Adiponectin-to-leptin Ratio and Incident Chronic Kidney Disease: Sex and Body Composition-dependent Association

Overview

Journal J Cachexia Sarcopenia Muscle

Date 2024 Apr 18

PMID 38632706

Authors

Hye-Sun Park

Sang Ho Park

Yeseul Seong

Hyo Jeong Kim

Hoon Young Choi

Yumie Rhee

Hyeong Cheon Park

Jong Hyun Jhee

Affiliations

Soon will be listed here.

Abstract

Background: The association between the adiponectin-to-leptin ratio (A/L ratio) and the risk of incident chronic kidney disease (CKD) is poorly understood. This study aimed to investigate the association between A/L ratio and the risk of incident CKD and to examine whether such a relationship varied according to sex and body composition.

Methods: In this prospective community-based cohort, participants with normal kidney function were analysed (N = 5192). The association between the A/L ratio at baseline and the risk of incident CKD, defined as two or more occasions with an estimated glomerular filtration rate of <60 mL/min/m or proteinuria of ≥1+ on a dipstick test during the follow-up period, was evaluated using multivariable Cox proportional hazards analyses. Subgroup analyses were conducted based on sex, body mass index (BMI) and the presence of sarcopenia.

Results: The participants' mean age was 57.2 ± 8.3 years, and 53.2% were women. The A/L ratio was higher in men compared with women (1.5 [0.8-3.2] and 0.5 [0.3-0.9] μg/ng, P < 0.001). During a median follow-up of 9.8 [9.5-10.0] years, 417 incident CKD events occurred (8.7 per 1000 person-years). Men in the highest quartile of A/L ratio had a lower risk of incident CKD (adjusted hazard ratio [aHR], 0.57; 95% confidence interval [CI], 0.33-0.99) than those in the lowest quartile. Additionally, a 1.0 increase in A/L ratio was associated with a 12% decreased risk of incident CKD in men (aHR, 0.88; 95% CI, 0.80-0.97). However, no significant association was observed in women. In subgroup analysis stratified by BMI and the presence of sarcopenia, the association between a high A/L ratio and a reduced risk of incident CKD was consistent in men with a BMI < 23.0 kg/m and those with sarcopenia. However, no significant association was observed between men with a BMI ≥ 23.0 kg/m and those without sarcopenia.

Conclusions: A high A/L ratio is an independent marker of a reduced risk of incident CKD in men, especially in those with a BMI < 23.0 kg/m and sarcopenia.

Citing Articles

Adiponectin-to-leptin ratio and incident chronic kidney disease: Sex and body composition-dependent association.

Park H, Park S, Seong Y, Kim H, Choi H, Rhee Y J Cachexia Sarcopenia Muscle. 2024; 15(4):1298-1308.

PMID: 38632706 PMC: 11294033. DOI: 10.1002/jcsm.13475.

References

Lonnqvist F, Arner P, Nordfors L, Schalling M . Overexpression of the obese (ob) gene in adipose tissue of human obese subjects. Nat Med. 1995; 1(9):950-3. DOI: 10.1038/nm0995-950. View

Wolf G, Hamann A, Han D, Helmchen U, Thaiss F, Ziyadeh F . Leptin stimulates proliferation and TGF-beta expression in renal glomerular endothelial cells: potential role in glomerulosclerosis [seecomments]. Kidney Int. 1999; 56(3):860-72. DOI: 10.1046/j.1523-1755.1999.00626.x. View

Kollerits B, Fliser D, Heid I, Ritz E, Kronenberg F . Gender-specific association of adiponectin as a predictor of progression of chronic kidney disease: the Mild to Moderate Kidney Disease Study. Kidney Int. 2007; 71(12):1279-86. DOI: 10.1038/sj.ki.5002191. View

Bedard A, Tchernof A, Lamarche B, Corneau L, Dodin S, Lemieux S . Effects of the traditional Mediterranean diet on adiponectin and leptin concentrations in men and premenopausal women: do sex differences exist?. Eur J Clin Nutr. 2014; 68(5):561-6. DOI: 10.1038/ejcn.2014.27. View

Vega G, Grundy S . Metabolic risk susceptibility in men is partially related to adiponectin/leptin ratio. J Obes. 2013; 2013:409679. PMC: 3606776. DOI: 10.1155/2013/409679. View

