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비당뇨병성 말기신부전 환자에서 심혈관질환 발생의 예측 인자로서 아디포넥틴의 유용성

Other Titles
 Serum Adiponectin as a Predictor for Cardiovascular Outcomes in Non-Diabetic End-Stage Renal Disease Patients 
 안혜림  ;  문성진  ;  박형천  ;  이용규  ;  김좌경  ;  김범석  ;  김형종  ;  한대석  ;  하성규 
 Korean Journal of Nephrology, Vol.29(4) : 465-473, 2010 
Journal Title
Korean Journal of Nephrology
Issue Date
Adiponectin ; End-stage renal disease ; Cardiovascular disease
Purpose: Adiponectin (ADPN) has been known to protect against cardiovascular disease (CVD) in
metabolic syndrome with normal renal function for its anti-inflammatory and anti-atherogenic property.
However, it is still unclear whether ADPN is associated with cardiovascular outcomes in end-stage
renal disease (ESRD) patients.
Methods: This study included 80 non-diabetic ESRD patients [mean age, 52.8±13.7 years; dialysis
duration, 67.1±52.0 months; hemodialysis (HD), 35 pts; peritoneal dialysis (PD), 45 pts] who survived
for more than 3 months after the start of dialysis, and serum ADPN levels were measured at the beginning
of the study. We conducted a longitudinal follow-up to evaluate the association of serum ADPN
level with cardiovascular outcomes for 29.3±6.7 months.
Results: ADPN was inversely correlated with fasting serum insulin (r=-0.309, p=0.006) and HOMA-IR
(r=-0.321, p=0.004) in ESRD patients. In a multiple linear regression analysis adjusted for age, gender,
waist to hip ratio (WHR), and HDL-cholesterol, HOMA-IR (β=-0.880, p=0.041) was an independent
factor associated with serum ADPN level. Kaplan-Meier analysis revealed that patients with higher
ADPN levels (≥15.8 μg/mL) had a significantly higher survival rate compared with lowers (<15.8 μg/
mL) (p=0.032). Cox proportional hazard model adjusted for age, WHR, creatinine, CRP, and previous
CVD history revealed that serum ADPN level (HR, 0.899; 95% CI, 0.818-0.987; p=0.026) was an independent
determinant of cardiovascular outcomes.
Conclusion: These findings suggest that lower ADPN levels independently predict cardiovascular events
in non-diabetic ESRD patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Kim, Jwa Kyung(김좌경)
Moon, Sung Jin(문성진)
Park, Hyeong Cheon(박형천) ORCID logo https://orcid.org/0000-0002-1550-0812
Lee, Yong Kyu(이용규)
Ha, Sung Kyu(하성규)
Han, Dae Suk(한대석)
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