Abstract: SA-PO383
Leptin-to-Adiponectin Ratio and Survival in a Prospective Hemodialysis Cohort
Session Information
- Hemodialysis and Frequent Dialysis: CV and Risk Prediction
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Bui, Thuy-Anh, University of California Irvine, Irvine, California, United States
- You, Amy Seung, University of California Irvine, Irvine, California, United States
- Narasaki, Yoko, University of California Irvine, Irvine, California, United States
- Yoon, Ji Hoon, University of California Irvine, Irvine, California, United States
- Guerrero, Yalitzi, University of California Irvine, Irvine, California, United States
- Kalantar, Sara S., University of California Irvine, Irvine, California, United States
- Arora, Ria, University of California Irvine, Irvine, California, United States
- Nakata, Tracy, University of California Irvine, Irvine, California, United States
- Nguyen, Danh V., University of California Irvine, Irvine, California, United States
- Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
- Rhee, Connie, University of California Irvine, Irvine, California, United States
Background
Leptin and adiponectin are two major adipocytokines believed to play key roles in the regulation of CV and metabolic status. While animal studies show leptin and adiponectin have inverse effects on the CV system (leptin promotes atherosclerosis, while adiponectin reduces vascular injury), it is suggested that the leptin-to-adiponectin (L/A) ratio may be an important predictor of CV disease and death. Despite their exceedingly high CV risk,no studies have examined the association between the L/A ratio and mortality in HD patients.
Methods
In a multicenter prospective cohort of 448 HD patients from the NIH “Malnutrition, Diet, and Racial Disparities in Kidney Disease” Study who underwent protocolized serum leptin/adiponectin measures, we examined the association of L/A ratio (categorized as tertiles) with all-cause mortality in unadjusted, case-mix, and case-mix+laboratory (adjusted for serum albumin, creatinine, nPCR, and IL-6) Cox rmodels. We additionally examined clinical characteristics associated with high leptin and adiponectin levels (defined as the highest tertile) using logistic regression.
Results
We observed that increasingly higher L/A ratio tertiles were associated with incrementally lower death risk across all Cox models (ref: lowest tertile): HR (95%CI) 0.37 (0.18, 0.76) and 0.18 (0.07, 0.46), respectively for the middle and highest tertiles, respectively, in case-mix+laboratory models (Fig). In case-mix+laboratory logistic regression models, female sex, diabetes, AV access use, and lower serum albumin were associated with higher leptin, whereas female sex, Black race, and longer vintage were associated with higher adiponectin.
Conclusion
In a multicenter prospective cohort of HD patients, higher L/A ratios were associated with lower mortality. Further studies are needed to determine mechanistic pathways underlying the relationship between adipocytokines, CV health, and survival in HD.
Funding
- NIDDK Support