Abstract
BackgroundAdiponectin is a major adipocyte-derived protein with insulin-sensitizing, anti-inflammatory and anti-atherogenic properties. Adiponectin levels correlate inversely with renal function and higher levels are predictive of lower cardiovascular disease (CVD) in patients with normal renal function and chronic kidney disease. No data exists on the association between adiponectin and CVD in renal transplant recipients (RTR).MethodsStandard biochemistry, clinical data and adiponectin were collected from 137 RTR recruited to the LANDMARK 2 study at baseline. The LANDMARK 2 study is an ongoing randomized controlled study that compares the outcome of aggressive risk factor modification for cardiovascular disease versus standard post-transplant care in renal transplant recipients with impaired glucose tolerance or diabetes mellitus.ResultsMean patient age was 53.4 ± 12 years and the median post-transplantation period was 5 (0.5-31.9) years. Mean serum adiponectin level was 12.3 ± 7.1 μg/mL. On univariate analysis, adiponectin was positively associated with female gender (P = 0.01) and serum high-density lipoprotein (HDL) concentration (P < 0.001), and inversely with body mass index (P = 0.009), metabolic syndrome (P = 0.047), abnormal glucose tolerance (P = 0.01), C-reactive protein (P = 0.001) and serum triglyceride (P < 0.001). On stepwise multivariate analysis, adiponectin in males was negatively correlated with combined baseline CVD (P = 0.03), waist-hip ratio (P = 0.003) and glomerular filtration rate (P = 0.046), and positively with HDL (P < 0.001). In contrast, in females adiponectin was inversely associated with C-reactive protein (P = 0.001) and serum triglyceride.ConclusionIn conclusion, adiponectin is positively correlated with inflammation, dyslipidemia and abnormal glucose tolerance in RTR. Furthermore, hypoadiponectinemia correlated with increased baseline CVD in male RTR.
Highlights
Adiponectin is a major adipocyte-derived protein with insulin-sensitizing, antiinflammatory and anti-atherogenic properties
Recent observational studies have shown adiponectin to be a novel risk marker of cardiovascular disease (CVD) in patients with stage 1 to 5 chronic kidney disease (CKD). These prospective studies have revealed that low adiponectin levels to be predictive of the development of new cardiovascular events in patients with CKD, including the hemodialysis population [9,10,11] While adiponectin has been shown to predict the development of type 2 diabetes in renal transplant recipients [12], there is yet to date any published data on the association between adiponectin and CVD in RTR
We examined the relationship between cardiovascular disease and adiponectin in RTR recruited to participate in the LANDMARK 2 study
Summary
Adiponectin is a major adipocyte-derived protein with insulin-sensitizing, antiinflammatory and anti-atherogenic properties. Cardiovascular disease (CVD) remains a major cause of premature death in patients with chronic kidney disease (CKD), including renal transplant recipients (RTR). Recent observational studies have shown adiponectin to be a novel risk marker of CVD in patients with stage 1 to 5 CKD. These prospective studies have revealed that low adiponectin levels to be predictive of the development of new cardiovascular events in patients with CKD, including the hemodialysis population [9,10,11] While adiponectin has been shown to predict the development of type 2 diabetes in renal transplant recipients [12], there is yet to date any published data on the association between adiponectin and CVD in RTR. We examined the relationship between cardiovascular disease and adiponectin in RTR recruited to participate in the LANDMARK 2 study
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