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Serum adiponectin complexes and cardiovascular risk in children with chronic kidney disease

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Abstract

In contrast to the general population, patients with chronic kidney disease (CKD) experience increased total adiponectin levels despite an increased prevalence of cardiovascular disease. Adiponectin circulates as trimer, low molecular weight (LMW), and high molecular weight (HMW) complexes. The distribution and role of each subfraction in CKD is unknown. This cross-sectional analysis examined the association of serum adiponectin and its subfractions with known cardiovascular risk factors in 105 children (median age 12 years; 56% male) enrolled into the Chronic Kidney Disease in Children (CKiD) study, an observational cohort study of children with CKD stage 2–4.HMW accounted for 46% of total adiponectin, followed by LMW (34%) and trimer (20%). In multivariable analysis, LMW was independently associated with iohexol glomerular filtration rate (GFR) (p = 0.004) and was higher in pubertal versus prepubertal children (p = 0.005). HMW/LMW ratio was independently associated with age and iohexol GFR (all p < 0.001). Unexpectedly, systolic blood pressure was positively correlated with HMW (p = 0.01), and HMW/LMW ratio (p = 0.007) and inversely correlated with LMW (p = 0.009). Among subfractions, only LMW was significantly correlated with left ventricular mass (LVM) index (p = 0.05). In multivariable analysis, decreased LMW was independently associated with higher LVM index [β= −0.25, 95% confidence interval (CI) −0.50, −0.03, p=0.04) after adjustment for body mass index (BMI), age, and blood pressure.The higher total adiponectin levels in children with CKD are associated with higher HMW and lower LMW. This imbalance may be an important biomarker for increased cardiovascular risk despite higher levels of total adiponectin in children with CKD.

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Acknowledgements

This study was funded by the research grant DK076957 from the National Institute of Diabetes and Digestive and Kidney Diseases (MMM). Data in this manuscript were collected by the Chronic Kidney Disease in Children Prospective ohort Study (CKiD) with clinical coordinating centers (principal investigators) at Children’s Mercy Hospital and the University of Missouri - Kansas City (Bradley Warady, MD) and Children’s Hospital of Philadelphia (Susan Furth, MD, Ph.D.), Central Biochemistry Laboratory (George Schwartz, MD) at the University of Rochester Medical Center and data coordinating center (principal investigator) at the Johns Hopkins Bloomberg School of Public Health (Alvaro Muñoz, Ph.D.). The CKiD is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (U01-DK-66143)

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Cincinnati Children’s Hospital Medical Center, MLC: 7022, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA

    Megan M. Lo & Mark M. Mitsnefes

  2. Touchstone Diabetes Center, Department of Internal Medicine, The University of Texas, Southwestern Medical Center, Dallas, TX, USA

    Philipp E. Scherer

  3. The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Susan L. Furth

  4. Children’s Mercy Hospital, Kansas City, MO, USA

    Bradley A. Warady

  5. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, MLC: 5041, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA

    Shelia Salisbury

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  1. Megan M. Lo
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  2. Shelia Salisbury
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  3. Philipp E. Scherer
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  4. Susan L. Furth
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Correspondence to Mark M. Mitsnefes.

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MMM, SLF, and BAW are the Chronic Kidney Disease in Children, CKiD, study investigators.

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Lo, M.M., Salisbury, S., Scherer, P.E. et al. Serum adiponectin complexes and cardiovascular risk in children with chronic kidney disease. Pediatr Nephrol 26, 2009–2017 (2011). https://doi.org/10.1007/s00467-011-1906-x

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  • DOI: https://doi.org/10.1007/s00467-011-1906-x

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