The relationship of serum adipokines with malnutrition inflammation score in haemodialysis

Background Protein–energy wasting is a prevalent disorder in haemodialysis. Zinc‐α2‐glycoprotein ( ZAG ) and adipose triglyceride lipase ( ATGL ) are novel adipokines with recognized lipolytic effects and proposed role in metabolic homoeostasis. This study was conducted to investigate the association of ZAG and ATGL concentrations with malnutrition–inflammation score ( MIS ) and metabolic profile of patients with haemodialysis. Materials and methods Eighty‐eight patients under regular haemodialysis were divided based on MIS to normal to mild wasting ( NMW ; n  = 35) or moderate wasting ( MW ; n  = 53) group. Anthropometric measurements along with fasting serum concentrations of ZAG , ATGL , free fatty acids ( FFA s), albumin, transferrin, total iron‐binding capacity ( TIBC ), hs‐ CRP , lipid profile and glucose metabolism were assessed. Results Adipose triglyceride lipase concentration was significantly higher in MW than NMW group (10·89 ± 5·7 vs. 8·02 ± 3·37 mIU / mL ; P  = 0·008). The ZAG and FFA s were not significantly different between two groups. ATGL was directly correlated with FFA s in all of the patients ( r  = 0·284, P  = 0·007) and MW ( r  = 0·32, P  = 0·021), and marginally in NMW ( r  = 0·31, P  = 0·057) groups. ATGL and odds of having mild or moderate wasting were significantly correlated (OR = 1·21, P  = 0·033). A positive association was observed between ATGL with TG ( r  = 0·31, P  = 0·049) and also with transferrin and TIBC ( r  = 0·44, P  = 0·001) only in MW group. An inverse relationship was observed between ATGL and HDL in all of the participants ( r =−0·222, P  = 0·04). No significant correlation was observed between ZAG and other parameters. Conclusions The serum concentrations of ATGL , but not ZAG , were significantly higher in MW compared to NMW group. Each unit increase in ATGL concentrations was correlated with 21% increase in the odds of wasting severity. ATGL might play a role in wasting pathogenesis and metabolic profile in haemodialysis.