Abstract
Aims: To compare plasma adiponectin levels between healthy controls and patients with chronic
renal failure and to examine for a relationship between plasma adiponectin levels
and ischemic heart disease as well as aortic distensibility which is an early marker
of atherosclerosis. Methods: We included 89 patients with CRF (45 on and 44 not on hemodialysis) and 70 controls
in a cross-sectional study. Plasma adiponectin levels were measured by radioimmunoassay.
Aortic distensibility was assessed by high-resolution ultrasonography. Results: Plasma adiponectin levels were significantly almost twice as high in patients with
renal failure compared to controls (9.7 ± 1.1 vs. 5.4 ± 0.6 µg/ml, p < 0.0001). No significant differences were found between renal
patients on hemodialysis and not on hemodialysis (p = 0.71). Multivariate linear regression
analysis in the renal patient group demonstrated a significant negative relationship
between plasma adiponectin levels and ischemic heart disease (p = 0.02). The same
analysis in the control subjects group showed a significant, negative relationship
between plasma adiponectin levels and body mass index (p = 0.02) and a highly significant
positive relationship with the high density lipoprotein cholesterol (p < 0.0001).
In the total study population, glomerular filtration rate was the only independent
predictor of plasma adiponectin concentrations. Aortic distensibility was lower in
renal patients than in controls at a high level of significance (p < 0.0001). However,
no significant relationship could be found between plasma adiponectin and aortic distensibility
in either the controls or the renal patients. Conclusions: Plasma adiponectin levels are almost twice as high in patients with chronic renal
failure in comparison with healthy controls, but not different between renal patients
on and those not on hemodialysis. In addition, low plasma adiponectin levels are strongly
associated with ischemic heart disease, but not with aortic distensibility in chronic
renal failure.
Key words
Aortic distensibility - HDL cholesterol - Glomerular filtration rate - Diabetic nephropathy
- Insulin resistance - Parathyroid hormone - Atherosclerosis
References
- 1
Maeda K, Okubo K, Shimomura I, Funahashi T, Matsuzawa Y, Matsubara K.
cDNA cloning and expression of a novel adipose specific collagen-like factor, apM1
(AdiPose Most abundant Gene transcript 1).
Biochem Biophys Res Commun.
1996;
221
286-289
- 2
Chandran M, Phillips S A, Ciaraldi T, Henry R R.
Adiponectin: more than just another fat cell hormone?.
Diabetes Care.
2003;
26
2442-2450
- 3
Thamer C, Machann J, Tschritter O, Haap M, Wietek B, Dahl D, Bachmann O, Fritsche A,
Jacob S, Stumvoll M, Schick F, Haring H U.
Relationship between serum adiponectin concentration and intramyocellular lipid stores
in humans.
Horm Metab Res.
2002;
34
646-649
- 4
Stefan N, Stumvoll M.
Adiponectin-its role in metabolism and beyond.
Horm Metab Res.
2002;
34
469-474
- 5
Arita Y, Kihara S, Ouchi N, Maeda K, Kuriyama H, Okamoto Y, Kumada M, Hotta K, Nishida M,
Takahashi M, Nakamura T, Shimomura I, Muraguchi M, Ohmoto Y, Funahashi T, Matsuzawa Y.
Adipocyte-derived plasma protein adiponectin acts as a platelet-derived growth factor-BB-binding
protein and regulates growth factor-induced common postreceptor signal in vascular
smooth muscle cell.
Circulation.
2002;
18
2893-2898
- 6
Diez J J, Iglesias P.
The role of the novel adipocyte-derived hormone adiponectin in human disease.
Eur J Endocrinol.
2003;
148
293-300
- 7
Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y, Iwahashi H, Kuriyama H,
Ouchi N, Maeda K, Nishida M, Kihara S, Sakai N, Nakajima T, Hasegawa K, Muraguchi M,
Ohmoto Y, Nakamura T, Yamashita S, Hanafusa T, Matsuzawa Y.
Plasma concentrations of a novel adipose specific protein adiponectin in type 2 diabetic
patients.
Arterioscler Thromb Vasc Biol.
2000;
20
1595-1599
- 8
Zoccali C, Mallamaci F, Tripepi G, Benedetto F A, Cutrupi S, Parlongo S, Malatino L S,
Bonanno G, Seminara G, Rapisarda F, Fatuzzo P, Buemi M, Nicocia G, Tanaka S, Ouchi N,
Kihara S, Funahashi T, Matsuzawa Y.
Adiponectin, metabolic risk factors, and cardiovascular events among patients with
end-stage renal disease.
J Am Soc Nephrol.
2002;
13
134-141
- 9
Chudek J, Adamczak M, Karkoszka H, Budzinski G, Ignacy W, Funahashi T, Matsuzawa Y,
Cierpka L, Kokot F, Wiecek A.
Plasma adiponectin concentration before and after successful kidney transplantation.
Transplant Proc.
2003;
35
2186-2189
- 10 K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification,
and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 2001
39: S1-246
- 11 The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation
and Treatment of High Blood Pressure: the JNC 7 Report. JAMA 2003 289: 2560-2571
- 12
Matthews D R, Hosker J P, Rudenski A S, Naylor B A, Treacher D F, Turner R C.
