Adiponectin, metabolic risk factors, and cardiovascular events among patients with end-stage renal disease.
Adiponectin (ADPN), which is a secretory protein of adipose tissue, attenuates endothelial inflammatory responses in vitro. Among human subjects, plasma ADPN concentrations are reduced among patients with atherosclerotic complications but are substantially increased among patients with advanced renal failure. The clinical and biochemical correlates of plasma ADPN levels were investigated and the predictive power of ADPN levels with respect to survival rates and cardiovascular events was prospectively tested in a cohort of 227 hemodialysis patients, who were monitored for 31 +/- 13 mo. Plasma ADPN levels were 2.5 times higher (P < 0.0001) among dialysis patients (15.0 +/- 7.7 microg/ml) than among healthy subjects (6.3 +/- 2.0 microg/ml), were independent of age, and were higher (P = 0.03) among women (15.2 +/- 7.9 microg/ml) than among men (14.0 +/- 7.4 microg/ml). For both genders, plasma ADPN levels were inversely related to body mass index values, plasma leptin levels, insulin levels, serum triglyceride levels, and homeostatic model assessment index values. Furthermore, plasma ADPN levels were directly related to HDL cholesterol levels and inversely related to von Willebrand factor levels. Plasma ADPN levels were lower (P < 0.05) among patients who experienced new cardiovascular events (13.7 +/- 7.3 microg/ml) than among event-free patients (15.8 +/- 7.8 microg/ml). There was a 3% risk reduction for each 1 microg/ml increase in plasma ADPN levels, and the relative risk of adverse cardiovascular events was 1.56 times (95% confidence interval, 1.12 to 1.99 times) higher among patients in the first ADPN tertile, compared with those in the third tertile. Plasma ADPN levels are an inverse predictor of cardiovascular outcomes among patients with end-stage renal disease. Furthermore, ADPN is related to several metabolic risk factors in a manner consistent with the hypothesis that this protein acts as a protective factor for the cardiovascular system.
Zoccali
Carmine
C
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Mallamaci
Francesca
F
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Tripepi
Giovanni
G
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Benedetto
Francesco A
FA
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Cutrupi
Sebastiano
S
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Parlongo
Saverio
S
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Malatino
Lorenzo S
LS
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Bonanno
Graziella
G
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Seminara
Giuseppe
G
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Rapisarda
Francesco
F
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Fatuzzo
Pasquale
P
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Buemi
Michele
M
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Nicocia
Giacomo
G
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Tanaka
Sachiyo
S
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Ouchi
Noriyuki
N
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Kihara
Shinji
S
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Funahashi
Tohru
T
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Matsuzawa
Yuji
Y
*National Research Council Center of Clinical Physiology, Reggio Calabria, Italy; Cardiology Division, Ospedale Morelli, Reggio Calabria, Italy; Departments of Internal Medicine and Nephrosurgery and Institute of Internal Medicine and Geriatry, Catania University, Catania, Italy; Clinical Pathology and Nephrology Units, University of Messina, Messina, Italy; and Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
D052242:Adiponectin; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011506:Proteins / Q000378:metabolism*; D006435:Renal Dialysis; D012307:Risk Factors; D016019:Survival Analysis
D052242:Adiponectin; D036341:Intercellular Signaling Peptides and Proteins; D011506:Proteins; D004921:Erythropoietin