Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
Biochimie. 2012 Oct;94(10):2150-6. doi: 10.1016/j.biochi.2012.02.024. Epub 2012 Mar 2.
Although adiponectin, an adipocytokine released from adipose tissue, is thought to have anti-atherogenic, anti-inflammatory, and insulin-sensitizing effects, it appears that high, rather than low, circulating levels of adiponectin predict increased mortality in chronic kidney disease (CKD) patients in whom the circulating levels may rise to about three times higher than the levels in healthy subjects. As it could be hypothesized that in the uremic milieu high adiponectin levels reflect protein-energy wasting, lower residual renal function and/or volume overload, this may explain, at least in part, the observed paradoxical link between hyperadiponectinemia and poor outcome in CKD. To determine the biological consequences of high circulating adiponectin levels on carbohydrate and insulin metabolism as well as relations with cardiovascular function and mortality in the uremic milieu, further studies need to take into account both high-, and low-molecular weight adiponectin moieties as well as the role of adiponectin receptors. This brief review summarizes some of the recent advances in our understanding of the complex and context-sensitive role of this elusive and intriguing adipokine in the uremic milieu.
尽管脂联素是一种由脂肪组织释放的脂肪细胞因子，被认为具有抗动脉粥样硬化、抗炎和胰岛素增敏作用，但似乎是高而非低循环水平的脂联素预测慢性肾脏病 (CKD) 患者死亡率增加，在这些患者中，循环水平可能升高约三倍高于健康受试者的水平。由于可以假设在尿毒症环境中，高脂联素水平反映了蛋白质-能量消耗、残余肾功能降低和/或容量超负荷，这至少可以部分解释观察到的尿毒症环境中高脂联素血症与不良预后之间的矛盾联系。为了确定高循环脂联素水平对碳水化合物和胰岛素代谢的生物学后果，以及与心血管功能和死亡率的关系，进一步的研究需要考虑高和低分子量的脂联素片段以及脂联素受体的作用。这篇简短的综述总结了我们对这种难以捉摸和有趣的脂肪因子在尿毒症环境中的复杂和上下文敏感作用的一些最新认识。
