Low circulating adiponectin levels are associated with insulin resistance in non-obese peritoneal dialysis patients.
In patients with end-stage renal disease (ESRD), circulating adipokine levels are increased due to decreased renal clearance, irrespective of obesity. However, whether adipokines play a role in the development of insulin resistance (IR) in non-obese ESRD patients is unknown. We conducted a cross-sectional study to identify factors associated with IR in 62 non-obese patients on peritoneal dialysis (PD). Non-obesity was defined as body mass index (BMI) <25 kg/m(2). IR was determined using homeostatic model assessment-IR (HOMA-IR). We also measured serum concentrations of adiponectin, leptin, resistin, high-sensitivity C-reactive protein (hsCRP), and IL-6. The average BMI of the study patients was 21.6 kg/m(2). When patients were divided into two groups according to the median value of HOMA-IR, serum adiponectin levels were significantly lower in patients with HOMA-IR > 1.85 than in those with HOMA-IR ≤1.85, whereas serum concentrations of leptin and resistin did not differ between the two groups. In addition, log-transformed HOMA-IR was negatively correlated with adiponectin (γ = -0.464, P < 0.001) and log-transformed high-density lipoprotein cholesterol (γ = -0.250, P = 0.050) and positively correlated with age (γ = 0.334, P = 0.008) and triglyceride (γ = 0.392, P = 0.002). However, resistin, log-transformed leptin and log-transformed hsCRP were not associated with HOMA-IR. In a multiple linear regression model, adiponectin was independently associated with HOMA-IR (β = -0.023, P = 0.015). In conclusion, this study suggests that low circulating adiponectin levels might be involved in IR even in non-obese patients undergoing PD.
Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea.
Dong Eun
DE
Yoo
Mi Jung
MJ
Lee
Hyung Jung
HJ
Oh
Seung Jun
SJ
Kim
Dong Ho
DH
Shin
Tae-Hyun
TH
Yoo
Shin-Wook
SW
Kang
Kyu Hun
KH
Choi
Dae Suk
DS
Han
Seung Hyeok
SH
Han
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010530:Peritoneal Dialysis; D052243:Resistin / Q000097:blood
D052242:Adiponectin; D008076:Cholesterol, HDL; D015850:Interleukin-6; D020738:Leptin; D052243:Resistin; D002097:C-Reactive Protein