RESUMO
AIMS SUBJECTS AND METHODS: Markers of oxidative stress and inflammatory activation of endothelium, as well as the adipose tissue secreted adipokines, e.g. adiponectin show altered pattern in renal failure. However, their internal relations have not been fully evaluated in this special patient population. In our cross sectional study, beside the routine clinical and biochemical parameters, plasma malondialdehyde, glutathione (GSH), catalase, total peroxidase, as well as serum E-selectin and adiponectin were measured in 70 hemodialysed (HD) patients. RESULTS: GSH showed negative correlations with systolic and diastolic blood pressure (BP) values, while a positive one with HDL-cholesterol level, as expected. Interestingly, the level of sE-selectin was inversely correlated only with the age. In multiple regression analyses where anthropometric, BP and laboratory parameters were included and sE-selectin was the dependent variable, the inverse association between the age and level of sE-Selectin turned out being an independent factor. CONCLUSIONS: In HD kidney failure patients of the biochemical cardiovascular risk markers those related to oxidative stress, endothelial dysfunction, or altered adipokine homeostasis are not necessarily strongly associated. Larger studies may be needed to confirm our novel observation, a negative and independent correlation of age to sE-Selectin level.
RESUMO
BACKGROUND/AIMS: In hemodialyzed (HD) patients, adiponectin and sE-selectin levels are elevated, while antioxidant paraoxonase 1 activity (PON1) is decreased. We determined if the hyperadiponectinemia in HD patients has a protective effect on the decrease in PON1 and elevation in sE-selectin in kidney failure. METHODS AND DESIGN: Predialysis serum adiponectin, PON1 and sE-selectin as well as other metabolic variables were measured in 70 HD patients. RESULTS: Adiponectin had (1) no association with PON1 or sE-selectin, (2) a positive association with dialysis efficiency and HDL-C, and (3) an inverse association with BMI, waist circumference, HOMA IR, triglyceride, hsCRP, fibrinogen, and albumin. Moreover, albumin, BMI, and HOMA-IR were independent negative predictors of adiponectin. CONCLUSIONS: In kidney failure, in contrast to normal renal function, higher adiponectin levels had no correlation with PON1 activity or the sE-selectin level. However, adiponectin has an association with dialysis efficiency and, similar to individuals with preserved kidney function, traits of metabolic syndrome. In addition to BMI and HOMA-IR, the serum albumin concentration is also one of the independent negative predictors of the serum adiponectin level. Collectively, these findings may add details to the understanding of the role that adiponectin plays in chronic renal disease related to 'reverse epidemiology'.
