Leptin/adiponectin ratio is an independent predictor of mortality in nondiabetic peritoneal dialysis patients

Jung Tak Park, Tae Hyun Yoo, Jwa Kyung Kim, Hyung Jung Oh, Seung Jun Kim, Dong Eun Yoo, Mi Jung Lee, Dong Ho Shin, Seung Hyeok Han, Dae Suk Han, Shin Wook Kang

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Abstract

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.

Original languageEnglish
Pages (from-to)67-74
Number of pages8
JournalPeritoneal Dialysis International
Volume33
Issue number1
DOIs
Publication statusPublished - 2013 Jan 1

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All Science Journal Classification (ASJC) codes

  • Nephrology

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