HIGH BODY MASS INDEX (BMI) IS ASSOCIATED WITH ADIPOKINES AND INSULIN RESISTANCE IN NONDIALYSED CHRONIC KIDNEY DISEASE (CKD) PATIENTS

• Main Authors: Maria Inês Barreto-Silva, Carla Avesani, Laura Kawakami, Renata Martucci, Rachel Bregman
• Format: Article
• Language: English
• Published: The Korean Society of Nephrology 2012-06-01
• Series: Kidney Research and Clinical Practice
• Online Access: http://www.sciencedirect.com/science/article/pii/S2211913212003695

The aim of this study was to assess the association between body adiposity with adipokines and with insulin resistance in non-dialysed CKD patients. This is a cross-sectional study including CKD patients under regular treatment in an outpatient clinic. Glomerular filtration rate was estimated by MDRD equation (eGFR). The nutritional status was assessed by BMI, total body fat (BF; dual-energy X-ray absorptiometry), midarm muscle circumference and serum albumin. Laboratorial parameters included serum glucose, triglycerides; leptin and insulin (radioimmunoassay); high molecular weight adiponectin (HMWAdipo; ELISA). The insulin resistance was assessed by HOMA-IR. Data are expressed as mean + SD. One hundred and thirty four CKD patients (male=56%; eGFR= 29±13ml/min.; 65±12 years old) were included. None of the patients presented protein energy wasting and most of them had BMI≥25kg/m2 (overweight/obese group: OwOb) (n= 72; 54%). BMI was correlated with BF (r= 0.74; p<0.0001). Both BMI groups showed similar eGFR and CKD stages distribution (stage 3:42%, 4: 37%, 5: 21%), hence the comparisons were held between groups with normal and OwOb BMI. The OwOb group had BMI, BF, glucose, triglycerides, leptin and HOMA-IR higher than normal BMI group (P<0.05), while HMWAdipo was lower in OwOb group (P<0.05). BMI was significantly associated with leptin (r= 0.58); HOMA-IR (r= 0.36) and HMWAdipo (r= −0.45). HOMA-IR was associated with leptin (r= 0.28) and with HMWAdipo (r= −0.29) (P<0.01), even after adjusting for BF, eGFR, gender and age. In conclusion, BMI and BF were associated with increased leptin and HOMA-IR, but with decreased HMWAdipo. The OwOb CKD patients presented higher risk for metabolic and cardiovascular disorders.