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Leptin/Adiponectin Ratio Is an Independent Predictor of Mortality in Nondiabetic Peritoneal Dialysis Patients

Authors
 Jung Tak Park  ;  Tae-Hyun Yoo  ;  Shin-Wook Kang  ;  Dae-Suk Han  ;  Seung Hyeok Han  ;  Dong Ho Shin  ;  Mi Jung Lee  ;  Dong Eun Yoo  ;  Seung Jun Kim  ;  Hyung Jung Oh  ;  Jwa-Kyung Kim 
Citation
 Peritoneal Dialysis International, Vol.33(1) : 67-74, 2013 
Journal Title
 Peritoneal Dialysis International 
ISSN
 0896-8608 
Issue Date
2013
Abstract
BACKGROUND: The leptin/adiponectin (L/A) ratio has been suggested to be an atherosclerotic index for diabetic patients and a useful marker of insulin resistance in patients with and without diabetes. Even though end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) are well characterized by abnormal adipocytokine metabolism, the significance of alterations in the L/A ratio is largely unexplored in these patients. In this prospective study, we investigated the associations of leptin, adiponectin, and the L/A ratio with clinical outcomes in nondiabetic PD patients. METHODS: The study included 131 stable nondiabetic ESRD patients who had been on PD for more than 3 months. Serum leptin and adiponectin levels were determined at baseline. Mortality was evaluated over a 5-year follow-up period. RESULTS: During the follow-up period, 22 patients died (16.8%), including 10 (45.5%) as a result of cardiovascular disease. The L/A ratio showed a significant positive correlation with body mass index [BMI (r = 0.47, p < 0.001)], high-sensitivity C-reactive protein (r = 0.32, p < 0.001), and triglycerides (r = 0.43, p < 0.001). In addition, we observed significant inverse correlations between the L/A ratio and percentage lean body mass (r = -0.30, p = 0.001) and high-density lipoprotein cholesterol (r = -0.31, p = 0.001). In contrast to individual leptin and adiponectin levels, the L/A ratio was found to be independently associated with an increased mortality risk (relative risk: 1.15; 95% confidence interval: 1.05 to 1.27; p = 0.003) even after adjustments for age and BMI. CONCLUSIONS: The L/A ratio might be better related to patient outcomes than adipocytokines are individually in nondiabetic patients undergoing PD.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86248
DOI
10.3747/pdi.2011.00066
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강신욱(Kang, Shin Wook) ; 김승준(Kim, Seung Jun) ; 김좌경(Kim, Jwa Kyung) ; 박정탁(Park, Jung Tak) ; 신동호(Shin, Dong Ho) ; 오형중(Oh, Hyung Jung) ; 유동은(Yoo, Dong Eun) ; 유태현(Yoo, Tae Hyun) ; 이미정(Lee, Mi Jung) ; 한대석(Han, Dae Suk) ; 한승혁(Han, Seung Hyeok)
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