Hypoadiponectinemia and the presence of metabolic syndrome in patients with chronic kidney disease: results from the KNOW-CKD study

Background: In patients with chronic kidney disease, metabolic syndrome has been demonstrated to be the culprit behind diverse complications. Adiponectin is known to have anti-atherogenic and cardio-protective effects. Meanwhile, the relationship between adiponectin and metabolic syndrome in patients with chronic kidney disease has not been clarified. The aim of this study was to elucidate the relationship between adiponectin level and metabolic syndrome in patients with chronic kidney disease. Methods: The KoreaN Cohort Study for Outcome in Patients with Chronic Kidney Disease is a cohort study that enrolled subjects with chronic kidney disease throughout South Korea. From February 2011 to July 2014, data were collected from 1332 patients with chronic kidney disease. Results: The mean age of the patients was 53.5 years and 803 patients (60.7%) were men. The median adiponectin level was 10.7 μg/mL and 585 (44.3%) patients had metabolic syndrome. In multiple linear regression analysis, log adiponectin was positively associated with high-density lipoprotein cholesterol levels (β = 0.006), whereas it was negatively associated with serum albumin (β = −0.284), triglyceride (log β = −0.288), high sensitivity C-reactive protein (log β = −0.058) levels and estimated glomerular filtration rate (β = −0.005). Multiple logistic regression analysis indicated that low adiponectin level was independently associated with a higher risk of metabolic syndrome (per 1 μg/mL increase; odds ratio = 0.953, 95% confidence interval = 0.898-0.970, P < 0.001) after adjustment for multiple confounding factors. Conclusions: Hypoadiponectinemia is independently associated with the presence of metabolic syndrome in patients with chronic kidney disease.