Correlation analysis of adipocytokines insulin resistance and cardiac structure and function in patients undergoing maintenance hemodialysis

Abstract

Objective To analyze the relatonship between adipocytokines(adiponectin, leptin), in-sulin resistunce and cardiac structure and function in patients undergoing maintenance hemodialysis(MHD). Methods The level of adiponecfin (ADPN), leptin(LEP), fasting glucose(FBG) and fasting insulin (FINS) were measured in 79 MHD patents and 16 healthy individuals. The left atrial diameter(LAD), left ventricular diastolic diameter(LVDd), left ventricular end -systolic diameter(LVDs), interventricular septal thickness(IVST), left ventricular posterior wall thickness(LVPWT) and left ventricular ejection frac-tion(LVEF) were also detected by ultrasonic cardiography. Calculated HOMA -IR, left ventricular mass index (LVMI) by established formulasThe 79 MHD patents were divided into two groups: left ventricular hypertro-phy(LVH) group and Non -LVH group. Results The average serum ADPN, LEP, HOMA-IR were signifi-cantly higher in MHD patients than those in the healthy individuals(P < 0.05) ;LVMI, LVDd, IVST, LVW PT, LADincreasedsignificantly (P < 0.05, < 0.01), whileLVEF, E/Adecreasedmarkedly (P < 0.01).54.4% of patients with MHD had left ventricular hypertrophy. Serum LEP, FINS,HOMA-IR, LVMI in the LVH group was significantly higher than those in Non-LVH group(P <0.05, < 0.01). While serum ADPN in the LVH group was significantly lower than that in Non-LVH group(P < 0.01). The level of ADPN was negatively correlated with the levels of LEP, FINS, HOMA -IR, LVMI, IVST and LVPWT in MHD patients (P < 0.01) ;the level of LEP was positivsly correlated with those of FINS、HOMA-IR. The levels of LEP, FINS, HOMA-IR were positivsly correlated with the levels of LVMI, IVST, LVPWT,but negatively correlated with the levels of E/A, LVEF(P <0.05, <0.01). Conclusion Adipocytokines (ADPN,LEP) are closely correlated with insulin resistance. They are probably involved in presence and progression of cardiovascular complications in MHD patients. Key words: Adiponectin; Leptin; Isulin resistance; Heart; Hemodialysis