Association of plasma adiponectin and cardiovascular risk profiles in nondiabetic uremic patients on peritoneal dialysis.

BACKGROUND: Adiponectin, a novel adipocytokine with antiinflammatory and antiatherosclerosis properties, has been found to be an inverse predictor of cardiovascular outcomes among uremic patients on hemodialysis. However, its role in uremic patients on continuous ambulatory peritoneal dialysis (CAPD) remains unclear. The aim of the study was to evaluate the association of adiponectin and cardiovascular risk factors in nondiabetic CAPD patients.

METHODS: Sixty nondiabetic uremic patients on CAPD for more than 6 months were enrolled. Plasma adiponectin levels were measured along with cardiovascular risk profiles, including body mass index (BMI), waist to hip ratio (WHR), insulin resistance, lipid profiles, ankle-brachial pressure index (ABPI), brachial-ankle pulse wave velocity (BaPWV), inflammatory markers and peritoneal membrane characteristics. Dialysis adequacy, protein intake, residual renal function and serum biochemistries were also studied.

RESULTS: Plasma adiponectin levels were significantly higher in CAPD patients than healthy subjects (16.0 +/- 11.8 vs. 6.4 +/- 1.8 microg/mL, p<0.001); inversely related to BMI, WHR, triglyceride levels, atherogenic index, insulin levels, homeostasis model assessment of insulin resistance and C-reactive protein (CRP), and directly related to high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). There was also a positive trend between plasma adiponectin levels and the ratios of dialysate to plasma creatinine concentration (D/P Cr). On multivariate regression analysis, BMI and HDL-C were the strongest variables associated with plasma adiponectin levels.

CONCLUSIONS: Hyperadiponectinemia in nondiabetic uremic patients on CAPD is in part associated with cardiovascular risk factors. Whether elevated adiponectin concentrations exert cardioprotective and antiinflammation effects in uremic patients on CAPD warrants further prospective investigation.