Odamaki Mari, Furuya Ryuichi, Kinumura Yumie, Ikegaya Naoki, Kumagai Hiromichi
Department of Clinical Nutrition, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan.
Nephron Clin Pract. 2006;102(1):c8-13. doi: 10.1159/000088293. Epub 2005 Sep 13.
Cardiovascular diseases resulting from atherosclerotic complications are major causes of death in hemodialysis (HD) patients. Adiponectin (ADPN) is a recently discovered adipocyte-derived protein that appears to have protective role against atherosclerosis. HD patients have an excess accumulation of intra-abdominal fat mass in association with an atherogenic serum lipid profile despite low body mass index; however, the role of intra-abdominal fat mass in the progress of atherosclerosis remains to be clarified.
We evaluated visceral (VFA) and subcutaneous fat areas (SFA) by computed tomography and measured the plasma ADPN in 47 HD patients. We also examined the relationship between visceral fat accumulation and plasma ADPN levels and clinical parameters related to atherosclerosis.
Plasma ADPN was 29.0 +/- 12.5 microg/ml in HD patients (mean +/- SD), two-fold higher than that in control subjects (14.0 +/- 9.1 microg/ml). Plasma ADPN correlated significantly and negatively with visceral fat area (VFA) (r = -0.49, p < 0.001) and subcutaneous fat area (SFA) (r = -0.42, p < 0.01) in HD patients. Plasma ADPN also correlated significantly and positively with HDL-cholesterol (r = 0.45, p < 0.005) and significantly and negatively with atherosclerotic index (AI, r = -0.39, p < 0.01) and triglycerides (r = -0.32, p < 0.05) in HD patients. Multiple stepwise regression analysis identified VFA as a significant independent predictor of plasma ADPN concentration in HD patients.
Our findings indicate that visceral fat is a major determinant of plasma ADPN level, suggesting that visceral fat accumulation might be closely associated with the progression of atherosclerotic vascular disease in HD patients.
动脉粥样硬化并发症导致的心血管疾病是血液透析（HD）患者死亡的主要原因。脂联素（ADPN）是一种最近发现的脂肪细胞衍生蛋白，似乎对动脉粥样硬化具有保护作用。尽管HD患者体重指数较低，但他们腹部脂肪量过多，伴有致动脉粥样硬化的血脂谱；然而，腹部脂肪量在动脉粥样硬化进展中的作用仍有待阐明。
我们通过计算机断层扫描评估了47例HD患者的内脏脂肪面积（VFA）和皮下脂肪面积（SFA），并测量了血浆ADPN。我们还研究了内脏脂肪堆积与血浆ADPN水平以及与动脉粥样硬化相关的临床参数之间的关系。
HD患者的血浆ADPN为29.0±12.5微克/毫升（平均值±标准差），是对照组受试者（14.0±9.1微克/毫升）的两倍。HD患者血浆ADPN与内脏脂肪面积（VFA）显著负相关（r = -0.49，p < 0.001）和皮下脂肪面积（SFA）显著负相关（r = -0.42，p < 0.01）。HD患者血浆ADPN还与高密度脂蛋白胆固醇显著正相关（r = 0.45，p < 0.005），与动脉粥样硬化指数（AI，r = -0.39，p < 0.01）和甘油三酯显著负相关（r = -0.32，p < 0.05）。多步回归分析确定VFA是HD患者血浆ADPN浓度的重要独立预测因子。
我们的研究结果表明，内脏脂肪是血浆ADPN水平的主要决定因素，提示内脏脂肪堆积可能与HD患者动脉粥样硬化性血管疾病的进展密切相关。
