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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

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Serum adiponectin complexes and cardiovascular risk in children with chronic kidney disease

Megan M Lo1, Shelia Salisbury, Philipp E Scherer

  • 1Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, MLC: 7022, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.

Pediatric Nephrology (Berlin, Germany)
|May 10, 2011
PubMed

Insights

In children with chronic kidney disease (CKD), higher total adiponectin levels are linked to an imbalance of its subfractions, specifically more high molecular weight (HMW) and less low molecular weight (LMW) adiponectin. This imbalance may indicate increased cardiovascular risk.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Endocrinology

Background:

  • Patients with chronic kidney disease (CKD) exhibit elevated total adiponectin levels, yet paradoxically face a higher prevalence of cardiovascular disease.
  • Adiponectin exists in various forms, including trimer, low molecular weight (LMW), and high molecular weight (HMW) complexes, whose specific roles in pediatric CKD remain unclear.

Purpose of the Study:

  • To investigate the association between serum adiponectin subfractions (trimer, LMW, HMW) and cardiovascular risk factors in children with CKD stages 2-4.
  • To determine the distribution of adiponectin subfractions in this pediatric CKD population.

Main Methods:

  • A cross-sectional analysis was conducted on 105 children (median age 12 years) from the Chronic Kidney Disease in Children (CKiD) study.
  • Serum adiponectin and its subfractions (HMW, LMW, trimer) were measured and correlated with cardiovascular risk factors, including glomerular filtration rate (GFR), blood pressure, and left ventricular mass (LVM) index.

Main Results:

  • High molecular weight (HMW) adiponectin constituted 46% of total adiponectin, followed by LMW (34%) and trimer (20%).
  • Low molecular weight (LMW) adiponectin was independently associated with iohexol glomerular filtration rate (GFR) and pubertal status.
  • Systolic blood pressure showed positive correlations with HMW and the HMW/LMW ratio, and an inverse correlation with LMW. Decreased LMW was independently associated with a higher left ventricular mass (LVM) index.

Conclusions:

  • Children with CKD display an adiponectin profile characterized by increased HMW and decreased LMW subfractions, despite higher overall adiponectin levels.
  • This altered subfraction distribution, particularly lower LMW, may serve as a critical biomarker for heightened cardiovascular risk in pediatric CKD.
  • Further research is warranted to elucidate the specific pathophysiological roles of adiponectin subfractions in pediatric CKD and cardiovascular complications.

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