Lim Cynthia Ciwei, Teo Boon Wee, Tai E Shyong, Lim Su Chi, Chan Choong Meng, Sethi Sunil, Wong Tien Y, Sabanayagam Charumathi
Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
Department of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.
PLoS One. 2015 Mar 20;10(3):e0122009. doi: 10.1371/journal.pone.0122009. eCollection 2015.
Adiponectin and leptin, two of the key cytokines secreted by adipocytes, have been shown to be associated with cardiovascular disease. However, the association of these adipocytokines with chronic kidney disease (CKD) is not clear. We examined the association of serum adiponectin, leptin levels and leptin to adiponectin ratio (LAR) with CKD in a population-based sample of Asian adults.
We conducted a case-control study (450 CKD cases and 920 controls matched for age, sex and ethnicity) involving Chinese and Indian adults aged 40-80 years who participated in the Singapore Epidemiology of Eye Diseases Study (2007-2011). CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73m2 from serum creatinine. Serum adiponectin and leptin levels were measured using commercially available ELISA. Odds ratio of CKD associated with elevated adiponectin and leptin levels were estimated using logistic regression models adjusted for age, gender, ethnicity, education, smoking, body mass index, diabetes, blood pressure, total and HDL cholesterol.
CKD cases had higher levels of leptin (mean [SD] 9.7 [11.5] vs.16.9 [20.2] ng/mL, p<0.0001) and adiponectin (10.4 [7.4] vs. 9.2 [4.2], p = 0.001) compared to controls. In multi-variable models, compared to those in the lowest quartile, the OR (95% confidence interval) of CKD among those in the highest quartile were: 6.46 (3.84, 10.88), 1.94 (1.32-2.85) and 2.88 (1.78-4.64) for leptin, adiponectin and LAR. Similar associations were also observed when adiponectin and leptin were analyzed as continuous variables. This positive association of serum adiponectin, leptin and LAR with CKD was consistently present in subgroups of gender, ethnicity, diabetes, hypertension and overweight status (all P-interaction >0.1).
Higher levels of serum adiponectin, leptin and LAR were positively associated with CKD independent of traditional risk factors in this Asian population.
脂联素和瘦素是脂肪细胞分泌的两种关键细胞因子，已被证明与心血管疾病有关。然而，这些脂肪细胞因子与慢性肾脏病（CKD）的关系尚不清楚。我们在一个基于人群的亚洲成年人样本中研究了血清脂联素、瘦素水平以及瘦素与脂联素比值（LAR）与CKD的关系。
我们进行了一项病例对照研究（450例CKD病例和920例年龄、性别和种族相匹配的对照），研究对象为年龄在40 - 80岁的中国和印度成年人，他们参与了新加坡眼病流行病学研究（2007 - 2011年）。CKD定义为根据血清肌酐估算的肾小球滤过率<60 mL/min/1.73m²。使用市售酶联免疫吸附测定法（ELISA）测量血清脂联素和瘦素水平。使用经年龄、性别、种族、教育程度、吸烟、体重指数、糖尿病、血压、总胆固醇和高密度脂蛋白胆固醇调整的逻辑回归模型估算脂联素和瘦素水平升高与CKD相关的比值比。
与对照组相比，CKD病例的瘦素水平（均值[标准差]9.7[11.5]对16.9[20.2]ng/mL，p<0.0001）和脂联素水平（10.4[7.4]对9.2[4.2]，p = 0.001）更高。在多变量模型中，与处于最低四分位数的人群相比，处于最高四分位数的人群中CKD的比值比（95%置信区间）分别为：瘦素6.46（3.84，10.88）、脂联素为1.94（1.32 - 2.85）以及LAR为2.88（1.78 - 4.64）。当将脂联素和瘦素作为连续变量进行分析时，也观察到了类似的关联。血清脂联素、瘦素和LAR与CKD的这种正相关在性别、种族、糖尿病、高血压和超重状态的亚组中均持续存在（所有P交互作用>0.1）。
在这个亚洲人群中，血清脂联素、瘦素和LAR水平升高与CKD呈正相关，且独立于传统危险因素。
