MO1035: Adipokine Profile and Protein-Energy Wasting in Children with Chronic Kidney Disease

Abstract

Abstract BACKGROUND AND AIMS This cross-sectional study investigates the association between adipokine profile, serum interleukin-6 (IL-6) levels and protein-energy wasting (PEW) in children with chronic kidney disease (CKD). METHOD Serum adiponectin, leptin, resistin and IL-6 were measured in 53 patients, with a median age of 12.9 years, presenting CKD stage 3–5. Body composition indices, lean tissue (LTI) and fat tissue index (FTI), were measured by bioimpedance analysis spectroscopy. PEW was defined as the presence of muscle wasting [LTI adjusted to height and age (LTI HA) Z-score < −1.65 SD] and at least two of the following criteria: poor growth [height Z-score < −1.88 SD], questionnaire-based reduced appetite, or serum albumin ≤ 3.8 g/dL. RESULTS PEW was present in 8 (15.1%) patients. At least 1,2,3 and 4 PEW criteria were present in 25 (47.2%), 16 (30.2%), 9 (17%), 3 (5.6%) patients respectively. Among the PEW criteria, muscle wasting was present in 18 (34%), poor growth in 14 (30.2%), reduced appetite in 8 (15%) and low serum albumin in 13 (24.5%) patients respectively. PEW was more frequent in CKD stage 5 (P = .010). Adiponectin and resistin levels were higher in CKD stage 5 (P < .001, P = .005), while leptin did not differ among CKD stages (P = .440). Adiponectin was negatively correlated to LTI HA (rs =− 0.417, P = .002), leptin was positively correlated to FTI (rs = 0.620, P < .001), while resistin was not correlated to body composition indices. IL-6 was positively correlated only to adipokine resistin (rs = 0.513, P < .001). Adiponectin and IL-6 were associated with PEW after adjustment for CKD stage [odds ratio (OR) 1.239, 95% confidence interval (95% CI) 1.040, 1.475 and OR 1.034, 95% CI 1.007–1.06), leptin was not associated with PEW, while resistin association with PEW lost significance in multivariate analysis. CONCLUSION In advanced paediatric CKD, adiponectin and resistin are probably involved in muscle wasting and systemic inflammation process respectively. Serum leptin reflects adiposity status. Apart from serum inflammatory cytokines, serum adiponectin may be a useful biomarker of PEW in children with CKD.