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

Jung Tak Park, TaeHyun Yoo, Jwa Kyung Kim, Hyung Jung Oh, Seung Jun Kim, Dong Eun Yoo, Mi Jung Lee, Dong Ho Shin, SeungHyeok Han, Dae Suk Han, Shin-Wook Kang

Research output: Contribution to journalArticle

22 Citations (Scopus)

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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Adiponectin
Peritoneal Dialysis
Leptin
Mortality
Adipokines
Chronic Kidney Failure
C-Reactive Protein
HDL Cholesterol
Insulin Resistance
Triglycerides
Body Mass Index
Cardiovascular Diseases
Prospective Studies
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Park, Jung Tak ; Yoo, TaeHyun ; Kim, Jwa Kyung ; Oh, Hyung Jung ; Kim, Seung Jun ; Yoo, Dong Eun ; Lee, Mi Jung ; Shin, Dong Ho ; Han, SeungHyeok ; Han, Dae Suk ; Kang, Shin-Wook. / Leptin/adiponectin ratio is an independent predictor of mortality in nondiabetic peritoneal dialysis patients. In: Peritoneal Dialysis International. 2013 ; Vol. 33, No. 1. pp. 67-74.
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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.",
author = "Park, {Jung Tak} and TaeHyun Yoo and Kim, {Jwa Kyung} and Oh, {Hyung Jung} and Kim, {Seung Jun} and Yoo, {Dong Eun} and Lee, {Mi Jung} and Shin, {Dong Ho} and SeungHyeok Han and Han, {Dae Suk} and Shin-Wook Kang",
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Leptin/adiponectin ratio is an independent predictor of mortality in nondiabetic peritoneal dialysis patients. / Park, Jung Tak; Yoo, TaeHyun; Kim, Jwa Kyung; Oh, Hyung Jung; Kim, Seung Jun; Yoo, Dong Eun; Lee, Mi Jung; Shin, Dong Ho; Han, SeungHyeok; Han, Dae Suk; Kang, Shin-Wook.

In: Peritoneal Dialysis International, Vol. 33, No. 1, 01.01.2013, p. 67-74.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Leptin/adiponectin ratio is an independent predictor of mortality in nondiabetic peritoneal dialysis patients

AU - Park, Jung Tak

AU - Yoo, TaeHyun

AU - Kim, Jwa Kyung

AU - Oh, Hyung Jung

AU - Kim, Seung Jun

AU - Yoo, Dong Eun

AU - Lee, Mi Jung

AU - Shin, Dong Ho

AU - Han, SeungHyeok

AU - Han, Dae Suk

AU - Kang, Shin-Wook

PY - 2013/1/1

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N2 - 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.

AB - 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.

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