title: Low pre-transplant adiponectin multimers are associated with adverse allograft outcomes in kidney transplant recipients a 3-year prospective study.
abstract: BACKGROUND
  In kidney transplant recipients endothelial dysfunction is almost a universal risk factor for allograft failure. Adiponectin, an adipocyte derived hormone, has endothelial-protective properties and the high-molecular weight (HMW) multimer is the major active form, exerting anti-inflammatory and anti-apoptotic effects on endothelial cells. This study evaluated, whether pre-transplant total and HMW multimer adiponectin levels are associated with markers of endothelial dysfunction and arteriosclerosis and predict long-term graft survival in patients after kidney transplantation.
  
  
  METHODS
  In 206 renal transplant recipients pre-transplant total and HMW adiponectin levels were measured in serum by ELISA and Western blot, respectively. During the 36 months active follow up (median [interquartile range] 1249 [1020; 1445] days) 13 patients died (94% patient survival) and renal allograft failure was reported in 18 patients (91% graft survival).
  
  
  RESULTS
  Pre-transplant total and HMW adiponectin levels were significantly associated with lipid and glucose parameters at baseline. After 3 years follow-up pre-transplant total and HMW adiponectin levels were significantly inversely associated with the incidence of allograft failure (adiponectin: r=-0.216; p=0.002: HMW: r=-0.218; p=0.002). In multivariable adjusted Cox proportional hazard regression models patients in the lowest total and HMW adiponectin quartile had a significantly increased risk for allograft failure within 3 years post-transplantation: odds ratio [95%CI]: total adiponectin: 4.25 [1.27-14.24; p=0.019], and HMW multimers: 3.35 [1.04-10.76; p=0.042], respectively.
  
  
  CONCLUSIONS
  Low pre-transplant levels of total and HMW adiponectin reflect a pro-atherogenic endothelial milieu and independently predict an increased risk of allograft failure in kidney-transplant recipients. Measurement of adiponectin levels may identify patients at risk for adverse allograft outcomes after kidney transplantation.
authors: Dept. of Nephrology, Technische Universität München, Munich, Germany. marphiro@hotmail.com
authors: Marcel
authors: M
authors: Roos
authors: Marcus
authors: M
authors: Baumann
authors: Dan
authors: D
authors: Liu
authors: Falko M
authors: FM
authors: Heinemann
authors: Monika
authors: M
authors: Lindemann
authors: Peter A
authors: PA
authors: Horn
authors: Tobias
authors: T
authors: Türk
authors: Jens
authors: J
authors: Lutz
authors: Uwe
authors: U
authors: Heemann
authors: Oliver
authors: O
authors: Witzke
authors: Maximilian
authors: M
authors: von Eynatten
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D001786:Blood Glucose; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D046912:Multiprotein Complexes / Q000097:blood*; D015999:Multivariate Analysis; D016017:Odds Ratio; D057234:Preoperative Period; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D001786:Blood Glucose; D008076:Cholesterol, HDL; D046912:Multiprotein Complexes