title: Associations of adiponectin and leptin levels with protein-energy wasting, in end stage renal disease patients.
abstract: OBJECTIVE
  The aim of the study was to examine the prevalence of protein-energy wasting (PEW) in hemodialysis (HD) and peritoneal dialysis (PD) patients in our center and determine whether adiponectin and leptin are involved in the development of PEW.
  
  
  METHODS
  Prospective (18 months).
  
  
  METHODS
  University Hospital of Heraklion, Crete, Greece.
  
  
  METHODS
  Seventy-four end-stage-renal-disease patients, 47 on HD and 27 on PD.
  
  
  METHODS
  At three sequential time points (baseline, 6 and 18 months) anthropometric, nutritional and inflammatory status data were collected. Serum adiponectin and leptin were also assessed at each time point. Patients were allocated to 3 strata according to PEW severity (0, 1-2 and ≥3 criteria for PEW).
  
  
  RESULTS
  Adiponectin and leptin levels were greater among PD compared to HD patients (p≤0.035). Adiponectin levels were incrementally greater across increasing strata of PEW (p≤0.002). Leptin showed the opposite trend, with lower levels in malnourished patients and higher levels in patients with zero PEW criteria (p≤0.042). Alterations of adiponectin levels during the observation period were dependent on PEW stratum (p≤0.021) and mode of dialysis (p≤0.002), after adjustment for age, dialysis vintage, gender and fat mass index. Particularly, adiponectin levels increased over time in HD patients with ≥3 criteria for PEW, whereas adiponectin levels decreased in PD patients with ≥3 criteria for PEW throughout the study. Leptin alterations over time were not affected by dialysis mode or PEW stratification.
  
  
  CONCLUSIONS
  Our study provides evidence that increased adiponectin and decreased leptin levels are independently associated with PEW and thus, poor prognosis.
authors.affiliation: Department of Nutrition & Dietetics, Technological Educational Institute of Crete, Sitia, Greece. Electronic address: anmarkaki@staff.teicrete.gr.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Markaki
authors.affiliation: Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Grammatikopoulou
authors.affiliation: Department of Clinical Chemistry, School of Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Venihaki
authors.affiliation: Department of Nephrology, General Hospital of Chios, Chios, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kyriazis
authors.affiliation: Department of Nephrology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Perakis
authors.affiliation: Department of Nephrology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Stylianou
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001823:Body Composition; D015897:Comorbidity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000097:blood* / Q000209:etiology; D006435:Renal Dialysis; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D020738:Leptin
keywords: Adipocitos; Adipocytes; CKD; Desgaste proteico-energético; Kidney disease; Malnutrición; Malnutrition; Mortalidad; Mortality; Nefropatía; Protein-energy wasting; Renal disease