Baker J, Newman A, Kanaya A, Leonard M, Zemel B, Miljkovic I . The Adiponectin Paradox in the Elderly: Associations With Body Composition, Physical Functioning, and Mortality. J Gerontol A Biol Sci Med Sci. 2018; 74(2):247-253. PMC: 6333931. DOI: 10.1093/gerona/gly017. View

Kappelle P, Dullaart R, van Beek A, Hillege H, Wolffenbuttel B . The plasma leptin/adiponectin ratio predicts first cardiovascular event in men: a prospective nested case-control study. Eur J Intern Med. 2012; 23(8):755-9. DOI: 10.1016/j.ejim.2012.06.013. View

Considine R, Sinha M, Heiman M, Kriauciunas A, STEPHENS T, Nyce M . Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med. 1996; 334(5):292-5. DOI: 10.1056/NEJM199602013340503. View

Coimbra S, Rocha S, Valente M, Catarino C, Bronze-da-Rocha E, Belo L . New Insights into Adiponectin and Leptin Roles in Chronic Kidney Disease. Biomedicines. 2022; 10(10). PMC: 9599100. DOI: 10.3390/biomedicines10102642. View

10.

Yang Q, Fu C, Zhang X, Zhang Z, Zou J, Xiao J . Adiponectin protects against uric acid‑induced renal tubular epithelial inflammatory responses via the AdipoR1/AMPK signaling pathway. Int J Mol Med. 2019; 43(3):1542-1552. DOI: 10.3892/ijmm.2019.4072. View

11.

Mente A, Razak F, Blankenberg S, Vuksan V, Davis A, Miller R . Ethnic variation in adiponectin and leptin levels and their association with adiposity and insulin resistance. Diabetes Care. 2010; 33(7):1629-34. PMC: 2890372. DOI: 10.2337/dc09-1392. View

12.

Fang F, Liu G, Kim C, Yassa R, Zhou J, Scholey J . Adiponectin attenuates angiotensin II-induced oxidative stress in renal tubular cells through AMPK and cAMP-Epac signal transduction pathways. Am J Physiol Renal Physiol. 2013; 304(11):F1366-74. DOI: 10.1152/ajprenal.00137.2012. View

13.

Jhee J, Joo Y, Han S, Yoo T, Kang S, Park J . High muscle-to-fat ratio is associated with lower risk of chronic kidney disease development. J Cachexia Sarcopenia Muscle. 2020; 11(3):726-734. PMC: 7296269. DOI: 10.1002/jcsm.12549. View

14.

von Haehling S, Coats A, Anker S . Ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: update 2021. J Cachexia Sarcopenia Muscle. 2021; 12(6):2259-2261. PMC: 8718061. DOI: 10.1002/jcsm.12899. View

15.

Kim Y, Han B . Cohort Profile: The Korean Genome and Epidemiology Study (KoGES) Consortium. Int J Epidemiol. 2016; 46(2):e20. PMC: 5837648. DOI: 10.1093/ije/dyv316. View

16.

Lee C, Kim H, Chang T, Wha Kang E, Joo Y, Kim H . Synergic association of diabetes mellitus and chronic kidney disease with muscle loss and cachexia: results of a 16-year longitudinal follow-up of a community-based prospective cohort study. Aging (Albany NY). 2021; 13(18):21941-21961. PMC: 8507303. DOI: 10.18632/aging.203539. View

17.

Han D, Isono M, Chen S, Casaretto A, Hong S, Wolf G . Leptin stimulates type I collagen production in db/db mesangial cells: glucose uptake and TGF-beta type II receptor expression. Kidney Int. 2001; 59(4):1315-23. DOI: 10.1046/j.1523-1755.2001.0590041315.x. View

18.

Achari A, Jain S . Adiponectin, a Therapeutic Target for Obesity, Diabetes, and Endothelial Dysfunction. Int J Mol Sci. 2017; 18(6). PMC: 5486142. DOI: 10.3390/ijms18061321. View

19.

Christen T, Trompet S, Noordam R, van Klinken J, Willems van Dijk K, Lamb H . Sex differences in body fat distribution are related to sex differences in serum leptin and adiponectin. Peptides. 2018; 107:25-31. DOI: 10.1016/j.peptides.2018.07.008. View

20.

Fruhbeck G, Catalan V, Rodriguez A, Gomez-Ambrosi J . Adiponectin-leptin ratio: A promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk. Adipocyte. 2017; 7(1):57-62. PMC: 5915018. DOI: 10.1080/21623945.2017.1402151. View