The association of adiponectin with metabolic syndrome and clinical outcome in patients with non-diabetic chronic kidney disease

Abstract

Adiponectin is the most abundant circulating adipokine, and it has insulin-sensitizing and anti-inflammatory properties. Although it has been speculated that kidney function decline associated with elevated adiponectin is attributable to decreased renal clearance and compensatory responses to adiponectin resistance, it is unclear how elevated adiponectin affects clinical outcomes in chronic kidney disease (CKD) patients and whether the effects are the same as those in the general population. Therefore, the aim of this study is to examine whether the association between serum adiponectin levels and clinical outcomes in non-diabetic CKD patients is independent of adiposity and metabolic syndrome. We enrolled 196 non-diabetic CKD patients with eGFR ranging between 10 and 60 mL/min/1.73 m 2 , these patients were divided into two groups based on the presence of metabolic syndrome. The primary endpoint was all-cause mortality or renal events (renal failure requiring renal replacement therapy [RRT] or 50% reduction in eGFR). During the mean follow-up period of 5 years, 48 (24.5%) incident cases of end-stage renal disease (ESRD) were observed, and 33 (16.8%) deaths occurred. The mean eGFR was 29.8 ± 12.8 mL/min/1.73m 2 . The baseline median adiponectin concentration in the cohort was 29.4(interquartile range, 13.3–108.7) μg/ml. Adiponectin levels were inversely related to body mass index (BMI) ( r = −0.29; P < 0.001) and waist circumference ( r = −0.35; P < 0.001). In the fully adjusted Cox regression model, the hazard ratios (HRs) were 2.08 (95% confidence interval [CI], 1.08–4.02; P = 0.03) for RRT and 1.66 (95% CI, 1.03–2.65; P = 0.04) for composite renal outcome. The risks remained consistent within different subgroups. However, no association was observed with mortality risk. In conclusion, higher adiponectin levels are associated with a higher risk of ESRD independent of conventional risk factors, BMI, and metabolic syndrome components.

FTO Variant rs1421085 Associates With Increased Body Weight, Soft Lean Mass, and Total Body Water Through Interaction With Ghrelin and Apolipoproteins in Arab Population

“…In addition, this is also supported by our previous observations showing interactions between Apo-A1/ HDL and a genetic variant in TCN2 regulate WC (Hebbar et al, 2017). Others have demonstrated a positive correlation between ApoB48 and abdominal circumference (Kuo et al, 2019), with obese and hyperlipidemic subjects showing higher levels of ApoB48 (Otokozawa et al, 2009). SLM contributes to LBM.…”

Obesity and chronic kidney disease: prevalence, mechanism, and management

“…A r t i c l e (45)(46)(47)(48) Increased podocyte injury (29) Glomerulomegaly & glomerulosclerosis (29) Excessive tubular sodium reabsorption (49)(50)(51) Increased sympathetic activity (29) Increased RAAS activity (47,51) Metabolic effects Abnormal lipid metabolism (52,53,73) Adipokine dysregulation (54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(66)(67)(68)(69) Increased insulin resistance (64,65) Increased inflammation (70,71,73) Increased oxidative stress (73,74) Lipid nephrotoxicity Excessive renal fat accumulation (70)(71)(72) Glomerular and tubular cell injuries (71)(72)(73) Mitochondrial dysfunction, oxidative stress & inflammation (71,73,74) Increased FFA toxicity to proximal tubu...…”

Impact of adipose tissue in chronic kidney disease development (Review)

“…Adiponectin levels were inversely related to BMI (r=-0.29; P<0.001) and waist circumference (r=-0.35; P<0.001). A decreased adiponectin level was associated with a higher risk of ESRD independent of conventional risk factors, BMI, and even metabolic syndrome (74).…”