Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2 B-5, Yamada-oka, Suita, Osaka 565-0871, Japan.
BMC Nephrol. 2013 Feb 26;14:50. doi: 10.1186/1471-2369-14-50.
Patients on maintenance hemodialysis (HD) have much higher levels of adiponectin (Total-APN). Adiponectin and C1q form a protein complex in human blood, and serum C1q-binding adiponectin (C1q-APN) can be measured. We recently reported that C1q-APN/Total-APN ratio rather than Total-APN correlated with atherosclerosis in diabetics. However, the characteristics of C1q-APN in HD patients remain unclear. The preset study investigated the characteristics of the adiponectin parameters including C1q-APN and also to clarify the relationship between various serum adiponectin parameters and atherosclerotic cardiovascular diseases (ACVD) in HD patients.
The single cross-sectional study subjects were 117 Japanese patients (males/females = 61/56) on regular HD. Blood Total-APN, high molecular weight-adiponectin (HMW-APN), C1q-APN and C1q concentrations were measured by enzyme-linked immunosorbent assays. ACVD were defined as stroke, coronary and peripheral artery diseases, thoracic and abdominal aneurysms.
Stepwise regression analysis identified high-density lipoprotein-cholesterol (HDL-C) as the only significant and independent determinant of C1q-APN in males, and duration of HD as the only significant and independent determinant of C1q-APN in females. Stepwise regression analysis identified uric acid, low-density lipoprotein-cholesterol and triglyceride as significant and independent determinants of C1q-APN/Total-APN ratio in males, and leukocyte count and HDL-C as significant and independent determinants of C1q-APN/Total-APN ratio in females. Multiple logistic regression analysis identified inorganic phosphorus and C1q-APN or C1q-APN/C1q ratio as significant determinants of ACVD.
Low serum C1q-APN and C1q-APN/C1q ratio, but not C1q-APN/Total-APN ratio, correlated with ACVD in HD patients.
ClinicalTrials.gov: UMIN http://000004318.
维持性血液透析（HD）患者的脂联素（Total-APN）水平较高。脂联素和 C1q 在人血液中形成蛋白质复合物，可测量血清 C1q 结合脂联素（C1q-APN）。我们最近报道，C1q-APN/Total-APN 比值而非 Total-APN 与糖尿病患者的动脉粥样硬化相关。然而，HD 患者的 C1q-APN 特征尚不清楚。本研究调查了包括 C1q-APN 在内的脂联素参数的特征，并阐明了 HD 患者各种血清脂联素参数与动脉粥样硬化性心血管疾病（ACVD）的关系。
本单中心横断面研究的对象为 117 名日本常规 HD 患者（男/女=61/56）。通过酶联免疫吸附试验测定血 Total-APN、高分子量脂联素（HMW-APN）、C1q-APN 和 C1q 浓度。ACVD 定义为中风、冠状动脉和外周动脉疾病、胸腹部动脉瘤。
逐步回归分析确定高密度脂蛋白胆固醇（HDL-C）是男性 C1q-APN 的唯一显著独立决定因素，HD 时间是女性 C1q-APN 的唯一显著独立决定因素。逐步回归分析确定尿酸、低密度脂蛋白胆固醇和甘油三酯是男性 C1q-APN/Total-APN 比值的显著独立决定因素，白细胞计数和 HDL-C 是女性 C1q-APN/Total-APN 比值的显著独立决定因素。多元逻辑回归分析确定无机磷和 C1q-APN 或 C1q-APN/C1q 比值是 ACVD 的显著决定因素。
低血清 C1q-APN 和 C1q-APN/C1q 比值而非 C1q-APN/Total-APN 比值与 HD 患者的 ACVD 相关。
ClinicalTrials.gov：UMIN http://000004318。
