title: Adiponectin, metabolic risk factors, and cardiovascular events among patients with end-stage renal disease.
abstract: 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.
authors.affiliation: *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.
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
authors.affiliation: *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.
authors.forename: Francesca
authors.initials: F
authors.lastname: Mallamaci
authors.affiliation: *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.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tripepi
authors.affiliation: *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.
authors.forename: Francesco A
authors.initials: FA
authors.lastname: Benedetto
authors.affiliation: *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.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cutrupi
authors.affiliation: *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.
authors.forename: Saverio
authors.initials: S
authors.lastname: Parlongo
authors.affiliation: *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.
authors.forename: Lorenzo S
authors.initials: LS
authors.lastname: Malatino
authors.affiliation: *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.
authors.forename: Graziella
authors.initials: G
authors.lastname: Bonanno
authors.affiliation: *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.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Seminara
authors.affiliation: *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.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rapisarda
authors.affiliation: *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.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Fatuzzo
authors.affiliation: *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.
authors.forename: Michele
authors.initials: M
authors.lastname: Buemi
authors.affiliation: *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.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Nicocia
authors.affiliation: *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.
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: *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.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Ouchi
authors.affiliation: *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.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kihara
authors.affiliation: *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.
authors.forename: Tohru
authors.initials: T
authors.lastname: Funahashi
authors.affiliation: *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.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuzawa
mesh_terms: 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
chemical_list: D052242:Adiponectin; D036341:Intercellular Signaling Peptides and Proteins; D011506:Proteins; D004921:Erythropoietin