Original Report: Patient-Oriented, Translational Research

Increased Serum High-Molecular-Weight Complex of Adiponectin in Type 2 Diabetic Patients with Impaired Renal Function
Hirotaka Komaba, Naoya Igaki, Shunsuke Goto, Kazuki Yokota, Hisako Doi, Toshiyuki Takemoto, Maki Kohno, Yoshiaki Hirosue, Takeo Goto

Department of Internal Medicine, Takasago Municipal Hospital, Takasago, Japan

Address of Corresponding Author

Am J Nephrol 2006;26:476-482 (DOI: 10.1159/000096870)

  Key Words

• High-molecular-weight adiponectin
• Type 2 diabetes mellitus
• Diabetic nephropathy
• Visceral fat area
• Subcutaneous fat area
• Gender differences, high-molecular-weight adiponectin
• Pioglitazone

  Abstract

Background/Aim: Adiponectin, an adipocyte-derived protein, has been shown to exert antidiabetic, anti-inflammatory, and antiatherosclerotic effects. Although recent reports show an increase in the total adiponectin levels in chronic kidney disease patients and in patients with end-stage renal disease, the nature of biodegradation and renal involvement of adiponectin is largely unknown. We aimed at determining whether the high-molecular-weight (HMW) complex of adiponectin is associated with renal insufficiency in type 2 diabetic patients. Methods: A total of 179 type 2 diabetic patients were selected from among outpatients and divided into four groups according to their albumin-to-creatinine ratio: patients with normoalbuminuria (n = 86), patients with microalbuminuria (n = 44), patients with macroalbuminuria (n = 23), and patients on hemodialysis (n = 26). The serum HMW adiponectin was specifically assayed with a commercially available enzyme-linked immunosorbent assay kit. Results: The HMW adiponectin levels were higher in patients on hemodialysis (17.1 ± 8.2 µg/ml) and in those with macroalbuminuria (14.3 ± 8.7 µg/ml) than in patients with normoalbuminuria (7.2 ± 5.6 µg/ml) and microalbuminuria (10.8 ± 7.0 µg/ml). Univariate linear regression analysis showed that the HMW adiponectin concentrations correlated negatively with the estimated glomerular filtration rate in patients with normoalbuminuria, microalbuminuria, and macroalbuminuria (r = -0.42, p < 0.001). Multiple stepwise regression analysis disclosed that estimated glomerular filtration rate, pioglitazone therapy, gender differences, and systolic blood pressure were independently associated with HMW adiponectin levels (r = 0.56). Conclusions: The serum HMW adiponectin concentrations are higher in type 2 diabetic patients with nephropathy, and these levels are also associated with renal insufficiency.

Copyright © 2006 S. Karger AG, Basel

  Author Contacts

Hirotaka Komaba, MD
Division of Nephrology and Dialysis Center, Kobe University School of Medicine
7-5-2 Kusunoki-cho, Chuo-ku
Kobe 650-0017 (Japan)
Tel. +81 78 382 6500, Fax +81 78 382 6509, E-Mail hkomaba@med.kobe-u.ac.jp

  Article Information

Received: July 24, 2006
Accepted: September 22, 2006
Published online: November 7, 2006
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 2, Number of References : 32