| Serum Adiponectin as a Predictor for Cardiovascular Outcomes in Non-Diabetic End-Stage Renal Disease Patients |
| Hye Rim An, M.D.1, Sung Jin Moon, M.D.1, Hyeong Cheon Park, M.D.1, Yong Kyu Lee, M.D.1, Jwa-Kyung Kim, M.D.1, Beom Seok Kim, M.D.1, Hyung-Jong Kim, M.D.2, Dae Suk Han, M.D.1 and Sung Kyu Ha, M.D.1 |
Department of Internal Medicine1
Yonsei University College of Medicine, Seoul, Korea, Department of Internal Medicine2
CHA University College of Medical Science Bundang CHA Hospital, Sungnam, Korea |
| 원저 : 비당뇨병성 말기신부전 환자에서 심혈관질환 발생의 예측 인자로서 아디포넥틴의 유용성 |
| 안혜림1 , 문성진1 , 박형천1 , 이용규1 , 김좌경1 , 김범석1 , 김형종2 , 한대석1 , 하성규1 |
| 연세대학교 의과대학 내과학교실1 , CHA의과학대학교 분당차병원 내과학교실2 |
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| Abstract |
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Purpose: Adiponectin (ADPN) has been known to protect against cardiovascular disease (CVD) in metabolic syndrome with normal renal function for its anti-inflammatory and anti-atherogenic property. However, it is still unclear whether ADPN is associated with cardiovascular outcomes in end-stage renal disease (ESRD) patients.
Methods: This study included 80 non-diabetic ESRD patients [mean age, 52.8±13.7 years; dialysis duration, 67.1±52.0 months; hemodialysis (HD), 35 pts; peritoneal dialysis (PD), 45 pts] who survived for more than 3 months after the start of dialysis, and serum ADPN levels were measured at the beginning of the study. We conducted a longitudinal follow-up to evaluate the association of serum ADPN level with cardiovascular outcomes for 29.3±6.7 months.
Results: ADPN was inversely correlated with fasting serum insulin (r=-0.309, p=0.006) and HOMA-IR (r=-0.321, p=0.004) in ESRD patients. In a multiple linear regression analysis adjusted for age, gender, waist to hip ratio (WHR), and HDL-cholesterol, HOMA-IR (β=-0.880, p=0.041) was an independent factor associated with serum ADPN level. Kaplan-Meier analysis revealed that patients with higher ADPN levels (≥15.8 μg/mL) had a significantly higher survival rate compared with lowers (<15.8 μg/mL) (p=0.032). Cox proportional hazard model adjusted for age, WHR, creatinine, CRP, and previous CVD history revealed that serum ADPN level (HR, 0.899; 95% CI, 0.818-0.987; p=0.026) was an independent determinant of cardiovascular outcomes.
Conclusion: These findings suggest that lower ADPN levels independently predict cardiovascular events in non-diabetic ESRD patients. |
| Key Words:
Adiponectin, End-stage renal disease, Cardiovascular disease |
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