Association of High Serum Adiponectin Level With Adverse Cardiovascular Outcomes and Progression of Coronary Artery Calcification in Patients With Pre-dialysis Chronic Kidney Disease

Sang Heon Suh; Tae Ryom Oh; Hong Sang Choi; Chang Seong Kim; Joongyub Lee; Yun Kyu Oh; Ji Yong Jung; Kyu-Beck Lee; Kook-Hwan Oh; Seong Kwon Ma; Eun Hui Bae; Soo Wan Kim

doi:10.3389/fcvm.2021.789488

Association of High Serum Adiponectin Level With Adverse Cardiovascular Outcomes and Progression of Coronary Artery Calcification in Patients With Pre-dialysis Chronic Kidney Disease

Front Cardiovasc Med. 2022 Jan 13:8:789488. doi: 10.3389/fcvm.2021.789488. eCollection 2021.

Authors

Affiliations

¹ Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea.
² Department of Prevention and Management, School of Medicine, Inha University, Incheon, South Korea.
³ Department of Internal Medicine, Seoul National University, Seoul, South Korea.
⁴ Division of Nephrology, Department of Internal Medicine, Gachon University of Gil Medical Center, Incheon, South Korea.
⁵ Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Abstract

Background: Serum adiponectin level predicts cardiovascular (CV) outcomes and progression of coronary artery calcification (CAC) in the general population, although the association has not been validated in patients with chronic kidney disease (CKD). In this study, we investigated the association of high serum adiponectin level with the risk of adverse CV outcomes and progression of CAC in patients with pre-dialysis CKD. Methods: A total of 1,127 patients with pre-dialysis CKD from a nationwide prospective cohort of patients with pre-dialysis CKD in Korea were divided into the tertile by serum adiponectin level at the baseline. CV outcome of interest was fatal and non-fatal CV events and all-cause mortality. Progression of CAC was defined as coronary artery calcium score (CACS) change more than 200 during a 4-year follow-up. Results: Cox regression analysis revealed that high serum adiponectin is associated with increased risk of fatal and non-fatal CV events (adjusted hazard ratio 2.799, 95% CI 1.348-5.811). In contrast, high serum adiponectin level was not significantly associated with all-cause mortality (adjusted hazard ratio 0.655, 95% CI 0.203-2.113). Binary logistic regression analysis revealed that high serum adiponectin level is also associated with increased risk of progression of CAC (adjusted odds ratio [OR] 2.078, 95% CI 1.014-4.260). Subgroup analyses demonstrated that the association of high serum adiponectin with increased risk of fatal and non-fatal CV events is not modified by age, gender, history of diabetes, estimated glomerular filtration rate (eGFR), or spot urine albumin-to-creatinine ratio (ACR). Conclusions: High serum adiponectin level is associated with adverse CV outcomes and progression of CAC in patients with pre-dialysis CKD.

Keywords: adiponectin; cardiovascular disease; cardiovascular event; chronic kidney disease; coronary artery calcification.