Abstract
BackgroundAdiponectin and leptin, two of the key cytokines secreted by adipocytes, have been shown to be associated with cardiovascular disease. However, the association of these adipocytokines with chronic kidney disease (CKD) is not clear. We examined the association of serum adiponectin, leptin levels and leptin to adiponectin ratio (LAR) with CKD in a population-based sample of Asian adults.MethodsWe conducted a case-control study (450 CKD cases and 920 controls matched for age, sex and ethnicity) involving Chinese and Indian adults aged 40–80 years who participated in the Singapore Epidemiology of Eye Diseases Study (2007–2011). CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73m2 from serum creatinine. Serum adiponectin and leptin levels were measured using commercially available ELISA. Odds ratio of CKD associated with elevated adiponectin and leptin levels were estimated using logistic regression models adjusted for age, gender, ethnicity, education, smoking, body mass index, diabetes, blood pressure, total and HDL cholesterol.ResultsCKD cases had higher levels of leptin (mean [SD] 9.7 [11.5] vs.16.9 [20.2] ng/mL, p<0.0001) and adiponectin (10.4 [7.4] vs. 9.2 [4.2], p = 0.001) compared to controls. In multi-variable models, compared to those in the lowest quartile, the OR (95% confidence interval) of CKD among those in the highest quartile were: 6.46 (3.84, 10.88), 1.94 (1.32–2.85) and 2.88 (1.78–4.64) for leptin, adiponectin and LAR. Similar associations were also observed when adiponectin and leptin were analyzed as continuous variables. This positive association of serum adiponectin, leptin and LAR with CKD was consistently present in subgroups of gender, ethnicity, diabetes, hypertension and overweight status (all P-interaction >0.1).ConclusionsHigher levels of serum adiponectin, leptin and LAR were positively associated with CKD independent of traditional risk factors in this Asian population.
Highlights
Chronic kidney disease (CKD) is common in Asia, with epidemiological studies reporting prevalences of 6–17% [1]
Odds ratio of chronic kidney disease (CKD) associated with elevated adiponectin and leptin levels were estimated using logistic regression models adjusted for age, gender, ethnicity, education, smoking, body mass index, diabetes, blood pressure, total and high-density lipoprotein (HDL) cholesterol
This positive association of serum adiponectin, leptin and leptin to adiponectin ratio (LAR) with CKD was consistently present in subgroups of gender, ethnicity, diabetes, hypertension and overweight status
Summary
Chronic kidney disease (CKD) is common in Asia, with epidemiological studies reporting prevalences of 6–17% [1]. It is associated with increased mortality and cardiovascular disease (CVD), as well as substantial healthcare cost [2,3,4]. As obesity and insulin resistance are associated with CKD [5,6], there is increasing interest in the relationship between adipokines secreted by adipose tissue and kidney disease. Elevated leptin levels have been consistently shown to be associated with CKD in the general population as well as among diabetic and obese non-diabetic patients [11,19,20,21,22,23]. We examined the association of serum adiponectin, leptin levels and leptin to adiponectin ratio (LAR) with CKD in a population-based sample of Asian adults
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