Aims: Our aim was to evaluate the prognostic value of 2 measurements of serum adiponectin levels for all-cause mortality and cardiovascular (CV) mortality in uremic patients. Methods: We analyzed 184 patients (19–86 years) undergoing peritoneal dialysis (n = 86) or hemodialysis (n = 98). All patients had 2 measurements of serum adiponectin levels (at baseline and after 1 year). Relationships between adiponectin and mortality were studied by means of survival analysis and Cox regression analysis. Results: During a median follow-up time of 31.2 months, 67 patients (36.4%) died, 26 (14.1%) as a result of CV disease. Mean survival time for CV mortality in patients with 1-year adiponectin values in the upper tertile was significantly higher than that found in patients in the middle and lower tertiles. Hazard ratios (HR) for all-cause mortality per SD change were 0.70 (95% CI, 0.50–0.98; p < 0.05) for baseline adiponectin levels and 0.68 (0.49–0.95; p < 0.05) for mean baseline and 1-year adiponectin levels. Mean adiponectin levels were also negatively related with CV mortality [HR 0.43 (0.21–0.86); p < 0.05] and CV events [HR 0.74 (0.55–0.99); p < 0.05]. Conclusions: In this population of dialysis patients, adiponectin seems to behave as a CV protective factor. Patients with high mean adiponectin levels had a better survival rate.

1.
Díez JJ, Iglesias P: The role of the novel adipocyte-derived hormone adiponectin in human disease. Eur J Endocrinol 2003;148:293–300.
2.
Zoccali C, Mallamaci F, Tripepi G, Benedetto FA, Cutrupi S, Parlongo S, Malatino LS, Bonanno G, Seminara G, Rapisarda F, Fatuzzo P, Buemi M, Nicocia G, Tanaka S, Ouchi N, Kihara S, Funahashi T, Matsuzawa Y: Adiponectin, metabolic risk factors, and cardiovascular events among patients with end-stage renal disease. J Am Soc Nephrol 2002;13:134–141.
3.
Stenvinkel P, Marchlewska A, Pecoits-Filho R, Heimburger O, Zhang Z, Hoff C, Holmes C, Axelsson J, Arvidsson S, Schalling M, Barany P, Lindholm B, Nordfors L: Adiponectin in renal disease: relationship to phenotype and genetic variation in the gene encoding adiponectin. Kidney Int 2004;65:274–281.
4.
Rao M, Li L, Tighiouart H, Jaber BL, Pereira BJ, Balakrishnan VS; the HEMO Study Group. Plasma adiponectin levels and clinical outcomes among haemodialysis patients. Nephrol Dial Transplant 2008;23:2619–2628.
5.
Costacou T, Zgibor JC, Evans RW, Otvos J, Lopes-Virella MF, Tracy RP, Orchard TJ: The prospective association between adiponectin and coronary artery disease among individuals with type 1 diabetes. The Pittsburgh Epidemiology in Diabetes Complications Study. Diabetologia 2004;48:41–48.
6.
Pischon T, Girman C, Hotamisligil GS, Rifai N, Hu FB, Rimm EB: Plasma adiponectin levels and risk of myocardial infarction in men. JAMA 2004;291:1730–1731.
7.
Efstathiou SP, Tsioulos DI, Tsiakou AG, Gratsias YE, Pefanis AV, Mountokalakis TD: Plasma adiponectin levels and five-year survival after first-ever ischemic stroke. Stroke 2005;36:1915–1918.
8.
Frystyk J, Berne C, Berglund L, Jensevik K, Flyvberg A, Zethelius B: Serum adiponectin is a predictor of coronary heart disease: a population-based 10-year follow-up study in elderly men. J Clin Endocrinol Metab 2007;92:571–576.
9.
Kojima S, Funahashi T, Otsuka F, Maruyoshi H, Yamashita T, Kajiwara I, Shimomura H, Miyao Y, Fujimoto K, Sugiyama S, Sakamoto T, Yoshimura M, Ogawa H: Future adverse cardiac events can be predicted by persistently low plasma adiponectin concentrations in men and marked reductions of adiponectin in women after acute myocardial infarction. Atherosclerosis 2007;194:204–213.
