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

 Jung Tak Park  ;  Tae-Hyun Yoo  ;  Jwa-Kyung Kim  ;  Hyung Jung Oh  ;  Seung Jun Kim  ;  Dong Eun Yoo  ;  Mi Jung Lee  ;  Dong Ho Shin  ;  Seung Hyeok Han  ;  Dae-Suk Han  ;  Shin-Wook Kang 
 Peritoneal Dialysis International, Vol.33(1) : 67-74, 2013 
Journal Title
 Peritoneal Dialysis International 
Issue Date
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.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
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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