Obesity indices and adipokines in non-diabetic obese patients with early stages of chronic kidney disease
Mariusz Stępień, Anna Stępień, Rafał Nikodem Wlazeł, Marek Paradowski, Maciej Banach, Magdalena Rysz, Jacek Rysz
Department of Nephrology, Hypertension and Family Medicine, Medical University of Łódź, Łódź, Poland
Med Sci Monit 2013; 19:1063-1072
The aim of this study was to estimate obesity parameters: waist circumference (WC), waist-to-hip ratio (WHR), weight-to-height ratio (WHtR), visceral adiposity index (VAI), body adiposity index (BAI), and serum adipokines (leptin, adiponectin, resistin) and their associations with estimated glomerular filtration rate (eGFR), serum creatinine, and microalbuminuria (MA) in patients with early stages of CKD and in non-CKD obese patients.
Material and Methods: 67 non-diabetic obese (BMI ≥30 mg/kg2) out-clinic patients (25 males, 42 females), aged from 36.5 to 64 years were divided into 2 groups: Group A (n=15) – patients with early stages of CKD (eGFR between 30 and 60 ml/min/1.73 m2 or with MA >20 mg/l in morning urine sample independently from GFR) and Group B – patients without chronic CKD (n=52).
Results: In Group A compared to Group B, BAI and leptin were higher (42.2±7.1 vs. 37.5±7.0; p<0.05 and 51.8±26.7 ng/mL vs. 35.3±24.9 ng/mL; p<0.05; respectively) and negative correlations occurred between eGFR and BAI (r=–0.709; p=0.003), leptin (r=–0.68; p=0.005), and resistin (r=–0.528; p<0.05). In Group B, negative correlations occurred between creatinine and VAI (r=–0.332; p<0.05), BAI (r=–0.619; p<0.0001), leptin (r=–0.676; p<0.0001), and adiponectin (r=–0.423; p=0.002), and between eGFR and resistin (r=–0.276; p<0.05).
Conclusions: BAI may be a valuable obesity parameter as a predictor of early stages of CKD in patients with obesity. Leptin may be an important pathogenic factor in obese patients with early stages of CKD. Resistin is associated with eGFR in obese patients, independently of CKD.
Keywords: Adiposity - physiology, Adipokines - blood, Adult, Albuminuria - physiopathology, Biological Markers, Body Height - physiology, Case-Control Studies, Creatinine - blood, Glomerular Filtration Rate - physiology, Insulin Resistance, Obesity - physiopathology, Renal Insufficiency, Chronic - physiopathology, Statistics, Nonparametric, Waist Circumference - physiology, Waist-Hip Ratio