Paradoxical positive association of serum adiponectin with all-cause mortality based on body composition in Japanese haemodialysis patients

Yuri Machiba,Masafumi Kurajoh,Kyoko Norimine,Senji Okuno,Tomoyuki Yamakawa,Shigeichi Shoji,Masaaki Inaba,Katsuhito Mori,Kozo Nishide

doi:10.1038/s41598-018-33011-y

Yuri Machiba, Masafumi Kurajoh + Show 7 more

Open Access

https://doi.org/10.1038/s41598-018-33011-y

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Journal: Scientific Reports	Publication Date: Oct 2, 2018
Citations: 6	License type: open-access

Affiliation: Osaka City University, Shirasagi Hospital

Abstract

We have previously reported a paradoxical association of serum adiponectin with aortic calcification in haemodialysis patients. Because serum adiponectin is a nutritional marker, we examined the association between serum adiponectin and all-cause mortality based on body composition in haemodialysis patients. The trunk and total body fat were determined. The patients were divided into two groups based on serum adiponectin levels. In Kaplan–Meier analysis, the higher adiponectin group showed higher mortality than the lower adiponectin group. Serum adiponectin showed an inverse correlation with the percentage of truncal fat, suggesting serum adiponectin as an inverse marker for adiposity in haemodialysis patients. However, even after adjustment for other factors, multivariate Cox proportional hazards analysis identified higher serum adiponectin as an independent factor positively associated with higher mortality in haemodialysis patients. This association held true even when the total fat mass was replaced with the percentage of truncal fat, and when total fat mass and percentage of truncal fat were simultaneously included. Thus, we found a paradoxical association of higher serum adiponectin with higher all-cause mortality in Japanese haemodialysis patients, independent of adiposity.

Highlights

We have previously reported the reversal of an inverse association between serum adiponectin and abdominal aortic calcification in the general population to a positive association in haemodialysis patients[1], accumulated evidence indicates that higher serum adiponectin might predict lower cardiovascular disease (CVD) risk in the general population and in diabetes mellitus (DM) patients[2,3]
The present study demonstrated that higher serum adiponectin, a factor known to be protective against atherosclerosis in the general population[12,13], was paradoxically associated with higher all-cause mortality in Japanese haemodialysis patients (Fig. 1)
Because these findings confirmed our previous finding that serum adiponectin correlated inversely with total fat mass and percentage of truncal fat in Japanese male haemodialysis patients[14] and in the general population, they suggest the possibility that improved nutritional status reflected in higher total fat mass and percentage of truncal fat may induce suppression of serum adiponectin while improving clinical outcomes in such patients

Summary

Introduction

We have previously reported the reversal of an inverse association between serum adiponectin and abdominal aortic calcification in the general population to a positive association in haemodialysis patients[1], accumulated evidence indicates that higher serum adiponectin might predict lower cardiovascular disease (CVD) risk in the general population and in diabetes mellitus (DM) patients[2,3]. Because a series of previous reports have shown the development of adiponectin resistance following receptor activation in chronic kidney disease (CKD) patients[9], it is important to elucidate the mechanism(s) that might contribute to the reversal of the inverse association observed in the general population mentioned above to a positive one in haemodialysis patients. This background prompted us to investigate the association between serum adiponectin and all-cause mortality in haemodialysis patients based on body composition such as total fat mass and percentage of truncal fat mass

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Conclusion