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Serum adiponectin and protein-energy wasting in predialysis chronic kidney disease

 Young Youl Hyun  ;  Kyu-Beck Lee  ;  Kook-Hwan Oh  ;  Curie Ahn  ;  Sue Kyung Park  ;  Dong Wan Chae  ;  Tae-Hyun Yoo  ;  Kyu Hun Cho  ;  Yong-Soo Kim  ;  Young-Hwan Hwang  ;  Representing KNOW-CKD Study Group 
 NUTRITION, Vol.33 : 254-260, 2017 
Journal Title
Issue Date
Adiponectin/blood* ; Adult ; Aged ; Biomarkers/blood ; Biomarkers/urine ; Cohort Studies ; Comorbidity ; Creatinine/urine ; Cross-Sectional Studies ; Female ; Hospitals, University ; Humans ; Kidney/physiopathology ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Protein-Energy Malnutrition/epidemiology* ; Renal Insufficiency, Chronic/blood* ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/physiopathology ; Renal Insufficiency, Chronic/urine ; Republic of Korea/epidemiology ; Risk Factors ; Severity of Illness Index ; Up-Regulation*
Adiponectin ; Chronic kidney disease ; Protein–energy wasting ; Urine creatinine excretion
OBJECTIVE: Adiponectin (ADPN) has antiatherogenic, anti-inflammatory, and insulin-sensitizing effects. Serum ADPN levels are increased in patients with chronic kidney diseases (CKD), and higher ADPN is paradoxically a predictor of mortality in these patients. The aim of this study was to determine the association between serum ADPN levels and protein-energy wasting (PEW) in predialysis CKD. METHOD: We examined serum ADPN concentrations and PEW in 1303 patients from the KNOW-CKD (KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease) study. PEW was defined as the presence of three or more of the following four indicators: serum albumin <3.8 g/dL, body mass index <23 kg/m2, urine creatinine excretion (UCE) below the lower quartile, and daily dietary protein intake <0.6 g/kg. We analyzed the association between PEW and ADPN using a multivariate regression model after adjustment for socioeconomic factors, comorbidities, and laboratory findings. RESULTS: Among 1303 predialysis CKD patients, 72 (5.5%) had PEW. In multivariate logistic regression analysis, higher ADPN level was associated with PEW (odds ratio, 1.04; 95% confidence interval [CI], 1.01-1.08 by 1 μg/mL ADPN). The highest ADPN quartile was associated with PEW in comparison with the lowest quartile (odds ratio, 10.54; 95% CI, 1.28-86.74). In multiple linear regression with PEW indicators, ADPN was more strongly associated with UCE (β = -2.21; 95% CI, -4.13 to -0.28; R2 = 0.67). CONCLUSION: High ADPN is independently associated with PEW. Among PEW indicators, serum ADPN is closely associated with UCE as an indirect measure of muscle mass.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
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