title: Administration of IL-1ra improves adiponectin levels in chronic hemodialysis patients.
abstract: BACKGROUND
  Adiponectin, an adipose tissue derived hormone, is known to have insulin-sensitizing, anti-inflammatory, and anti-atherogenic properties in the general population. Adiponectin secretion is suppressed by systemic inflammation, a highly prevalent condition in maintenance hemodialysis (MHD) patients. We evaluated whether short-term administration of interleukin 1 receptor antagonist (IL-1ra) improves adiponectin levels and insulin sensitivity in MHD patients.
  
  
  METHODS
  Ad hoc analysis was performed on a pilot randomized placebo-controlled trial of the administration of IL-1ra in chronically inflamed MHD patients. Twenty-two patients were randomly assigned to receive 100 mg of IL-1ra or placebo (1:1) for 4 weeks, and 14 completed the trial. ANCOVA was used to compare percent change from baseline to 4 weeks. The primary outcome was percent change in adiponectin and the secondary outcomes were changes in leptin, homeostatic model assessment of insulin resistance (HOMA-IR) and the leptin-to-adiponectin ratio (LAR).
  
  
  RESULTS
  Patients' mean age was 49 ± 13 years, and 71 % were males. At baseline, the median values for adiponectin, leptin, LAR and HOMA-IR were 11.5 μg/ml [interquartile range (IQR) 9, 28.5], 17.8 ng/ml (3.9, 50.0), 2.20 (0.13, 3.98), and 2.8 (2.0, 3.6), respectively. IL-1ra administration resulted in a mean percent increase in serum adiponectin of 22 % vs. 14 % decrease in the placebo arm (p = 0.003). Leptin, LAR or HOMA-IR levels did not change in either arm.
  
  
  CONCLUSIONS
  Short-term administration of IL-1ra significantly increased adiponectin levels among prevalent MHD patients. The intervention did not impact insulin sensitivity parameters. Studies of longer duration and larger sample size are needed to further evaluate the potential effect of anti-inflammatory interventions on metabolic markers and insulin sensitivity in MHD patients.
authors.affiliation: Clinical Science Research & Development Veterans Administration, TVHS, Nashville, TN, USA. adriana.hung@vanderbilt.edu.|Division of Nephrology, Vanderbilt University Medical Center, 1161 21st Ave. South, S-3223 MCN, Nashville, TN, 37232-2372, USA. adriana.hung@vanderbilt.edu.
authors.forename: Adriana M
authors.initials: AM
authors.lastname: Hung
authors.affiliation: Division of Nephrology, Vanderbilt University Medical Center, 1161 21st Ave. South, S-3223 MCN, Nashville, TN, 37232-2372, USA.
authors.forename: Chutatip
authors.initials: C
authors.lastname: Limkunakul
authors.affiliation: Universidad San Juan Bautista, Caguas, PR, USA.
authors.forename: Jenny S
authors.initials: JS
authors.lastname: Placido
authors.affiliation: Division of Nephrology, Vanderbilt University Medical Center, 1161 21st Ave. South, S-3223 MCN, Nashville, TN, 37232-2372, USA.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Siew
authors.affiliation: Division of Nephrology, Vanderbilt University Medical Center, 1161 21st Ave. South, S-3223 MCN, Nashville, TN, 37232-2372, USA.
authors.forename: Charles D
authors.initials: CD
authors.lastname: Ellis
authors.affiliation: Biostatistics, Vanderbilt University, Nashville, TN, USA.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shintani
authors.affiliation: Clinical Science Research & Development Veterans Administration, TVHS, Nashville, TN, USA.|Division of Nephrology, Vanderbilt University Medical Center, 1161 21st Ave. South, S-3223 MCN, Nashville, TN, 37232-2372, USA.
authors.forename: Talat Alp
authors.initials: TA
authors.lastname: Ikizler
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D007333:Insulin Resistance; D053590:Interleukin 1 Receptor Antagonist Protein / Q000009:adverse effects / Q000627:therapeutic use*; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D013714:Tennessee; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D000893:Anti-Inflammatory Agents; D015415:Biomarkers; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D020738:Leptin
keywords: Adiponectin; Anakinra; Dialysis; Insulin resistance; Interleukin 1-ra