Serum adiponectin and protein–energy wasting in predialysis chronic kidney disease

Young Youl Hyun, Kyu Beck Lee, Kook-Hwan Oh, Curie Ahn, Sue Kyung Park, Dong-Wan Chae, Tae Hyun Yoo, Kyu Hun Cho, Yong Soo Kim, Young Hwan Hwang

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Objective Adiponectin (ADPN) has antiatherogenic, anti-inflammatory, and insulin-sensitizing effects. Serum ADPN levels are increased in patients with chronic kidney diseases (CKD), and higher ADPN is paradoxically a predictor of mortality in these patients. The aim of this study was to determine the association between serum ADPN levels and protein–energy wasting (PEW) in predialysis CKD. Method We examined serum ADPN concentrations and PEW in 1303 patients from the KNOW-CKD (KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease) study. PEW was defined as the presence of three or more of the following four indicators: serum albumin <3.8 g/dL, body mass index <23 kg/m2, urine creatinine excretion (UCE) below the lower quartile, and daily dietary protein intake <0.6 g/kg. We analyzed the association between PEW and ADPN using a multivariate regression model after adjustment for socioeconomic factors, comorbidities, and laboratory findings. Results Among 1303 predialysis CKD patients, 72 (5.5%) had PEW. In multivariate logistic regression analysis, higher ADPN level was associated with PEW (odds ratio, 1.04; 95% confidence interval [CI], 1.01–1.08 by 1 μg/mL ADPN). The highest ADPN quartile was associated with PEW in comparison with the lowest quartile (odds ratio, 10.54; 95% CI, 1.28–86.74). In multiple linear regression with PEW indicators, ADPN was more strongly associated with UCE (β = −2.21; 95% CI, −4.13 to −0.28; R2 = 0.67). Conclusion High ADPN is independently associated with PEW. Among PEW indicators, serum ADPN is closely associated with UCE as an indirect measure of muscle mass.

Original languageEnglish
Pages (from-to)254-260
Number of pages7
JournalNutrition
Volume33
DOIs
StatePublished - 1 Jan 2017

Keywords

  • Adiponectin
  • Chronic kidney disease
  • Protein–energy wasting
  • Urine creatinine excretion

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