Serum Adipokine Levels in Renal Transplant Recipients K.-H. Shu, M.-J. Wu, C.-H. Chen, C.-H. Cheng, T.-M. Yu, Y.-W. Chuang, S.-T. Huang, S.-F. Tsai, Y.-C. Lo, S.-C. Weng, M.-C. Wen, and H.-C. Ho ABSTRACT Background. Metabolic syndrome (MS) is a common complication in renal transplant (RTx) recipients. This study aimed to explore the alterations and interrelationship of various adipokines in RTx recipients with and without MS. Methods. RTx recipients followed at our hospital were randomly selected for the crosssectional study of MS. The modified Adult Treatment Panel III criteria adopted for Asian populations were used to define MS. Overnight fasting blood samples were obtained for determination of adipokines, including adiponectin, leptin, resistin, and visfatin. Univariate and multivariate logistic regressions were performed to determine parameters that were associated with serum adipokine levels. Pearson correlation analysis was performed between adipokines. Results. A total of 280 RTx recipients were enrolled for the study. Seventy-three cases (26.1%) fulfilled the criteria of MS. A significantly higher serum leptin level was found in MS patients (16.61
13.90 vs 8.00
7.42 mg/mL; P < .0001). There was no significant difference in serum levels of adiponectin, resistin, and visfatin between the 2 groups. Serum adiponectin level was positively correlated with serum resistin (r ¼ 0.422; P < .0001) and visfatin levels (r ¼ 0.224; P < .0001). Serum resistin level was positively correlated with serum visfatin level. All but serum visfatin level were negatively correlated with estimated glomerular filtration rate. Univariate logistic regression revealed the following variables to be associated with serum leptin level: metabolic syndrome, sex, body weight, waist circumference, body mass index (BMI), hypertension, serum creatinine, fasting blood sugar, HbA1c, serum triglyceride, and uric acid. Multivariate analysis revealed that sex, body weight, BMI, and serum creatinine were associated with serum leptin level. Conclusions. Compared with RTx recipients without MS, patients with MS were associated with significantly higher serum leptin levels and similar adiponectin, resistin, and visfatin levels. A close interrelationship was also found in the serum levels of these adipokines.

C

ARDIOVASCULAR DISEASE (CVD) is a major cause of death not only in uremic patients undergoing dialysis but also in renal transplant (RTx) recipients. Successful renal transplantation only partially corrects some risk factors of CVD. For example, metabolic syndrome (MS), a well known risk factor of CVD, remains a highly prevalent complication among RTx patients [1]. Earlier studies revealed several alterations of adipokines in MS patients [1,2], which had been implicated in the pathogenesis of CVD through a crosstalk between adipose tissue and blood vessels [3,4]. The present study aimed at exploring the serum levels of several adipokines and their interrelationship in our RTx patients with and without MS. ª 2014 by Elsevier Inc. All rights reserved. 360 Park Avenue South, New York, NY 10010-1710 Transplantation Proceedings, 46, 381e384 (2014)

From the Division of Nephrology, Department of Internal Medicine (K.-H.S., M.-J.W., C.-H. Chen, C.-H. Cheng, T.-M.Y., Y.-W.C., S.-T.H., S.-F.T., Y.-C.L., S.-C.W.), Department of Pathology (M.-C.W.), and Division of Urology, Department of Surgery (H.-C.H.), Taichung Veterans General Hospital; Institute of Medicine, Chung-Shan Medical University (K.-H.S., M.-J.W., C.-H. Cheng.); and School of Medicine, China Medical University (C.-H. Chen.), Taichung, Taiwan. Supported in part by research grants from Taichung Veterans General Hospital (TCVGH-993603C) and the National Science Council (99-2314-B-075A-001-MY3). Address reprint requests to Kuo-Hsiung Shu, MD, Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, 160, Sec 3, Taichung-Kang Rd, Taichung, Taiwan. E-mail: [email protected] 0041-1345/14/$esee front matter http://dx.doi.org/10.1016/j.transproceed.2013.11.033 381

382

SHU, WU, CHEN ET AL Table 1. Comparison of Patient Characteristics

Sex, male (%) Age at transplant (y) Current age (y) Duration of follow-up (y) Body weight (kg) Waist circumference (cm) BMI (kg/m2) Pretransplant DM (%) Posttransplant DM (%) Hypertension (%) Number of anti-HTN drugs Serum creatinine (mg/dL) Fasting blood sugar (mg/dL) HbA1c (%) Total cholesterol (mg/dL) HDL cholesterol (mg/dL) LDL cholesterol (mg/dL) Triglyceride (mg/dL) Uric acid (mg/dL) Proteinuria (g/24 h)

Non-MS (n ¼ 207)

MS (n ¼ 73)

Total (n ¼ 280)

P Value

48.8 42.7
13.1 52.0
12.1 9.76
5.61 58.9
11.6 81.6
9.3 22.5
3.2 4.3 8.2 48.3 0.77
0.97 1.39
0.62 99.3
21.1 5.78
0.67 194.7
34.9 65.5
15.7 114.7
31.3 112.2
56.5 6.79
1.57 0.43
0.77

49.3 46.0
11.2 56.7
9.9 10.59
6.08 69.7
12.2 91.4
11.2 26.3
3.7 11.0 39.7 87.7 1.48
0.88 1.60
0.63 130.4
58.4 6.71
1.52 192.9
40.1 50.1
15.8 117.6
33.5 192.5
82.8 7.17
1.73 1.05
2.34

48.9 43.5
12.7 53.2
12.2 9.97
5.73 61.7
12.7 84.2
10.7 23.5
3.8 6.1 16.4 58.6 0.95
1.00 1.44
0.63 107.3
37.3 6.04
1.07 194.2
36.2 61.5
17.1 115.5
31.9 133.1
73.3 6.89
1.62 0.59
1.37

.939 .061 .001 .302