TY - JOUR
T1 - Clinical importance of an elevated circulating chemerin level in incident dialysis patients
AU - Yamamoto, Tae
AU - Qureshi, Abdul Rashid
AU - Anderstam, Björn
AU - Heimbürger, Olof
AU - Bárány, Peter
AU - Lindholm, Bengt
AU - Stenvinkel, Peter
AU - Axelsson, Jonas
N1 - Funding Information:
Acknowledgements. We would like to thank the patients and personnel involved in the creation of this cohort. Especially, we thank our research staff at KBC (Annika Nilsson, Ann-Kristin Emmot and Ulrika Jensen) and KFC (Monica Eriksson and Ann-Christin Bragfors-Helin). The authors were supported by grants from the Uehara Memorial Foundation (T.Y.), the Swedish Society of Medical Research (J.A.) and Sanofi-Aventis (J.A.). We also benefited from a grant from Baxter Healthcare Inc. (Deerfield, IL, USA) to the Karolinska Institutet.
Funding Information:
Conflict of interest statement. B.L. is an employee of Baxter Healthcare Inc. P.S. is a member of the scientific advisory board of Gambro AB. J.A. is the recipient of honoraria from Baxter and a research grant from Sanofi-Aventis. None of the other authors have any conflicts of interest to declare.
PY - 2010/12
Y1 - 2010/12
N2 - Background. Circulating chemerin, a novel adipokine linked to obesity, glucose tolerance and hyperlipidaemia, was recently reported to be increased in chronic kidney disease (CKD) patients. We explored possible links between chemerin and various clinical, nutritional and biochemical markers as well as its association with 5-year all-cause mortality.Methods. Fasting plasma samples were obtained from 252 CKD Stage 5 patients [median age 56 years, male 61%, glomerular filtration rate (GFR) 7 mL/min] enrolled at the initiation of dialysis. Serum chemerin was measured using commercial ELISA. Chemerin levels were related to clinical status and biomarkers of inflammation, glucose and lipid metabolism and body composition (body mass index and total and truncal fat mass by dual-energy X-ray absorptiometry). Survival, censored for transplantation, was recorded for a follow-up time of 5 years.Results. In univariate regression, circulating chemerin (119±26 ng/mL) was positively correlated with cholesterol (ρ=0.21; P=0.001), triglycerides (ρ=0.22; P=0.0007), apolipoprotein B (ρ=0.33; P<0.0001), high-sensitivity C-reactive protein (ρ=0.18; P=0.006), white blood cell count (ρ=0.23; P<0.001), insulin (ρ=0.18; P<0.05) and homeostatic model assessment (HOMA) index (ρ=0.17; P<0.05), whereas we found a negative correlation with GFR (ρ=-0.28; P=0.007), high-density lipoprotein cholesterol (ρ=-0.15; P<0.05) and homocysteine (ρ=-0.25; P=0.001). Moreover, a high chemerin predicted a better survival (log-rank χ2=3.85; P<0.05). Also, in a Cox model, adjustments for age, sex and CRP did not alter this finding (hazard ratio=1.98 [95% confidence interval=1.13-3.50], P=0.01). However, adjusting for GFR made the model non-significant.Conclusions. We report that, in incident dialysis patients, an elevated chemerin is associated with a survival advantage despite its significant positive association with markers of inflammation and dyslipidaemia.
AB - Background. Circulating chemerin, a novel adipokine linked to obesity, glucose tolerance and hyperlipidaemia, was recently reported to be increased in chronic kidney disease (CKD) patients. We explored possible links between chemerin and various clinical, nutritional and biochemical markers as well as its association with 5-year all-cause mortality.Methods. Fasting plasma samples were obtained from 252 CKD Stage 5 patients [median age 56 years, male 61%, glomerular filtration rate (GFR) 7 mL/min] enrolled at the initiation of dialysis. Serum chemerin was measured using commercial ELISA. Chemerin levels were related to clinical status and biomarkers of inflammation, glucose and lipid metabolism and body composition (body mass index and total and truncal fat mass by dual-energy X-ray absorptiometry). Survival, censored for transplantation, was recorded for a follow-up time of 5 years.Results. In univariate regression, circulating chemerin (119±26 ng/mL) was positively correlated with cholesterol (ρ=0.21; P=0.001), triglycerides (ρ=0.22; P=0.0007), apolipoprotein B (ρ=0.33; P<0.0001), high-sensitivity C-reactive protein (ρ=0.18; P=0.006), white blood cell count (ρ=0.23; P<0.001), insulin (ρ=0.18; P<0.05) and homeostatic model assessment (HOMA) index (ρ=0.17; P<0.05), whereas we found a negative correlation with GFR (ρ=-0.28; P=0.007), high-density lipoprotein cholesterol (ρ=-0.15; P<0.05) and homocysteine (ρ=-0.25; P=0.001). Moreover, a high chemerin predicted a better survival (log-rank χ2=3.85; P<0.05). Also, in a Cox model, adjustments for age, sex and CRP did not alter this finding (hazard ratio=1.98 [95% confidence interval=1.13-3.50], P=0.01). However, adjusting for GFR made the model non-significant.Conclusions. We report that, in incident dialysis patients, an elevated chemerin is associated with a survival advantage despite its significant positive association with markers of inflammation and dyslipidaemia.
KW - adipokine
KW - dyslipidaemia
KW - end-stage renal disease
KW - insulin resistance
KW - outcome
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U2 - 10.1093/ndt/gfq329
DO - 10.1093/ndt/gfq329
M3 - Article
C2 - 20543210
AN - SCOPUS:78649528499
SN - 0931-0509
VL - 25
SP - 4017
EP - 4023
JO - Proceedings of the European Dialysis and Transplant Association - European Renal Association. European Dialysis and Transplant Association - European Renal Association. Congress
JF - Proceedings of the European Dialysis and Transplant Association - European Renal Association. European Dialysis and Transplant Association - European Renal Association. Congress
IS - 12
ER -
