Abstract
Background and AimMetabolic disorders are prevalent in patients with chronic kidney disease (CKD) and may lead to protein energy wasting (PEW). Adipokines improve connections between PEW and energy metabolism. We aimed to determine the relationship between adipokine levels and resting energy expenditure (REE) in patients with CKD.MethodsA total of 208 patients in non-dialyzed CKD stages 3–5 were enrolled in this cross-sectional study. Serum adipokines (leptin, adiponectin, and interleukin 6 (IL-6) were measured using enzyme-linked immunosorbent assay. Patient's REE was measured using indirect calorimetry. Fat mass (FM) and lean tissue mass (LTM) were measured using multiple-frequency bioimpedance analysis. Spearman correlation analyses and multivariate linear regression models were used to assess the association between serum adipokines and REE.ResultsThe mean age was 52.7 ± 14.6 years, and 26.9, 26.4, and 46.7% of our participants had CKD stages 3, 4, and 5, respectively. The median values of serum adiponectin, leptin, and IL-6 were 470.4 (range, 291.1–802.2), 238.1 (range, 187.9–418.4), and 4.0 (range, 2.4–9.5) pg/mL, respectively. The male participants had significantly lower FM% (P = 0.001) and lower leptin levels (P < 0.001) than the female participants. After adjusting for age, diabetes, high-sensitivity C-reactive protein, intact parathyroid hormone, LTM, and FM, multiple linear regression analysis revealed that serum leptin levels were significantly positively associated with REE in men rather than in women (P < 0.05). Serum adiponectin levels were inversely associated with REE in men, but this association disappeared while FM was additionally adjusted. Adiponectin levels in women were not correlated with REE (P > 0.05). IL-6 was not significantly associated with REE in either men or women.ConclusionsA sex-specific relationship between serum adipokines (leptin and adiponectin) and REE was observed in patients with CKD stages 3–5, which was partly confounded by FM.
Highlights
Background and AimMetabolic disorders are prevalent in patients with chronic kidney disease (CKD) and may lead to protein energy wasting (PEW)
After adjusting for age, diabetes, high-sensitivity C-reactive protein, intact parathyroid hormone, lean tissue mass (LTM), and fat mass (FM), multiple linear regression analysis revealed that serum leptin levels were significantly positively associated with resting energy expenditure (REE) in men rather than in women (P < 0.05)
Serum adiponectin levels were inversely associated with REE in men, but this association disappeared while FM was adjusted
Summary
Metabolic disorders are prevalent in patients with chronic kidney disease (CKD) and may lead to protein energy wasting (PEW). Adipokines improve connections between PEW and energy metabolism. We aimed to determine the relationship between adipokine levels and resting energy expenditure (REE) in patients with CKD. Edited by: Barbara Perez Vogt, Federal University of Uberlandia, Brazil. Reviewed by: Vasiliki Karava, Aristotle University of Thessaloniki, Greece. Thaís De Oliveira Fernandes, Federal University of São Paulo, Brazil. Mariana De Oliveira, Centro Universitário Nossa Senhora do Patrocínio, Brazil. Specialty section: This article was submitted to Nutrition and Metabolism, a section of the journal
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