High serum adiponectin levels during steroid-responsive nephrotic syndrome relapse

Area of Science:

• Endocrinology and Metabolism
• Pediatric Nephrology
• Biochemistry

Background:

• Adiponectin (ADPN) is an adipokine with anti-atherogenic and anti-inflammatory properties.
• Elevated ADPN levels are associated with obesity and insulin resistance.
• Nephrotic syndrome is linked to increased ADPN in adults; its role in pediatric SRNS is unclear.

Purpose of the Study:

• To evaluate the effect of the nephrotic state on serum ADPN levels in pediatric patients with steroid-responsive nephrotic syndrome (SRNS).
• To compare ADPN levels during relapse and remission phases of SRNS.
• To investigate the relationship between ADPN, proteinuria, and serum protein/lipid parameters.

Main Methods:

• Serum ADPN levels were measured using ELISA in 34 pediatric SRNS patients (15 relapse, 19 remission) and 22 healthy controls.
• Blood chemistry including protein, albumin, triglyceride (TG), cholesterol (Cho), and lipoprotein levels were analyzed.
• 24-hour proteinuria was quantified.

Main Results:

• SRNS patients exhibited significant alterations in protein-lipid profiles and proteinuria consistent with disease activity.
• Serum ADPN levels were substantially higher in SRNS-relapse patients (36.77 ± 15.06 μg/ml) compared to SRNS-remission (14.17 ± 6.02 μg/ml) and control groups (11.84 ± 7.53 μg/ml) (p=0.001).
• ADPN showed strong positive correlations with cholesterol, TG, LDL, and 24-hour proteinuria, and inverse correlations with protein and albumin.

Conclusions:

• Remarkably increased serum ADPN levels were observed in pediatric SRNS patients during relapse compared to remission.
• The elevated ADPN in relapse may represent a compensatory response to the nephrotic state, characterized by massive proteinuria, hypoalbuminemia, and hyperlipidemia.
• ADPN warrants further investigation as a potential biomarker in pediatric SRNS.