Homeostasis model assessment: insulin resistance and b-cell function from fasting
plasma glucose and insulin concentrations in man.
Diabetologia.
1985;
28
412-419
- 13
Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P.
Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques
in healthy men and in men with arterial disease.
Eur Heart J.
1990;
11
990-996
- 14
Tentolouris N, Liatis S, Moyssakis I, Tsapogas P, Psallas M, Diakoumopoulou E, Voteas V,
Katsilambros N.
Aortic distensibility is reduced in subjects with type 2 diabetes and cardiac autonomic
neuropathy.
Eur J Clin Invest.
2003;
33
1075-1083
- 15
Hauner H, Hochberg Z.
Endocrinology of adipose tissue.
Horm Metab Res.
2002;
34
605-606
- 16
Mohlig M, Wegewitz U, Osterhoff M, Isken F, Ristow M, Pfeiffer A F, Spranger J.
Insulin decreases human adiponectin plasma levels.
Horm Metab Res.
2002;
34
655-658
- 17
Yamamoto Y, Hirose H, Saito I, Tomita M, Taniyama M, Matsubara K, Okazaki Y, Ishii T,
Nishikai K, Saruta T.
Correlation of the adipocyte-derived protein adiponectin with insulin resistance index
and serum high-density lipoprotein-cholesterol, independent of body mass index, in
the Japanese population.
Clin Sci (London).
2002;
103
137-142
- 18
Nishizawa H, Shimomura I, Kishida K, Maeda N, Kuriyama H, Nagaretani H, Matsuda M,
Kondo H, Furuyama N, Kihara S, Nakamura T, Tochino Y, Funahashi T, Matsuzawa Y.
Androgens decrease plasma adiponectin, an insulin-sensitizing adipocyte-derived protein.
Diabetes.
2002;
51
2734-2741
- 19
Gavrila A, Chan J L, Yiannakouris N, Kontogianni M, Miller L C, Orlova C, Mantzoros C S.
Serum adiponectin levels are inversely associated with overall and central fat distribution
but are not directly regulated by acute fasting or leptin administration in humans:
cross-sectional and interventional studies.
J Clin Endocrinol Metab.
2003;
88
4823-4831
- 20
Lenchik L, Register T C, Hsu F C, Lohman K, Nicklas B J, Freedman B I, Langefeld C D,
Carr J J, Bowden D W.
Adiponectin as a novel determinant of bone mineral density and visceral fat.
Bone.
2003;
33
646-651
- 21
Stamatiadis D N, Chan J L, Cogswell R, Stefanopoulou H C, Bullen J, Katsilambros N,
Stathakis C P, Mantzoros C S.
Elevated leptin fragments in renal failure correlate with BMI and haematopoiesis and
are normalized by haemodialysis.
Clin Endocrinol (Oxf).
2004;
60
434-441
- 22
Matsabura M, Maruoka S, Katayose S.
Inverse relationship between plasma adiponectin and leptin concentrations in normal-weight
and obese women.
Eur J Endocrinol.
2002;
147
173-180
- 23
Goldfine A B, Kahn C R.
Adiponectin: linking the fat cell to insulin sensitivity.
Lancet.
2003;
362
1431
- 24
Okamoto Y, Arita Y, Nishida M, Muraguchi M, Ouchi N, Takahashi M, Igura T, Inui Y,
Kihara S, Nakamura T, Yamashita S, Miyagawa J, Funahashi T, Matsuzawa Y.
An adipocyte-derived plasma protein, adiponectin, adheres to injured vascular walls.
Horm Metab Res.
2000;
32
47-50
- 25
Ouchi N, Kihara S, Funahashi T, Nakamura T, Nishida M, Kumada M, Okamoto Y, Ohashi K,
Nagaretani H, Kishida K, Nishizawa H, Maeda N, Kobayashi H, Hiraoka H, Matsuzawa Y.
Reciprocal association of C-reactive protein with adiponectin in blood stream and
adipose tissue.
Circulation.
2003;
107
671-674
- 26
Stenvinkel P, Marchlewska A, Pecoits-Filho R, Heimburger O, Zhang Z, Hoff C, Holmes C,
Axelsson J, Arvidsson S, Schalling M, Barany P, Lindholm B, Nordfors L.
Adiponectin in renal disease: relationship to phenotype and genetic variation in the
gene encoding adiponectin.
Kidney Int.
2004;
65
274-281
- 27
Cruickshank K, Riste L, Anderson S G, Wright J S, Dunn G, Gosling R G.
Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose
intolerance: an integrated index of vascular function?.
Circulation.
2002;
106
2085-2090
- 28
Pecoits-Filho R, Heimburger O, Barany P, Suliman M, Fehrman-Ekholm I, Lindholm B,
Stenvinkel P.
Associations between circulating inflammatory markers and residual renal function
in CRF patients.
Am J Kidney Dis.
2003;
41
1212-1218
Prof. N. Katsilambros
1st Department of Propedeutic Medicine, Athens University Medical School ·
5 Doryleou Street · 115 21 Athens · Greece
Phone: +30(210)745-62-61
Fax: +30(210)779-18-39 ·
Email: laennec@techlink.gr
