Adiponectin (ADPN), the most abundant secretory protein of the adipose tissue, attenuates endothelial inflammatory response in vitro. In man plasma ADPN concentration is reduced in patients with atherosclerotic complications but it is substantially increased in patients with advanced renal failure. We sought the clinical and biochemical correlates of plasma ADPN and prospectively tested its prediction power for survival and cardiovascular events (fatal and non fatal) in a cohort of 227 hemodialysis patients followed up for 31b13 months (range 1-45 months). Plasma ADPN in dialysis patients (15.0b7.7 Ýg/ml) was 2.5 times higher (P<0.0001) than in healthy subjects (6.3b2.0 Ýg/ml), was independent of age and it was higher (P=0.03) in women (15.2b7.9 Ýg/ml) than in men (14.0b7.4 Ýg/ml). In dialysis patients of both sexes plasma ADPN was inversely related to BMI, plasma leptin, insulin and serum triglycerides and to insulin sensitivity (HOMA-R index). Furthermore plasma ADPN was related directly to HDL cholesterol and inversely to Von Willebrand factor. Plasma ADPN was lower (P<0.05) in patients who had incident cardiovascular events (13.7b7.3 Ýg/ml) than in event free patients (15.8b7.8 Ýg/ml). There was a 3% risk reduction for each 1 Ýg/ml increase in plasma ADPN and the relative risk of adverse cardiovascular events was 1.56 times (95% CI: 1.12-1.99) higher in patients in the first ADPN tertile than in those in the third tertile. In a multivariate Cox¡¦s model plasma ADPN was confirmed to be an independent inverse predictor of fatal and non-fatal cardiovascular events [hazard ratio (1Ýg/ml increase in plasma ADPN): 0.97, 95% CI 0.93-0.99, P= 0.04). Plasma ADPN is an independent inverse predictor of cardiovascular outcomes in patients with end stage renal disease. Furthermore ADPN is related to several metabolic risk factors in a way coherent with the hypothesis that this protein acts as a protective factor for the cardiovascular system.
Adiponectin, the most abundant adipocyte-derived protein, is functionally related to metabolic risk factors and predicts cardiovascular events in patients with end stage renal disease
Tripepi G;Cutrupi S;
2002
Abstract
Adiponectin (ADPN), the most abundant secretory protein of the adipose tissue, attenuates endothelial inflammatory response in vitro. In man plasma ADPN concentration is reduced in patients with atherosclerotic complications but it is substantially increased in patients with advanced renal failure. We sought the clinical and biochemical correlates of plasma ADPN and prospectively tested its prediction power for survival and cardiovascular events (fatal and non fatal) in a cohort of 227 hemodialysis patients followed up for 31b13 months (range 1-45 months). Plasma ADPN in dialysis patients (15.0b7.7 Ýg/ml) was 2.5 times higher (P<0.0001) than in healthy subjects (6.3b2.0 Ýg/ml), was independent of age and it was higher (P=0.03) in women (15.2b7.9 Ýg/ml) than in men (14.0b7.4 Ýg/ml). In dialysis patients of both sexes plasma ADPN was inversely related to BMI, plasma leptin, insulin and serum triglycerides and to insulin sensitivity (HOMA-R index). Furthermore plasma ADPN was related directly to HDL cholesterol and inversely to Von Willebrand factor. Plasma ADPN was lower (P<0.05) in patients who had incident cardiovascular events (13.7b7.3 Ýg/ml) than in event free patients (15.8b7.8 Ýg/ml). There was a 3% risk reduction for each 1 Ýg/ml increase in plasma ADPN and the relative risk of adverse cardiovascular events was 1.56 times (95% CI: 1.12-1.99) higher in patients in the first ADPN tertile than in those in the third tertile. In a multivariate Cox¡¦s model plasma ADPN was confirmed to be an independent inverse predictor of fatal and non-fatal cardiovascular events [hazard ratio (1Ýg/ml increase in plasma ADPN): 0.97, 95% CI 0.93-0.99, P= 0.04). Plasma ADPN is an independent inverse predictor of cardiovascular outcomes in patients with end stage renal disease. Furthermore ADPN is related to several metabolic risk factors in a way coherent with the hypothesis that this protein acts as a protective factor for the cardiovascular system.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
