title: Potential impact of renin-angiotensin system inhibitors and calcium channel blockers on plasma high-molecular-weight adiponectin levels in hemodialysis patients.
abstract: Although metabolic syndrome confers an increased risk of cardiovascular disease in the general population, little is known about the alteration of abdominal adiposity and its association with adipocytokines in hemodialysis patients. We investigated the plasma high-molecular-weight (HMW) adiponectin level and its relationship to visceral fat area (VFA) and various markers of atherosclerosis in hemodialysis patients. In a cross-sectional study, conventional cardiovascular risk factors, plasma total and HMW adiponectin, the number of components of the metabolic syndrome and, using computed tomography, the distribution of abdominal adiposity were assessed in 144 hemodialysis patients (90 men and 54 women; mean age, 60.7 years) and 30 age- and sex-matched patients with chronic kidney disease (CKD). Plasma HMW adiponectin levels in hemodialysis patients were significantly higher than those in patients with CKD, negatively associated with VFA and serum triglycerides and positively associated with plasma total adiponectin, as well as the HMW-to-total adiponectin ratio in men and women (all P < 0.05) in a simple regression analysis. In a multiple regression analysis, VFA was a significant determinant of HMW adiponectin in hemodialysis patients. Furthermore, after adjustment for classical risk factors, HMW adiponectin levels were significantly higher in patients undergoing treatment with renin-angiotensin system inhibitors or calcium channel blockers compared with patients not undergoing such treatment. This study shows that plasma HMW adiponectin levels were negatively associated with VFA and positively associated with treatment with blockade of the renin-angiotensin system and of the calcium channel. Therefore, these drugs might be effective for improving adipocytokine-related metabolic abnormalities in hemodialysis patients.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Nephrology, Asahikawa, Japan. naka-nao@asahikawa-med.ac.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakagawa
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yao
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hirayama
authors.forename: Mari
authors.initials: M
authors.lastname: Ishida
authors.forename: Hironori
authors.initials: H
authors.lastname: Ishida
authors.forename: Atsushi
authors.initials: A
authors.lastname: Wada
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fujino
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Saijo
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hasebe
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000628:therapy; D012084:Renin-Angiotensin System / Q000187:drug effects*; D014280:Triglycerides / Q000097:blood
chemical_list: D052242:Adiponectin; D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides