Clinical importance of an elevated circulating chemerin level in incident dialysis patients

Tae Yamamoto, Abdul Rashid Qureshi, Björn Anderstam, Olof Heimbürger, Peter Bárány, Bengt Lindholm, Peter Stenvinkel, Jonas Axelsson

Research output: Contribution to journalArticlepeer-review

37 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)4017-4023
Number of pages7
JournalNephrology Dialysis Transplantation
Volume25
Issue number12
DOIs
Publication statusPublished - 2010 Dec

Keywords

  • adipokine
  • dyslipidaemia
  • end-stage renal disease
  • insulin resistance
  • outcome

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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