Association of Serum Adipokines and Resting Energy Expenditure in Patients With Chronic Kidney Disease.

BACKGROUND AND AIM

Metabolic disorders are prevalent in patients with chronic kidney disease (CKD) and may lead to protein energy wasting (PEW). Adipokines improve connections between PEW and energy metabolism. We aimed to determine the relationship between adipokine levels and resting energy expenditure (REE) in patients with CKD.

METHODS

A total of 208 patients in non-dialyzed CKD stages 3-5 were enrolled in this cross-sectional study. Serum adipokines (leptin, adiponectin, and interleukin 6 (IL-6) were measured using enzyme-linked immunosorbent assay. Patient's REE was measured using indirect calorimetry. Fat mass (FM) and lean tissue mass (LTM) were measured using multiple-frequency bioimpedance analysis. Spearman correlation analyses and multivariate linear regression models were used to assess the association between serum adipokines and REE.

RESULTS

The mean age was 52.7 ± 14.6 years, and 26.9, 26.4, and 46.7% of our participants had CKD stages 3, 4, and 5, respectively. The median values of serum adiponectin, leptin, and IL-6 were 470.4 (range, 291.1-802.2), 238.1 (range, 187.9-418.4), and 4.0 (range, 2.4-9.5) pg/mL, respectively. The male participants had significantly lower FM% ( = 0.001) and lower leptin levels ( < 0.001) than the female participants. After adjusting for age, diabetes, high-sensitivity C-reactive protein, intact parathyroid hormone, LTM, and FM, multiple linear regression analysis revealed that serum leptin levels were significantly positively associated with REE in men rather than in women ( < 0.05). Serum adiponectin levels were inversely associated with REE in men, but this association disappeared while FM was additionally adjusted. Adiponectin levels in women were not correlated with REE ( > 0.05). IL-6 was not significantly associated with REE in either men or women.

CONCLUSIONS

A sex-specific relationship between serum adipokines (leptin and adiponectin) and REE was observed in patients with CKD stages 3-5, which was partly confounded by FM.