The relationship between adiponectin levels and proinflammatory cytokines and left ventricular mass in dialysis patients.
BACKGROUND
Adiponectin is increased in end-stage renal disease. However, efforts to clarify the cause of that increase and its clinical effects have been inconclusive. The aim of this study was to compare serum adiponectin levels of dialysis patients against healthy individuals and evaluate the relationship among adiponectin levels, IL-6, TNF- alpha and left ventricular mass index (LVMI).


METHODS
Adiponectin, IL-6 and TNF- alpha measurements and echocardiographic evaluations were performed in 36 hemodialysis, 30 continuous ambulatory peritoneal dialysis (CAPD) patients and 22 healthy volunteers. Adiponectin, IL-6 and TNF- alpha levels were measured by ELISA.


RESULTS
Adiponectin was found to be higher in hemodialysis (52.78+/-18.01 ng/mL) and CAPD (52.96+/-17.53 ng/mL) groups than controls (28.36+/-13.20 ng/ mL; p=0.0003, p=0.0003, respectively). No difference was observed between the hemodialysis and CAPD groups. Adiponectin was positively correlated with IL-6 (r=0.293, p=0.02), TNF- alpha (r=0.458, p=0.0003) and LVMI (r=0.283, p=0.02). In the partial correlation analysis, by controlling for body mass index, the correlation between adiponectin and TNF- alpha (r=0.466, p=0.0003) persisted. When IL-6 was controlled with TNF- alpha, the relation between adiponectin and LVMI disappeared (r=0.145, p=0.30). In the linear regression analysis, with adiponectin as the dependent variable, and IL-6, TNF- alpha and body mass index as independent variables, a significant relationship was found between adiponectin and TNF- alpha (beta=0.488, p=0.001).


CONCLUSIONS
Increased adiponectin seems to be associated with increased proinflammatory cytokines in dialysis patients, and this relationship suggests adiponectin may have a role in the development of left ventricular hypertrophy.
Ayerden Ebinç
Fatma
F
Department of Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey. fayerdenebin@yahoo.com
Ebinç
Haksun
H
Derici
Ulver
U
Aral
Arzu
A
Aybay
Cemalettin
C
Taçoy
Gülten
G
Koç
Eyüp
E
Mutluay
Rüya
R
Altok Reis
Kadriye
K
Erten
Yasemin
Y
Arinsoy
Turgay
T
Sindel
Sükrü
S
D052242:Adiponectin / Q000097:blood*; D015992:Body Mass Index; D018450:Disease Progression; D018619:Echocardiography, Doppler, Pulsed; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D015850:Interleukin-6 / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013318:Stroke Volume; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D016277:Ventricular Function, Left / Q000502:physiology*
D052242:Adiponectin; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha