Kim Ha Yeon, Bae Eun Hui, Ma Seong Kwon, Chae Dong Wan, Choi Kyu Hun, Kim Yong-Soo, Hwang Young-Hwan, Ahn Curie, Kim Soo Wan
Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757, Korea.
Department of Internal Medicine, Seoul National University, Seoul, Korea.
Clin Exp Nephrol. 2016 Jun;20(3):443-9. doi: 10.1007/s10157-015-1173-4. Epub 2015 Oct 7.
Adiponectin, a peptide hormone secreted from adipocytes, exerts anti-diabetic, anti-atherogenic, and anti-inflammatory properties. We aimed to determine the relationship between serum adiponectin levels and albuminuria, and evaluate determinant factors for serum adiponectin in patients with chronic kidney disease (CKD).
In total, 1442 CKD patients were included and divided into three groups according to their albumin-to-creatinine ratios: patients with normoalbuminuria (N = 228), microalbuminuria (N = 444), and macroalbuminuria (N = 761). Serum adiponectin was specifically assayed with a commercially available enzyme-linked immunosorbent assay kit.
Serum adiponectin was significantly higher in patients with macroalbuminuria than in those without macroalbuminuria (9.7 ± 6.0, 12.4 ± 9.0, and 14.9 ± 11.0 μg/mL in patients with normoalbuminuria, microalbuminuria, and macroalbuminuria, respectively). Univariate linear regression analysis showed that the serum adiponectin concentrations were correlated with age, the albumin-to-creatinine ratio, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol, whereas they were negatively correlated with body mass index, the estimated glomerular filtration rate, and serum albumin and triglyceride levels. The stepwise regression multiple analysis showed that sex; the estimated glomerular filtration rate; body mass index; total cholesterol, high-density lipoprotein cholesterol, and triglyceride levels; and logarithm of the albumin-to-creatinine ratio were independently associated with the logarithm of serum adiponectin levels (r = 0.55, p < 0.001).
Serum adiponectin concentrations are higher in patients with increasing albuminuria, and these levels are associated with renal insufficiency and lipid profiles.
脂联素是一种由脂肪细胞分泌的肽类激素，具有抗糖尿病、抗动脉粥样硬化和抗炎特性。我们旨在确定血清脂联素水平与蛋白尿之间的关系，并评估慢性肾脏病（CKD）患者血清脂联素的决定因素。
总共纳入1442例CKD患者，并根据其白蛋白与肌酐比值分为三组：正常白蛋白尿患者（N = 228）、微量白蛋白尿患者（N = 444）和大量白蛋白尿患者（N = 761）。使用市售酶联免疫吸附测定试剂盒特异性检测血清脂联素。
大量白蛋白尿患者的血清脂联素显著高于无大量白蛋白尿患者（正常白蛋白尿、微量白蛋白尿和大量白蛋白尿患者的血清脂联素水平分别为9.7±6.0、12.4±9.0和14.9±11.0μg/mL）。单因素线性回归分析表明，血清脂联素浓度与年龄、白蛋白与肌酐比值、总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇相关，而与体重指数、估计肾小球滤过率、血清白蛋白和甘油三酯水平呈负相关。逐步回归多因素分析表明，性别、估计肾小球滤过率、体重指数、总胆固醇、高密度脂蛋白胆固醇和甘油三酯水平以及白蛋白与肌酐比值的对数与血清脂联素水平的对数独立相关（r = 0.55，p < 0.001）。
蛋白尿增加的患者血清脂联素浓度较高，且这些水平与肾功能不全和血脂谱相关。
