• Nutrition · Jan 2017

    Multicenter Study Observational Study

    Serum adiponectin and protein-energy wasting in predialysis chronic kidney disease.

    • Young Youl Hyun, Kyu-Beck Lee, Kook-Hwan Oh, Curie Ahn, Sue Kyung Park, Dong Wan Chae, Tae-Hyun Yoo, Kyu Hun Cho, Yong-Soo Kim, Young-Hwan Hwang, and Representing KNOW-CKD Study Group.
    • Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
    • Nutrition. 2017 Jan 1; 33: 254-260.

    ObjectiveAdiponectin (ADPN) has antiatherogenic, anti-inflammatory, and insulin-sensitizing effects. Serum ADPN levels are increased in patients with chronic kidney diseases (CKD), and higher ADPN is paradoxically a predictor of mortality in these patients. The aim of this study was to determine the association between serum ADPN levels and protein-energy wasting (PEW) in predialysis CKD.MethodWe examined serum ADPN concentrations and PEW in 1303 patients from the KNOW-CKD (KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease) study. PEW was defined as the presence of three or more of the following four indicators: serum albumin <3.8 g/dL, body mass index <23 kg/m(2), urine creatinine excretion (UCE) below the lower quartile, and daily dietary protein intake <0.6 g/kg. We analyzed the association between PEW and ADPN using a multivariate regression model after adjustment for socioeconomic factors, comorbidities, and laboratory findings.ResultsAmong 1303 predialysis CKD patients, 72 (5.5%) had PEW. In multivariate logistic regression analysis, higher ADPN level was associated with PEW (odds ratio, 1.04; 95% confidence interval [CI], 1.01-1.08 by 1 μg/mL ADPN). The highest ADPN quartile was associated with PEW in comparison with the lowest quartile (odds ratio, 10.54; 95% CI, 1.28-86.74). In multiple linear regression with PEW indicators, ADPN was more strongly associated with UCE (β = -2.21; 95% CI, -4.13 to -0.28; R(2) = 0.67).ConclusionHigh ADPN is independently associated with PEW. Among PEW indicators, serum ADPN is closely associated with UCE as an indirect measure of muscle mass.Copyright © 2016 Elsevier Inc. All rights reserved.

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