Takemoto Fumi, Katori Hideyuki, Sawa Naoki, Hoshino Junichi, Suwabe Tatsuya, Nakanishi Shohei, Arai Shigeyuki, Fukuda Seiichi, Kodaka Kenzo, Shimada Masaru, Yamazaki Chihiro, Yokoyama Keitaro, Nakano Yasuko, Funahashi Tohru, Ubara Yoshifumi, Yamada Akira, Takaichi Kenmei, Uchida Shunya
Kidney Center, Toranomon Hospital, Teikyo University School of Medicine, Tokyo, Japan.
Nephron Clin Pract. 2009;111(1):c12-20. doi: 10.1159/000178818. Epub 2008 Dec 4.
BACKGROUND/AIM: Plasma adiponectin may play a protective role in the pathogenesis of cardiovascular disease in hemodialysis (HD) patients. We examined the effect of plasma adiponectin levels on the prognosis of the HD patients.
68 HD patients (male:female = 38:30) were subjected to plasma adiponectin measurement in 1998 and followed up over 8 years.
Plasma adiponectin concentrations differed between male and female patients (9.3 vs. 15.7 microg/ml). The plasma adiponectin concentration as a whole was positively correlated with serum high-density lipoprotein cholesterol and negatively with serum creatinine and waist circumference. During an 8-year follow-up, the cardiac events occurred in 7 of 38 men and in 10 of 30 women. Cox's proportional hazard model analysis in a stepwise manner revealed that coronary heart disease (CHD) was associated with intact parathyroid hormone concentration, age, and the presence of diabetes in men whereas plasma adiponectin concentration was the most powerful single predictor in women. The impact of the plasma adiponectin concentration was strengthened by Kaplan-Meier survival analysis. In the group with a lower plasma adiponectin concentration, CHD events were significantly increased in men (p = 0.043) and in women (p = 0.007).
Plasma adiponectin concentration may predict CHD outcomes in HD patients.
背景/目的：血浆脂联素可能在血液透析（HD）患者心血管疾病的发病机制中发挥保护作用。我们研究了血浆脂联素水平对HD患者预后的影响。
1998年对68例HD患者（男:女 = 38:30）进行血浆脂联素检测，并随访8年。
男性和女性患者的血浆脂联素浓度不同（9.3对15.7微克/毫升）。总体血浆脂联素浓度与血清高密度脂蛋白胆固醇呈正相关，与血清肌酐和腰围呈负相关。在8年的随访期间，38名男性中有7人发生心脏事件，30名女性中有10人发生心脏事件。逐步进行的Cox比例风险模型分析显示，冠心病（CHD）与男性的完整甲状旁腺激素浓度、年龄和糖尿病的存在有关，而血浆脂联素浓度是女性中最有力的单一预测因素。Kaplan-Meier生存分析加强了血浆脂联素浓度的影响。在血浆脂联素浓度较低的组中，男性（p = 0.043）和女性（p = 0.007）的CHD事件显著增加。
血浆脂联素浓度可能预测HD患者的CHD结局。
