BACKGROUND: The leptin/adiponectin (L/A) ratio has been suggested to be an atherosclerotic index for diabetic patients and a useful marker of insulin resistance in patients with and without diabetes. Even though end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) are well characterized by abnormal adipocytokine metabolism, the significance of alterations in the L/A ratio is largely unexplored in these patients. In this prospective study, we investigated the associations of leptin, adiponectin, and the L/A ratio with clinical outcomes in nondiabetic PD patients. METHODS: The study included 131 stable nondiabetic ESRD patients who had been on PD for more than 3 months. Serum leptin and adiponectin levels were determined at baseline. Mortality was evaluated over a 5-year follow-up period. RESULTS: During the follow-up period, 22 patients died (16.8%), including 10 (45.5%) as a result of cardiovascular disease. The L/A ratio showed a significant positive correlation with body mass index [BMI (r = 0.47, p < 0.001)], high-sensitivity C-reactive protein (r = 0.32, p < 0.001), and triglycerides (r = 0.43, p < 0.001). In addition, we observed significant inverse correlations between the L/A ratio and percentage lean body mass (r = -0.30, p = 0.001) and high-density lipoprotein cholesterol (r = -0.31, p = 0.001). In contrast to individual leptin and adiponectin levels, the L/A ratio was found to be independently associated with an increased mortality risk (relative risk: 1.15; 95% confidence interval: 1.05 to 1.27; p = 0.003) even after adjustments for age and BMI. CONCLUSIONS: The L/A ratio might be better related to patient outcomes than adipocytokines are individually in nondiabetic patients undergoing PD.
BACKGROUND: The leptin/adiponectin (L/A) ratio has been suggested to be an atherosclerotic index for diabeticpatients and a useful marker of insulin resistance in patients with and without diabetes. Even though end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) are well characterized by abnormal adipocytokine metabolism, the significance of alterations in the L/A ratio is largely unexplored in these patients. In this prospective study, we investigated the associations of leptin, adiponectin, and the L/A ratio with clinical outcomes in nondiabetic PDpatients. METHODS: The study included 131 stable nondiabetic ESRDpatients who had been on PD for more than 3 months. Serum leptin and adiponectin levels were determined at baseline. Mortality was evaluated over a 5-year follow-up period. RESULTS: During the follow-up period, 22 patients died (16.8%), including 10 (45.5%) as a result of cardiovascular disease. The L/A ratio showed a significant positive correlation with body mass index [BMI (r = 0.47, p < 0.001)], high-sensitivity C-reactive protein (r = 0.32, p < 0.001), and triglycerides (r = 0.43, p < 0.001). In addition, we observed significant inverse correlations between the L/A ratio and percentage lean body mass (r = -0.30, p = 0.001) and high-density lipoprotein cholesterol (r = -0.31, p = 0.001). In contrast to individual leptin and adiponectin levels, the L/A ratio was found to be independently associated with an increased mortality risk (relative risk: 1.15; 95% confidence interval: 1.05 to 1.27; p = 0.003) even after adjustments for age and BMI. CONCLUSIONS: The L/A ratio might be better related to patient outcomes than adipocytokines are individually in nondiabeticpatients undergoing PD.
Authors: Vandana Menon; Lijun Li; Xuelei Wang; Tom Greene; Vaidyanathapuram Balakrishnan; Magdalena Madero; Arema A Pereira; Gerald J Beck; John W Kusek; Allan J Collins; Andrew S Levey; Mark J Sarnak Journal: J Am Soc Nephrol Date: 2006-08-02 Impact factor: 10.121
Authors: Juan J Díez; Pedro Iglesias; María J Fernández-Reyes; Abelardo Aguilera; María A Bajo; Pilar Alvarez-Fidalgo; Rosa Codoceo; Rafael Selgas Journal: Clin Endocrinol (Oxf) Date: 2005-02 Impact factor: 3.478
Authors: J L Halaas; K S Gajiwala; M Maffei; S L Cohen; B T Chait; D Rabinowitz; R L Lallone; S K Burley; J M Friedman Journal: Science Date: 1995-07-28 Impact factor: 47.728
Authors: Kelli R King-Morris; Serpil Muge Deger; Adriana M Hung; Phyllis Ann Egbert; Charles D Ellis; Amy Graves; Ayumi Shintani; T Alp Ikizler Journal: Perit Dial Int Date: 2015-11-02 Impact factor: 1.756