Adiponectin as an important link in the pathogenesis of protein-energy malnutrition in patients receiving treatment with programmed hemodialysis: yes or no?

Yakovenko A.A., Lavrischeva Yu.V.

1) Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia; 2) Almazov National Medical Research Center, St. Petersburg, Russia

Objective. Evaluation of the relationship between the blood serum adiponectin level and protein-energy malnutrition (PEM) indices in patients receiving programmed hemodialysis (HD). Material and methods. A total of 645 patients receiving programmed HD treatment were examined, including 300 men and 345 women aged 56.8±12.8 years. All patients received programmed HD treatment for 8.4±5.3 years. Nutritional status was assessed to diagnose PEM using the method proposed by ISRNM (International Society of Renal Nutrition and Metabolism). Serum adiponectin levels were determined by a method based on a three-stage "sandwich" version of solid-phase enzyme-linked immunosorbent assay using mono- and polyclonal antibodies to adiponectin using the commercial Adiponectin ELISA kit (Mediagnost, Germany), in accordance with the manufacturer's instructions. Reference values for adiponectin were: for women: 3.58–9.66 ng/ml, for men: 2–5.6 ng/ml. Results. The mean values of adiponectin levels in patients without signs of PEM were 8.4±3.0 ng/ml, and in patients with PEM – 12.1±2.6 ng/ml (p<0.0001). The results of nonparametric correlation analysis revealed negative statistically significant relationships between the serum adiponectin level and the level of the main indicators of nutritional status: total serum protein (Rs = - 0.472; p < 0.0001), serum albumin (Rs = - 0.764; p < 0.0001), serum prealbumin (Rs = - 0.428, p < 0.0001), serum transferrin (Rs = - 0.577; p < 0.0001), blood lymphocytes (Rs = - 0.518; p < 0.0001), arm muscle circumference - AMC (Rs = - 0.618; p < 0.0001), skeletal muscle mass index, according to bioimpedance analysis (Rs = - 0.636; p < 0.0001)) and positive statistically significant relationships between the serum adiponectin level and the percentage of body fat according to bioimpedancemetry (Rs=0.152; p<0.0001). Conclusion. The obtained data convincingly demonstrated a close relationship between elevated serum adiponectin levels and PEM in patients receiving treatment with programmed HD.

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About the Authors

Aleksandr A. Yakovenko – Cand.Sci. (Med.), Associate Professor at the Department of Nephrology and Dialysis, Pavlov First St. Petersburg State Medical University.
Address: 6–8 Lev Tolstoy st., St. Petersburg, 197022; tel.: 8 (952) 362-54-64; e-mail: leptin-rulit@mail.ru. ORCID ID: 0000-0003-1045-9336.
Yulia V. Lavrishcheva – Cand.Sci. (Med.), Associate Professor at the Department of Faculty Therapy with the Clinic, Almazov National Medical Research Center.
Address: 2 Akkuratov st., St. Petersburg, 197341; tel.: 8 (921) 790-10-07; e-mail: lavrischeva@gmail.com. ORCID ID: 0000-0002-3073-2785.

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