title: Increased serum high-molecular-weight complex of adiponectin in type 2 diabetic patients with impaired renal function.
abstract: OBJECTIVE
  Adiponectin, an adipocyte-derived protein, has been shown to exert antidiabetic, anti-inflammatory, and antiatherosclerotic effects. Although recent reports show an increase in the total adiponectin levels in chronic kidney disease patients and in patients with end-stage renal disease, the nature of biodegradation and renal involvement of adiponectin is largely unknown. We aimed at determining whether the high-molecular-weight (HMW) complex of adiponectin is associated with renal insufficiency in type 2 diabetic patients.
  
  
  METHODS
  A total of 179 type 2 diabetic patients were selected from among outpatients and divided into four groups according to their albumin-to-creatinine ratio: patients with normoalbuminuria (n = 86), patients with microalbuminuria (n = 44), patients with macroalbuminuria (n = 23), and patients on hemodialysis (n = 26). The serum HMW adiponectin was specifically assayed with a commercially available enzyme-linked immunosorbent assay kit.
  
  
  RESULTS
  The HMW adiponectin levels were higher in patients on hemodialysis (17.1 +/- 8.2 microg/ml) and in those with macroalbuminuria (14.3 +/- 8.7 microg/ml) than in patients with normoalbuminuria (7.2 +/- 5.6 microg/ml) and microalbuminuria (10.8 +/- 7.0 microg/ml). Univariate linear regression analysis showed that the HMW adiponectin concentrations correlated negatively with the estimated glomerular filtration rate in patients with normoalbuminuria, microalbuminuria, and macroalbuminuria (r = -0.42, p < 0.001). Multiple stepwise regression analysis disclosed that estimated glomerular filtration rate, pioglitazone therapy, gender differences, and systolic blood pressure were independently associated with HMW adiponectin levels (r = 0.56).
  
  
  CONCLUSIONS
  The serum HMW adiponectin concentrations are higher in type 2 diabetic patients with nephropathy, and these levels are also associated with renal insufficiency.
authors.affiliation: Department of Internal Medicine, Takasago Municipal Hospital, Takasago, Japan. hkomaba@med.kobe-u.ac.jp
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Komaba
authors.forename: Naoya
authors.initials: N
authors.lastname: Igaki
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Goto
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yokota
authors.forename: Hisako
authors.initials: H
authors.lastname: Doi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takemoto
authors.forename: Maki
authors.initials: M
authors.lastname: Kohno
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hirosue
authors.forename: Takeo
authors.initials: T
authors.lastname: Goto
mesh_terms: D052242:Adiponectin / Q000096:biosynthesis / Q000097:blood; D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin