بررسی ارتباط سطح سرمی آدیپونکتین با برخی از عوامل بیوشیمیایی و متابولیک در بیماران تحت همودیالیز

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دستیار، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران

2 استادیار، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران

چکیده

مقدمه: آدیپونکتین سرم یک هورمون ترشح شده از بافت چربی است و میزان آن در بیماران با نارسایی کلیه بیشتر می‌شود. در شرایط اورمی نه تنها نقش محافظت کننده در برابر آترواسکلروز را ندارد، بلکه خود آن یک عامل خطر به شمار می‎رود و این هورمون در بیماران با نارسایی کلیه، یک پیش‌بینی کننده‌ی مستقیم از عوارض قلبی و عروقی می‌باشد.روش‌ها: در این مطالعه ۷۳ نفر بیمار تحت همودیالیز بدون دیابت انتخاب شدند و نمونه‌ی خون ناشتا جهت اندازه‎گیری آدیپونکتین و برخی از عوامل بیوشیمیایی گرفته شد. دور کمر، دور شکم، وزن و شاخص توده‌ی بدنی اندازه‎گیری شد. جهت یافتن ارتباط میان آدیپونکتین و پارامترهای ذکر شده از روش آماری Pearson استفاده شد.یافته‌ها: سطح آدیپونکتین به طور معکوس و معنی‎داری با وزن (001/0 > P)، شاخص توده‌ی بدنی (001/0 > P)، دور کمر (050/0 > P)، دور شکم (010/0 > P) و تری‎گلیسرید (010/0 > P) ارتباط دارد.نتیجه‌گیری: سطح سرمی آدیپونکتین بیماران همودیالیزی با وزن و شاخص توده‌ی بدنی ارتباط معکوس و معنی‎داری داشت که بیانگر تأثیر احتمالی این هورمون است. در نتیجه، با یافتن ارتباط‎های درست و مشخص این سایتوکین با دیگر عوامل خطر آترواسکلروز و هایپرکاتابولیک، در آینده‎ای نزدیک می‌توان آدیپونکتین سرم را به عنوان یک نشانگر قابل اندازه‎گیری و مهم برای میزان آترواسکلروز و پیش‎‌آگهی و پیشرفت به سمت مرگ و میر در این بیماران معرفی نمود. 

کلیدواژه‌ها


عنوان مقاله [English]

The Association of Serum Adiponectin Level and Various Biochemical and Metabolic Factors in Patients under Hemodialysis

نویسنده [English]

  • Saeed Mardani 2
1 Resident, Department of Internal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Assistant Professor, Department of Internal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
چکیده [English]

Background: Serum adiponectin (ADPN), an adipocyte-produced hormone, has a higher level in patients with uremia with or without diabetes. Plasma ADPN levels are direct predictor of cardiovascular outcomes among patients with end stage renal disease (ESRD). Also, Studies showed that level of adiponectin reflects death.Methods: Seventy-three under-hemodialysis patients without diabetes were selected. Fasting blood sample of all patients was caught to determine ADPN level and other parameters. Weight, body mass index, waist and abdomen were measured, too. To assess the relationship of ADPN level with other parameters, Pearson test was used.Findings: There was significant negative association of ADPN level with weight (P < 0.001), body mass index (P < 0.001), waist (P < 0.05) and abdomen (P < 0.01) circumferences and serum triglyceride level (P < 0.01).Conclusion: Our results demonstrated that serum ADPN level in without-diabetes patients under hemodialysis show malnutrition, wasting and lower muscle and fat tissue. The findings need further evaluation to precisely find the impact of ADPN on mortality and morbidity of under-hemodialysis patients.

کلیدواژه‌ها [English]

  • Adiponectin
  • End-stage renal disease
  • Renal Function
  • Hemodialysis
  1. Maeda K, Okubo K, Shimomura I, Funahashi T, Matsuzawa Y, Matsubara K. cDNA cloning and expression of a novel adipose specific collagen-like factor, apM1 (AdiPose Most abundant Gene transcript 1). Biochem Biophys Res Commun 1996; 221(2): 286-9.
  2. Maesaka JK, Sodam B, Palaia T, Ragolia L, Batuman V, Miyawaki N, et al. Prostaglandin D2 synthase: Apoptotic factor in alzheimer plasma, inducer of reactive oxygen species, inflammatory cytokines and dialysis dementia. J Nephropathol 2013; 2(3): 166-80.
  3. Spasovski D. Renal markers for assessment of renal tubular and glomerular dysfunction. J Nephropharmacol 2013; 2(2): 23-5.
  4. Nasri H. The awareness of chronic kidney disease and aging; the focus of world kidney day in 2014. J Nephropharmacol 2014; 3(1): 1-2.
  5. Rafieian-Kopaei M, Nasri H. Vitamin D therapy in diabetic kidney disease. J. Nephropharmacol 2014; 3(1): 3-4.
  6. Ardalan MR, Sanadgol H, Nasri H, Baradaran A, Tamadon MR, Rafieian-Kopaei R. Impact of vitamin D on the immune system in kidney disease. J Parathyr Dis 2013; 1(2): 17-20.
  7. Nasri H, Rafieian-Kopaei M. Association of serum vitamin D level with age in individuals with normal renal function. J Nephropharmacol 2012; 1(1): 7-9.
  8. Chandran M, Phillips SA, Ciaraldi T, Henry RR. Adiponectin: more than just another fat cell hormone? Diabetes Care 2003; 26(8): 2442-50.
  9. Nasri H. Impact of diabetes mellitus on parathyroid hormone in hemodialysis patients. J. Parathyr Dis 2013; 1(1): 9-11.
  10. Hajivandi A, Amiri M. World diabetes day: diabetes mellitus and nephrology. J Nephropharmacol 2013; 2(2): 31-2.
  11. Solati M, Mahboobi HR. Paraoxonase enzyme activity and dyslipidemia in chronic kidney disease patients. J Nephropathol. 2012; 1(3): 123-5.
  12. Rafieian-Kopaei M, Nasri H. Correlation of serum leptin with levels of hemoglobin in hemodialysis. J Nephropharmacol 2012;1(2): 23-6.
  13. Tamadon MR, Ardalan MR, Nasri H. World Kidney Day 2013; acute renal injury; a global health warning. J Parathyr Dis 2013; 1(2): 27-8.
  14. Shahbazian N, Shahbazian H, Mohammadjafari R, Mousavi M. Ambulatory monitoring of blood pressure and pregnancy outcome in pregnant women with white coat hypertension in the third trimester of pregnancy: A prospective cohort study. J Nephropharmacol 2013; 2(1): 5-9.
  15. Madsen EL, Rissanen A, Bruun JM, Skogstrand K, Tonstad S, Hougaard DM, et al. Weight loss larger than 10% is needed for general improvement of levels of circulating adiponectin and markers of inflammation in obese subjects: a 3-year weight loss study. Eur J Endocrinol 2008; 158(2): 179-87.
  16. Rafieian-Kopaei M, Nasri H. Serum lipoprotein (a) and atherosclerotic changes in hemodialysis patients. J Renal Inj Prev 2013; 2(2): 47-50.
  17. Hajivandi A, Amiri M. World Kidney Day 2014: Kidney disease and elderly. J Parathyr Dis 2014; 2(1): 3-4.
  18. Haghighi M, Nematbakhsh M, Talebi A, Nasri H, Ashrafi F, Roshanaei K, et al The role of angiotensin II receptor 1 (AT1) blockade in cisplatin-induced nephrotoxicity in rats: gender-related differences. Ren Fail 2012; 34(8): 1046-51.
  19. Engeli S, Feldpausch M, Gorzelniak K, Hartwig F, Heintze U, Janke J, et al. Association between adiponectin and mediators of inflammation in obese women. Diabetes 2003; 52(4): 942-7.
