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Gelsolin and Adipokines Are Associated With Protein‐Energy Wasting in Hemodialysis Patients
Author(s) -
Chiu Terry TingYu,
Liao ShangChih,
Lee WenChin,
Lee PoShun,
Ng HweeYeong,
Chien YuSu,
Lee ChienTe
Publication year - 2015
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12342
Subject(s) - adiponectin , adipokine , medicine , gelsolin , endocrinology , hemodialysis , leptin , biology , obesity , insulin resistance , actin , microbiology and biotechnology
Protein‐energy wasting ( PEW ) contributes to mortality in hemodialysis ( HD ) patients. Adipokines regulate energy homeostasis and body weight. Circulating gelsolin can modulate inflammation and is correlated with HD mortality. Whether adipokines and gelsolin play important roles in PEW remains unclear. Based on the criteria proposed by the I nternational S ociety of R enal N utrition and M etabolism, we examined the associations between PEW and biomarkers (gelsolin, leptin, adiponectin, interleukin‐6, tumor necrosis factor alpha [ TNF ‐α]) in 188 stable HD patients. Patients with PEW had significantly lower serum leptin levels, and tended to have higher adiponectin, TNF ‐α, and lower gelsolin levels. Logistic regression analysis revealed that gelsolin, leptin, adiponectin, and blood urea nitrogen were independently associated with PEW score. Serum creatinine, TNF ‐α, gender, renin‐angiotensin system ( RAS ) blockade, and lipid‐lowering agents were not associated with PEW score. Patients on lipid‐lowering agents had lower PEW scores and those with RAS blockade had higher PEW scores. Our study confirms that gelsolin, adiponectin, and leptin are significant associates with PEW in HD patients. Further understanding of how these factors contribute to PEW may help design novel therapeutic strategies for PEW in chronic kidney disease.