10.
Lim S, Koo BK, Cho SW, Kihara S, Funahashi T, Cho YM, Kim SY, Lee HK, Shimomura I, Park KS: Association of adiponectin and resistin with cardiovascular events in Korean patients with type 2 diabetes: the Korean atherosclerosis study (KAS): a 42-month prospective study. Atherosclerosis 2008;196:398–404.
11.
Lawlor DA, Davey Smith G, Ebrahim S, Thompson C, Sattar N: Plasma adiponectin levels are associated with insulin resistance, but do not predict future risk of coronary heart disease in women. J Clin Endocrinol Metab 2005;90:5677–5683.
12.
Lindsay RS, Resnick HE, Zhu J, Tun ML, Howard BV, Zhang Y, Yeh J, Best LG: Adiponectin and coronary heart disease: the Strong Heart Study. Arterioscler Thromb Vasc Biol 2005;25:15–16.
13.
Koenig W, Khuseyinova N, Baumert J, Meisinger C, Lowel H: Serum concentrations of adiponectin and risk of type 2 diabetes mellitus and coronary heart disease in apparently healthy middle-aged men: results from the 18-year follow-up of a large cohort from southern Germany. J Am Coll Cardiol 2006;48:1369–1377.
14.
Schulze MB, Shai I, Rimm EB, Li T, Rifai N, Hu FB: Adiponectin and future coronary heart disease events among men with type 2 diabetes. Diabetes 2006;54:534–539.
15.
Cavusoglu E, Ruwende C, Chopra V, Yanamadala S, Eng C, Clark LT, Pinsky DJ, Marmur JD: Adiponectin is an independent predictor of all-cause mortality, cardiac mortality, and myocardial infarction in patients presenting with chest pain. Eur Heart J 2006;27:2300–2309.
16.
Pilz S, Mangge H, Wellnitz B, Seelhorst U, Winkelmann BR, Tiran B, Boehm BO, März W: Adiponectin and mortality in patients undergoing coronary angiography. J Clin Endocrinol Metab 2006;91:4277–4286.
17.
Kanaya AM, Wassel Fyr C, Vittinghoff E, Havel PJ, Cesari M, Nicklas B, Harris T, Newman AB, Satterfield S, Cummings SR; Health ABC Study: Serum adiponectin and coronary heart disease risk in older black and white Americans. J Clin Endocrinol Metab 2006;91:5044–5050.
18.
Laughlin GA, Barrett-Connor E, May S, Langenberg C: Association of adiponectin with coronary heart disease and mortality. Am J Epidemiol 2007;165:164–174.
19.
Kistorp C, Faber J, Galatius S, Gustafsson F, Frystyk J, Flyvberg A, Hildebrandt P: Plasma adiponectin, body mass index, and mortality in patients with chronic heart failure. Circulation 2005;112:1756–1762.
20.
Wannamethee SG, Whincup PH, Lennon L, Sattar N: Circulating adiponectin levels and mortality in elderly men with and without cardiovascular disease and heart failure. Arch Intern Med 2007;167:1510–1517.
21.
Dekker JM, Funahashi T, Nijpels G, Pilz S, Stehouwer CD, Snijder MB, Bouter LM, Matsuzawa Y, Shimomura I, Heine RJ: Prognostic value of adiponectin for cardiovascular disease and mortality. J Clin Endocrinol Metab 2008;93:1489–1496.
22.
Huang JW, Yen CJ, Chiang HW, Hung KY, Tsai TJ, Wu KD: Adiponectin in peritoneal dialysis patients: a comparison with hemodialysis patients and subjects with normal renal function. Am J Kidney Dis 2004;43:1047–1055.
23.
Mantzoros CS, Li T, Manson JE, Meigs JB, Hu FB: Circulating adiponectin levels are associated with better glycemic control, more favorable lipid profile, and reduced inflammation in women with type 2 diabetes. J Clin Endocrinol Metab 2005;90:4542–4548.
24.