  20. Nematbakhsh M, Ashrafi F, Safari T, Talebi A, Nasri H, Mortazavi M, et al. J Administration of vitamin E and losartan as prophylaxes in cisplatin-induced nephrotoxicity model in rats. Nephrol 2012; 25(3): 410-7.
  21. Nasri H. Correlation of serum magnesium with serum levels of 25-hydroxyvitamin D in hemodialysis patients. J Parathyr Dis 2014; 2(1): 11-3.
  22. Nasri H, Rafieian-Kopaei M. Significant difference of serum 25-hydroxyvitamin D level in male hemodialysis patients with our without diabetes; a single center study. J Nephropharmacol 2012; 1(2): 15-6.
  23. Ardalan MR, Sanadgol H, Nasri H, Baradaran A, Tamadon MR, Rafieian-Kopaei R. Vitamin D therapy in diabetic kidney disease; current knowledge on a public health problem. J Parathyr Dis 2014; 2(1): 15-7.
  24. Baradaran A. Beyond mineral metabolism, the bright immunomodulatory effect of vitamin D in renal disease. J Nephropharmacol 2012; 1(2): 17-8.
  25. Baradaran A, Behradmanesh S, Nasri H. Association of body mass index and serum vitamin D level in healthy Iranian adolescents. Endokrynol Pol 2012; 63(1): 29-33.
  26. Schupp M, Clemenz M, Gineste R, Witt H, Janke J, Helleboid S, et al. Molecular characterization of new selective peroxisome proliferator-activated receptor gamma modulators with angiotensin receptor blocking activity. Diabetes 2005; 54(12): 3442-52.
  27. Huang JW, Yen CJ, Chiang HW, Hung KY, Tsai TJ, Wu KD. Adiponectin in peritoneal dialysis patients: a comparison with hemodialysis patients and subjects with normal renal function. Am J Kidney Dis 2004; 43(6): 1047-55.
  28. Baradaran A, Nasri H. Correlation of serum magnesium with serum parathormone levels in patients on regular hemodialysis. Saudi J Kidney Dis Transpl 2006; 17(3): 344-50.
  29. Ardalan MR. Parathyroid carcinoma in hemodialysis patients; it should not be diagnosed as a thyroid nodule. J Parathyr Dis 2013; 1(2):25-6.
  30. Rastegari E, Nasri H. Association of serum leptin with serum C-reactive protein in hemodialysis patients. J Nephropharmacol 2012; 1(2): 19-21.
  31. Nasri H. Influence of parathyroid hormone on platelet counts and mean platelet volume in hemodialysis. J Parathyr Dis 2014; 2(1): 7-9.
  32. Ardalan MR, Nasri H. Acute kidney injury; the focus of world kidney day in 2013. J Nephropharmacol 2013; 2(2): 15-6.
  33. Nasri H, Shirani S, Baradaran A. Lipids in association with leptin in maintenance hemodialysis patients. J Med Sci 2006; 6(2): 173-9.
  34. Kollerits B, Fliser D, Heid IM, Ritz E, Kronenberg F. Gender-specific association of adiponectin as a predictor of progression of chronic kidney disease: the Mild to Moderate Kidney Disease Study. Kidney Int 2007; 71(12): 1279-86.
  35. Levey AS. Controlling the epidemic of cardiovascular disease in chronic renal disease: where do we start? Am J Kidney Dis 1998; 32(5 Suppl 3): S5-13.
  36. Rafiean-Kopaie M, Nasri H. Impact of inflammation on anemia of hemodialysis patients who were under treatment of recombinant human erythropoietin. J Renal Inj Prev 2013; 2(3): 93-5.
  37. Nasri H. Serum C-reactive protein (CRP) in association with various nutritional parameters in maintenance hemodialysis patients. Bratisl Lek Listy 2005; 106(12): 390-5.
  38. Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y, et al. Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients. Arterioscler Thromb Vasc Biol 2000; 20(6): 1595-9.
  39. Jia T, Carrero JJ, Lindholm B, Stenvinkel P. The complex role of adiponectin in chronic kidney disease. Biochimie 2012; 94(10): 2150-6.
