Hypoadiponectinemia is associated with metabolic syndrome in hemodialysis patients

Jen-Pi Tsai^{a, b}, Hsiang-Man Liu^c, Chung-Jen Lee^d, Horng-Rong Chang^{a, e}, Bang-Gee Hsu^{f, g}

^a Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
^b Department of Nephrology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
^c Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^d Department of Nursing, Tzu Chi College of Technology, Hualien, Taiwan
^e Division of Nephrology, Chung Shan Medical University Hospital, Taichung, Taiwan
^f Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^g School of Medicine, Tzu Chi University, Hualien, Taiwan

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Abstract
Objective

The serum adiponectin level decreases in patients with metabolic syndrome (MetS) and is an inverse predictor of cardiovascular outcomes in hemodialysis (HD) patients. The aim of this study was to investigate the relationship of adiponectin and MetS among HD patients.

Materials and Methods

Fasting blood samples were obtained from 101 HD patients. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation.

Results

Forty-eight of the 101 HD patients (47.5%) had MetS. Adiponectin levels negatively correlated with MetS among HD patients (p = 0.001). Univariate linear regression analysis showed that the pre-HD body weight (p < 0.001); waist circumference (p = 0.001); body mass index (BMI; p < 0.001); hemoglobin (p = 0.038); triglyceride level (p < 0.001); insulin level (p = 0.005); and homeostasis model assessment of insulin resistance (p = 0.001) correlated negatively with the fasting serum adiponectin levels, whereas the high-density-lipoprotein cholesterol (HDL-C; p < 0.001) level correlated positively with the fasting serum adiponectin levels in the HD patients. Multivariate forward stepwise linear regression analysis of the significant variables showed that the HDL-C level (R2 change = 0.142, p = 0.001) and BMI (R2 change = 0.078, p = 0.002) were independent predictors of fasting serum adiponectin levels in HD patients.

Conclusion

The serum adiponectin concentration correlates inversely with MetS in HD patients. For these patients, the HDL-C level and BMI are independent predictors of the serum adiponectin value.

Keywords
Adiponectin; Body mass index; Hemodialysis; High-density-lipoprotein cholesterol; Metabolic syndrome