Abstract
Adiponectin and leptin, adipose-specific secretory proteins, are associated with obesity. It has been reported that the plasma adiponectin and leptin concentrations were both higher in women than in men, and were markedly increased among hemodialysis patients in comparison with healthy controls.
This study was conduced in 104 hemodialysis patients and 35 healthy controls. To obtein a novel indicator for the visceral fat area in hemodialysis patients, we measured total adiponectin (t-Adipo), high molecular weight adiponectin (h-Adipo) and leptin (Lep) in serum and evaluated visceral and subcutaneous fat areas using computed tomography. In addition, we calculated the percentage of the high molecular weight form per total adiponectin (h-Adipo/t-Adipo) and the ratio of adiponectin to leptin (Adipo/Lep ratio). Hemodialysis patients were divided into four groups based on their visceral fat area level (under 40 cm2 ; group I, 40-70 cm2 ; group II, 70-100 cm2 ; group III, 100 cm2 or more ; group IV). T-Adipo, h-Adipo, leptin and h-Adipo/t-Adipo were significantly higher in women than in men. T-Adipo, h-Adipo and h-Adipo/t-Adipo were lower in group IV than in group I. Leptin were higher in group III and IV than in group I. The T-Adipo/Lep ratio and h-Adipo/Lep ratio were lower in group III and IV than in group I. Especially, the h-Adipo/Lep ratio in group IV was significantly decreased compared with that in group III. By simple regression analysis of the correlation between visceral fat area and each parameter of adipocytokine, the highest correlation coefficients were seen with the log transformed h-Adipo/Lep ratio. Log transformed h-Adipo/Lep ratio were inversely related to visceral fat area for men (y=-36.16x+75.8, r=-0.558, p<0.001) and for women (y=-36.07x+68.2, r=-0.725, p<0.001). The two regression lines between-gender difference were equivalent in slope. We conclude that h-Adipo/Lep ratio may be a marker for evaluating visceral fat area in hemodialysis patients.