  40. Sanadgol H, Abdani S, Tabatabaiee P, Mohammadi M. Protective effect of high dose short term statin therapy with normal saline in prevention of contrast-induced nephropathy among iodixanol-receiving patients. J Renal Inj Prev 2012; 1(1): 43-5.
  41. Nasri H. Elevated serum parathyroid hormone is a heart risk factor in hemodialysis patients. J Parathyr Dis 2013; 1(1):13-4.
  42. Tamadon MR. Secondary hyperparathyroidism and chronic kidney disease. J Parathyr Dis2013; 1(1):15-6.
  43. Jorsal A, Tarnow L, Frystyk J, Lajer M, Flyvbjerg A, Parving HH, et al. Serum adiponectin predicts all-cause mortality and end stage renal disease in patients with type I diabetes and diabetic nephropathy. Kidney Int 2008; 74(5): 649-54.
  44. Nasri H, Baradaran A. The influence of serum 25-hydroxy vitamin D levels on Helicobacter Pylori Infections in patients with end-stage renal failure on regular hemodialysis. Saudi J Kidney Dis Transpl 2007; 18(2): 215-9.
  45. Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J, et al. Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity. Biochem Biophys Res Commun 1999; 257(1): 79-83.
  46. Looker HC, Krakoff J, Funahashi T, Matsuzawa Y, Tanaka S, Nelson RG, et al. Adiponectin concentrations are influenced by renal function and diabetes duration in Pima Indians with type 2 diabetes. J Clin Endocrinol Metab 2004; 89(8): 4010-7.
  47. Zoccali C, Mallamaci F, Tripepi G. Inflammatory proteins as predictors of cardiovascular disease in patients with end-stage renal disease. Nephrol Dial Transplant 2004; 19(Suppl 5): V67-V72.
  48. Nasri H. Helicobacter pylori infection and its relationship to plasma magnesium in hemodialysis patients. Bratisl Lek Listy 2007; 108(12): 506-9.
  49. Gable DR, Hurel SJ, Humphries SE. Adiponectin and its gene variants as risk factors for insulin resistance, the metabolic syndrome and cardiovascular disease. Atherosclerosis 2006; 188(2): 231-44.
  50. Nasri H. Pulmonary artery pressure in association with serum parathormone in maintenance hemodialysis patients. Arch Med Sci 2006; 2(1): 32-5.
  51. Yamauchi T, Nio Y, Maki T, Kobayashi M, Takazawa T, Iwabu M, et al. Targeted disruption of AdipoR1 and AdipoR2 causes abrogation of adiponectin binding and metabolic actions. Nat Med 2007; 13(3): 332-9.
  52. Nasri H. Serum leptin concentration and left ventricular hypertrophy and function in maintenance hemodialysis patients. Minerva Urol Nefrol 2006; 58(2): 189-93.
  53. Koshimura J, Fujita H, Narita T, Shimotomai T, Hosoba M, Yoshioka N, et al. Urinary adiponectin excretion is increased in patients with overt diabetic nephropathy. Biochem Biophys Res Commun 2004; 316(1): 165-9.
  54. Nasri H. Linkage of elevated CaxPO4 product with inflammation in maintenance hemodialysis patients. Minerva Urol Nefrol 2006; 58(4): 339-45.
  55. Nasri H. Impact of vitamin C on parathormone secretion in patients on hemodialysis with secondary hyperparathyroidism. J Parathyr Dis 2013; 1(2):29-31.
  56. Marchlewska A, Stenvinkel P, Lindholm B, Danielsson A, Pecoits-Filho R, Lonnqvist F, et al. Reduced gene expression of adiponectin in fat tissue from patients with end-stage renal disease. Kidney Int 2004; 66(1): 46-50.
  57. Nasri H, Kheiri S. Effects of diabetes mellitus, age, and duration of dialysis on parathormone in chronic hemodialysis patients. Saudi J Kidney Dis Transpl 2008; 19(4): 608-13.