Adiponectin and cardiovascular remodeling in end-stage renal disease and co-morbid diabetes mellitus.
OBJECTIVE
Altered plasma high-sensitivity C-reactive protein (hs-CRP) and adiponectin (ADP) may contribute to increased vascular inflammation and accelerated atherosclerosis in patients with end-stage renal disease (ESRD) and co-morbid diabetes. Common carotid artery intima-media thickness (CCA-IMT) and atherosclerotic plaque occurrence, left-ventricular mass index (LVMI), and pulse wave velocity of the proximal aorta (PWVr) were determined by ultrasound imaging in 120 ESRD (55 diabetic) patients, and 83 age-, sex-, and blood pressure-matched controls. Also, plasma levels of ADP and hs-CRP were determined and their relationships with the above cardiovascular alterations were analyzed.


RESULTS
LVMI, PWVr, CCA-IMT and atherosclerotic plaque occurrence were all increased in ESRD patients compared to controls (all p < 0.001). LVMI (p < 0.05), PWVr (p < 0.001), CCA-IMT (p < 0.001) and atherosclerotic plaque occurrence (p < 0.001) were increased in diabetic compared to nondiabetic ESRD patients. Hs-CRP levels were increased and ADP levels were decreased in diabetic compared to nondiabetic ESRD patients (both p < 0.001). ADP levels correlated inversely with hs-CRP (r = -0.473, p < 0.0001) in ESRD patients. Hs-CRP was positively correlated with LVMI (r = 0.365, p < 0.0001), PWVr (r = 0.42, p < 0.0001) and CCA-IMT (r = 0.18, p = 0.047) while ADP inversely correlated with PWVr (r = -0.263, p = 0.0035) and CCA-IMT (r = -0.207, p = 0.022) in ESRD patients.


CONCLUSIONS
The present results indicate diabetic disease-specific alterations in the biochemical parameters of hs-CRP and ADP in ESRD patients. The above biochemical parameters were intimately linked to the cardiovascular measurements of LVMI, PWVr and CCA-IMT in patients with ESRD and co-morbid diabetes mellitus.
Karakitsos
Dimitrios
D
Department of Nephrology, University Hospital of Heraklion, Stavrakia, Crete, Greece. karakd@edu.med.uoc.gr
De Groot
Eric
E
Patrianakos
Alexandros P
AP
Parthenakis
Frangiscos
F
Boletis
John
J
Karabinis
Andreas
A
Kyriazis
John
J
Vardas
Panos
P
Daphnis
Eugene
E
D052242:Adiponectin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D015897:Comorbidity; D048909:Diabetes Complications / Q000097:blood*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020257:Ventricular Remodeling
D052242:Adiponectin; D015415:Biomarkers; D002097:C-Reactive Protein