Shu K-H, Tsai I-C, Ho H-C, Wu M-J, Chen C-H, Cheng C-H, Yu T-M, Chuang Y-W, Huang S-T
Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Transplant Proc. 2012 Apr;44(3):676-9. doi: 10.1016/j.transproceed.2011.11.032.
Adiponectin (APN) is an adipocyte-derived protein that has anti-inflammatory, anti-atherogenic, and insulin-sensitizing effects. Lower serum APN level is associated with various inflammatory and metabolic diseases in the general population. Kidney transplant (KT) recipients are at higher risk for developing several metabolic disorders, including metabolic syndrome (MS). The aim of the current study was to assess the change of APN level in KT recipients with and without MS.
Prevalent KT recipients followed at our hospital were enrolled for the cross-sectional study of MS. The modified Adult Treatment Panel III criteria adopted for the Asian population were used to define MS. Overnight fasting blood samples were obtained for biochemistry and APN. APN was assayed with a commercially available enzyme-linked immunosorbent assay (ELISA) kit. The simplified Modification of Diet in Renal Disease (MDRD) equation was used for the calculation of estimated glomerular filtration rate (eGFR). Univariate and multivariate logistic regression were performed to determine parameters that were associated with serum APN level.
A total of 271 KT recipients (male:female = 133:138), with a mean age of 52.3 ± 12.6 years, were enrolled for the study of MS. The mean duration of follow-up posttransplantation was 9.02 ± 5.91 years. MS was found in 72 of 271 KT recipients (26.6%). Patients with MS were older, had significantly higher body weight, waist circumference, serum creatinine, fasting plasma sugar, and hemoglobin A1c, but lower serum APN level and eGFR than did patients without MS. Univariate logistic regression revealed the following variables were associated with APN level: MS, gender, body weight, body height, waist circumference, body mass index, serum creatinine, fasting blood sugar, triglyceride, high-density lipoprotein (HDL) cholesterol, and eGFR. Multivariate analysis revealed that gender, body weight, serum creatinine, triglyceride, and HDL cholesterol were associated with APN level.
Our results revealed that KT recipients with MS had significantly lower serum APN levels, even in the presence of lower eGFR, than those without MS.
脂联素（APN）是一种脂肪细胞衍生的蛋白质，具有抗炎、抗动脉粥样硬化和胰岛素增敏作用。在普通人群中，较低的血清APN水平与各种炎症和代谢性疾病相关。肾移植（KT）受者发生包括代谢综合征（MS）在内的多种代谢紊乱的风险较高。本研究的目的是评估有和没有MS的KT受者中APN水平的变化。
选取我院随访的KT受者进行MS的横断面研究。采用适用于亚洲人群的改良成人治疗小组III标准来定义MS。采集过夜空腹血样进行生化检查和APN检测。使用市售的酶联免疫吸附测定（ELISA）试剂盒检测APN。采用简化的肾脏疾病饮食改良（MDRD）方程计算估计肾小球滤过率（eGFR）。进行单因素和多因素逻辑回归以确定与血清APN水平相关的参数。
共有271名KT受者（男∶女 = 133∶138）纳入MS研究，平均年龄为52.3±12.6岁。移植后平均随访时间为9.02±5.91年。271名KT受者中有72名（26.6%）患有MS。患有MS的患者年龄更大，体重、腰围、血清肌酐、空腹血糖和糖化血红蛋白水平显著更高，但血清APN水平和eGFR低于没有MS的患者。单因素逻辑回归显示以下变量与APN水平相关：MS、性别、体重、身高、腰围、体重指数、血清肌酐、空腹血糖、甘油三酯、高密度脂蛋白（HDL）胆固醇和eGFR。多因素分析显示性别、体重、血清肌酐、甘油三酯和HDL胆固醇与APN水平相关。
我们的结果显示，患有MS的KT受者即使eGFR较低，其血清APN水平也显著低于没有MS的受者。