Yamauchi T, Kamon J, Ito Y, Tsuchida A, Yokomizo T, Kita S, Sugiyama T, Miyagishi M, Hara K, Tsunoda M, Murakami K, Ohteki T, Uchida S, Takekawa S, Waki H, Tsuno NH, Shibata Y, Terauchi Y, Froguel P, Tobe K, Koyasu S, Taira K, Kitamura T, Shimizu T, Nagai R, Kadowaki T: Cloning of adiponectin receptors that mediate antidiabetic metabolic effects. Nature 2003;423:762–769.
25.
Ouchi N, Kihara S, Arita Y, Nishida M, Matsuyama A, Okamoto Y, Ishigami M, Kuriyama H, Kishida K, Nishizawa H, Hotta K, Muraguchi M, Ohmoto Y, Yamashita S, Funahashi T, Matsuzawa Y: Adipocyte-derived plasma protein, adiponectin, suppresses lipid accumulation and class A scavenger receptor expression in human monocyte-derived macrophages. Circulation 2001;103:1057–1063.
26.
Chen H, Montagnani M, Funahashi T, Shimomura I, Quon MJ: Adiponectin stimulates production of nitric oxide in vascular endothelial cells. J Biol Chem 2003;278:45021–45026.
27.
Maahs DM, Ogden LG, Kinney GL, Wadwa P, Snell-Bergeon JK, Dabelea D, Hokanson JE, Ehrlich J, Eckel RH, Rewers M: Low plasma adiponectin levels predict progression of coronary artery calcification. Circulation 2005;111:747–753.
28.
Schulze MB, Shai I, Rimm EB, Li T, Rifai N, Hu FB: Adiponectin and future coronary heart disease events among men with type 2 diabetes. Diabetes 2005;54:534–539.
29.
Becker B, Kronenberg F, Kielstein JT, Haller H, Morath C, Ritz E, Fliser D; MMKD Study Group: Renal insulin resistance syndrome, adiponectin and cardiovascular events in patients with kidney disease: the mild and moderate kidney disease study. J Am Soc Nephrol 2005;16:1091–1098.
30.
Tentolouris N, Doulgerakis D, Moyssakis I, Kyriaki D, Makrilakis K, Kosmadakis G, Stamatiadis D, Katsilambros N, Stathakis C: Plasma adiponectin concentrations in patients with chronic renal failure: relationship with metabolic risk factors and ischemic heart disease. Horm Metab Res 2004;36:721–727.
31.
Díez JJ, Iglesias P, Fernández-Reyes MJ, Aguilera A, Bajo MA, Alvarez-Fidalgo P, Codoceo R, Selgas R: Serum concentrations of leptin, adiponectin and resistin, and their relationship with cardiovascular disease in patients with end-stage renal disease. Clin Endocrinol 2005;62:242–249.
32.
Menon V, Li L, Wang X, Greene T, Balakrishnan V, Madero M, Pereira AA, Beck GJ, Kusek JW, Collins AJ, Levey AS, Sarnak MJ: Adiponectin and mortality in patients with chronic kidney disease. J Am Soc Nephrol 2006;17:2599–2606.
33.
Shoji T, Kimoto E, Shinohara K, Hatsuda S, Nishizawa Y: Molecular forms of adiponectin in uraemic plasma. Nephrol Dial Transplant 2004;19:1937–1938.
34.
Kollerits B, Fliser D, Heid IM, Ritz E, Kronenberg F; MMKD Study Group: Gender-specific association of adiponectin as a predictor of progression of chronic kidney disease: the Mild to Moderate Kidney Disease Study. Kidney Int 2007;71:1279–1286.
35.
Kalantar-Zadeh K, Block G, Humphreys MH, Kopple JD: Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int 2003;63:793–808.
36.
Teta D, Maillard M, Halabi G, Burnier M: The leptin/adiponectin ratio: potential implications for peritoneal dialysis. Kidney Int 2008;73:S112–S118.
37.
Lara-Castro C, Luo N, Wallace P, Klein RL, Garvey WT: Adiponectin multimeric complexes and the metabolic syndrome trait cluster. Diabetes 2006;55:249–259.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.