorized into three tertiles (T1–T3) according to adiponectin levels. HR-QOL was assessed using SF-36. High physical component summary (PCS) and mental component summary (MCS) were defined as highest quartile of each score. Multivariate logistic regression was used to analyze odds ratio (OR) and 95% confidence interval (CI) for high PCS and MCS. Prevalence of high PCS were 33.3%, 27.5%, and 17.0% and that of high MCS were 31.7%, 24.8%, and 21.3% for T1, T2, and T3 (both p for trend < 0.001). The adjusted OR [95% CI] of T1 and T2 in reference to T3 were 1.56 [1.09–2.23] and 1.19 [0.85–1.68] for high PCS and 1.19 [0.85–1.68] and 0.94 [0.68–1.29] for high MCS. Serum adiponectin level was inversely associated with physical HR-QOL in Korean pre-dialysis CKD patients. This relationship was independent of various cardiovascular risk factors.

Association of High Serum Adiponectin Level With Adverse Cardiovascular Outcomes and Progression of Coronary Artery Calcification in Patients With Pre-dialysis Chronic Kidney Disease

“…Our finding in the current study is contrary to the previous reports from the general population with CAD ( 8 – 10 ), where low serum adiponectin level has been suggested as a predictor of CAC. The results in this study are rather in accordance with previous studies ( 14 – 16 ) that demonstrated the adiponectin paradox. A fundamental question to the adiponectin paradox is whether the biological action of adiponectin is actually altered in a context-dependent manner.…”

“…A study targeting the association of adipokines with blood pressure in rural Chinese adolescents reported that adiponectin was negatively associated with SBP only in men ( 13 ). Mounting evidence also suggests that chronic kidney disease (CKD) should alter the clinical interpretation of serum adiponectin level, as low serum adiponectin is associated with better health-related quality of life in a cohort study of patients with pre-dialysis CKD ( 14 ). Another study from the same cohort also reported the increased risk of anemia development with high serum adiponectin ( 15 ).…”

New Insights into Adiponectin and Leptin Roles in Chronic Kidney Disease

“…Indeed, it was reported that in CKD, a better physical health-related quality of life is associated with low circulating adiponectin levels [ 26 ]. The high adiponectin levels may reflect or mediate the wasting and malnutrition state that is common in this disease.…”