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Serum Adiponectin as a Predictor for Cardiovascular Outcomes in Non-Diabetic End-Stage Renal Disease Patients
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¾ÈÇý¸²(An Hye-Rim) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
¹®¼ºÁø(Moon Sung-Jin) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
¹ÚÇüõ(Park Hyeong-Cheon) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
ÀÌ¿ë±Ô(Lee Yong-Kyu) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
±èÁ°æ(Kim Jwa-Kyung) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ °³²¼¼ºê¶õ½ºº´¿ø ³»°ú
±è¹ü¼®(Kim Beom-Seok) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
±èÇüÁ¾(Kim Hyung-Jong) - CHAÀÇ°úÇдëÇб³ ³»°úÇб³½Ç
ÇÑ´ë¼®(Han Dae-Suk) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
Çϼº±Ô(Ha Sung-Kyu) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
Abstract
Purpose: Adiponectin (ADPN) has been known to protect against cardiovascular disease (CVD) in metabolic syndrome with normal renal function for its anti-inflammatory and anti-atherogenic property. However, it is still unclear whether ADPN is associated with cardiovascular outcomes in end-stage renal disease (ESRD) patients.
Methods: This study included 80 non-diabetic ESRD patients [mean age, 52.8¡¾13.7 years; dialysis duration, 67.1¡¾52.0 months; hemodialysis (HD), 35 pts; peritoneal dialysis (PD), 45 pts] who survived for more than 3 months after the start of dialysis, and serum ADPN levels were measured at the beginning of the study. We conducted a longitudinal follow-up to evaluate the association of serum ADPN level with cardiovascular outcomes for 29.3¡¾6.7 months.
Results: ADPN was inversely correlated with fasting serum insulin (r=-0.309, p=0.006) and HOMA-IR (r=-0.321, p=0.004) in ESRD patients. In a multiple linear regression analysis adjusted for age, gender, waist to hip ratio (WHR), and HDL-cholesterol, HOMA-IR (¥â=-0.880, p=0.041) was an independent factor associated with serum ADPN level. Kaplan-Meier analysis revealed that patients with higher ADPN levels (¡Ã15.8 ¥ìg/mL) had a significantly higher survival rate compared with lowers (<15.8 ¥ìg/mL) (p=0.032). Cox proportional hazard model adjusted for age, WHR, creatinine, CRP, and previous CVD history revealed that serum ADPN level (HR, 0.899; 95% CI, 0.818-0.987; p=0.026) was an independent determinant of cardiovascular outcomes.
Conclusion: These findings suggest that lower ADPN levels independently predict cardiovascular events in non-diabetic ESRD patients.
Å°¿öµå
Adiponectin, End-stage renal disease, Cardiovascular disease
KMID :
0359920100290040465
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À¯È¿¼º°á°ú(Recomendation)
There is no difference between HD and PD in Adiponectin (ADPN).