TY - JOUR
T1 - Adiponectin and mortality in patients with chronic kidney disease
AU - Menon, Vandana
AU - Li, Lijun
AU - Wang, Xuelei
AU - Greene, Tom
AU - Balakrishnan, Vaidyanathapuram
AU - Madero, Magdalena
AU - Pereira, Arema A.
AU - Beck, Gerald J.
AU - Kusek, John W.
AU - Collins, Allan J
AU - Levey, Andrew S.
AU - Sarnak, Mark J.
PY - 2006/9
Y1 - 2006/9
N2 - Adiponectin is presumed to possess antiatherogenic and cardioprotective properties. Limited data exist on the relationship between adiponectin and mortality in the earlier stages of chronic kidney disease. The Modification of Diet in Renal Disease study was a randomized, controlled trial that was conducted between 1989 and 1993. Adiponectin was measured in frozen samples that were obtained at baseline (N = 820). Survival status and cause of death, up to December 31, 2000, were obtained from the National Death Index. Multivariable Cox models were used to examine the relationship of adiponectin with all-cause and cardiovascular mortality. Mean ± SD age was 52 ± 12 yr, and mean ± SD glomerular filtration rate (GFR) rate was 33 ± 12 ml/min per 1.73 m2. Eighty-five percent of participants were white, and 60% were male. Mean ± SD adiponectin was 12.8 ± 8.0 μg/ml. Triglycerides, insulin resistance, glucose, body mass index, GFR, C-reactive protein, and albumin were inversely related and proteinuria and HDL cholesterol were directly related to adiponectin. During the 10-year follow-up period, 201 (25%) participants died of any cause, and 122 (15%) from cardiovascular disease. In multivariable adjusted Cox models, a 1-μg/ml increase in adiponectin was associated with a 3% (hazard ratio 1.03; 95% confidence interval 1.01 to 1.05; P = 0.02) increased risk for all-cause and 6% (hazard ratio 1.06; 95% confidence interval 1.03 to 1.09; P < 0.001) increased risk for cardiovascular mortality. High, rather than low, adiponectin is associated with increased mortality in this cohort of patients with chronic kidney disease stages 3 to 4. Further studies are necessary to confirm this association and to elucidate the underlying mechanisms.
AB - Adiponectin is presumed to possess antiatherogenic and cardioprotective properties. Limited data exist on the relationship between adiponectin and mortality in the earlier stages of chronic kidney disease. The Modification of Diet in Renal Disease study was a randomized, controlled trial that was conducted between 1989 and 1993. Adiponectin was measured in frozen samples that were obtained at baseline (N = 820). Survival status and cause of death, up to December 31, 2000, were obtained from the National Death Index. Multivariable Cox models were used to examine the relationship of adiponectin with all-cause and cardiovascular mortality. Mean ± SD age was 52 ± 12 yr, and mean ± SD glomerular filtration rate (GFR) rate was 33 ± 12 ml/min per 1.73 m2. Eighty-five percent of participants were white, and 60% were male. Mean ± SD adiponectin was 12.8 ± 8.0 μg/ml. Triglycerides, insulin resistance, glucose, body mass index, GFR, C-reactive protein, and albumin were inversely related and proteinuria and HDL cholesterol were directly related to adiponectin. During the 10-year follow-up period, 201 (25%) participants died of any cause, and 122 (15%) from cardiovascular disease. In multivariable adjusted Cox models, a 1-μg/ml increase in adiponectin was associated with a 3% (hazard ratio 1.03; 95% confidence interval 1.01 to 1.05; P = 0.02) increased risk for all-cause and 6% (hazard ratio 1.06; 95% confidence interval 1.03 to 1.09; P < 0.001) increased risk for cardiovascular mortality. High, rather than low, adiponectin is associated with increased mortality in this cohort of patients with chronic kidney disease stages 3 to 4. Further studies are necessary to confirm this association and to elucidate the underlying mechanisms.
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U2 - 10.1681/ASN.2006040331
DO - 10.1681/ASN.2006040331
M3 - Article
C2 - 16885405
AN - SCOPUS:33748050124
SN - 1046-6673
VL - 17
SP - 2599
EP - 2606
JO - Journal of the American Society of Nephrology
JF - Journal of the American Society of Nephrology
IS - 9
ER -