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Ofori EK, Adekena CN, Boima V, Asare‐Anane H, Yorke E, Nyarko ENY, Mohammed BN, Quansah E, Jayasinghe SU, Amanquah SD. Serum leptin levels in patients with chronic kidney disease and hypertensive heart disease: An observational cross-sectional study. Health Sci Rep 2023; 6:e1053. [PMID: 36698704 PMCID: PMC9851162 DOI: 10.1002/hsr2.1053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/19/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023] Open
Abstract
Background and Aim Adipocytes secrete a peptide hormone called leptin, which plays a crucial role in controlling appetite and energy expenditure. Alterations in leptin concentrations are associated with CKD-related cardiovascular problems such as hypertensive heart disease (HHD). Despite the link, data on the precise function of leptin in people with CKD and HHD is scant. Methods An observational cross-sectional study involving a total of 108 participants (72 CKD patients with HHD and 36 healthy controls). Their demographic and anthropometric information was collected using a standardized questionnaire. Certain clinical measures such as blood pressure and body mass index (BMI) were assessed. Fasting blood samples were analyzed for levels of plasma glucose (FPG), lipids, creatinine, and leptin. Data were analyzed with SPSS v23. Results Leptin, FPG, creatinine and triglyceride levels were all significantly higher in CKD patients with HHD compared to controls (p < 0.01 for all). Furthermore, advanced CKD status (being in stage 5), having a 6-year diagnosis of HHD, being female, having a higher BMI, and elevation in levels of HDL and FPG contributed significantly to the variance in serum leptin levels in the case group (β = 0.37, 0.22, 0.19, 0.18, 0.27, 0.28; p < 0.05 for all). In the control group, the female gender had the biggest unique effect on circulating leptin levels, followed by BMI and eGFR (β = 0.71, 0.34, -0.22; p < 0.01 for all). Conclusion Patients with CKD who also had HHD reported considerably higher circulating leptin levels. Significantly higher blood leptin levels were shown to be associated with CKD stage 5 in the case group. These results are consistent with the role of leptin in the metabolic complexity seen in CKD patients. There needs to be more research into treatments that aim to lower leptin levels in CKD patients with HHD.
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Affiliation(s)
- Emmanuel K. Ofori
- Department of Chemical PathologyUniversity of Ghana Medical SchoolAccraGhana
| | - Christian N. Adekena
- Department of Chemical PathologyUniversity of Ghana Medical SchoolAccraGhana,University of Ghana Medical CenterAccraGhana
| | - Vincent Boima
- Department of Medicine and TherapeuticsUniversity of Ghana Medical SchoolAccraGhana
| | - Henry Asare‐Anane
- Department of Chemical PathologyUniversity of Ghana Medical SchoolAccraGhana
| | - Ernest Yorke
- Department of Medicine and TherapeuticsUniversity of Ghana Medical SchoolAccraGhana
| | - Eric N. Y. Nyarko
- Department of Chemical PathologyUniversity of Ghana Medical SchoolAccraGhana
| | - Bismark N. Mohammed
- Department of Chemical PathologyUniversity of Ghana Medical SchoolAccraGhana
| | | | | | - Seth D. Amanquah
- Department of Chemical PathologyUniversity of Ghana Medical SchoolAccraGhana
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2
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Fumeron F, El Boustany R, Bastard JP, Fellahi S, Balkau B, Marre M, Venteclef N, Velho G, Roussel R. Plasma total adiponectin and changes in renal function in a cohort from the community: the prospective Data from an Epidemiological Study on the Insulin Resistance Syndrome study. Nephrol Dial Transplant 2021; 36:2058-2065. [PMID: 33141880 DOI: 10.1093/ndt/gfaa228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND High adiponectin levels are associated with diabetic nephropathy. Nevertheless, it is not known whether plasma adiponectin is associated with renal function decline in the general population. We evaluated whether adiponectin concentrations were associated with changes in renal function in a community cohort, the Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) study. METHODS Plasma adiponectin concentrations were measured in a random sample of 3284 people from the DESIR study, a 9-year prospective cohort from the general population. Data were analysed for three endpoints during follow-up: incidence of Stage 3 chronic kidney disease (CKD); the Kidney Disease: Improving Global Outcomes (KDIGO) criterion 'certain drop in eGFR' and rapid kidney function decline [estimated glomerular filtration rate (eGFR) slope steeper than -3 mL/min/1.73 m2/year]. RESULTS After exclusion of participants with an eGFR <60 mL/min/1.73 m2 at baseline and those with type 2 diabetes or impaired fasting glycaemia at any time during follow-up (remaining n = 2174), there was a 113% higher risk for a rapid decline in kidney function in participants with adiponectin above the third tertile (T3) versus below the first tertile (T1) (Ptrend = 0.004) and a 53% higher risk for kidney function decline as defined by the KDIGO criterion (Ptrend = 0.04). In a cross-sectional analysis, adiponectin was positively associated with urinary albumin:creatinine ratio at baseline (P = 0.009). CONCLUSIONS In a healthy cohort from the general population, higher levels of plasma adiponectin were associated with decreased renal function at baseline and at follow-up. This result is similar to what is observed in people with diabetic nephropathy, in contrast with animal models of nephropathy.
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Affiliation(s)
| | - Ray El Boustany
- Centre de Recherche des Cordeliers UMR-S 1138, Université de Paris, INSERM, Paris, France
| | - Jean-Philippe Bastard
- Biochemistry and Hormonology Department, AP-HP, Tenon Hospital, Paris, France.,Department of Biochemistry-Pharmacology-Molecular Biology-Medical Genetics, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Soraya Fellahi
- Biochemistry and Hormonology Department, AP-HP, Tenon Hospital, Paris, France
| | - Beverley Balkau
- Centre for Research in Epidemiology and Population Health (CESP), INSERM, UMR-S 1018, University Paris-Sud, University Versailles Saint-Quentin, Villejuif, France
| | - Michel Marre
- Centre de Recherche des Cordeliers UMR-S 1138, Université de Paris, INSERM, Paris, France
| | - Nicolas Venteclef
- Centre de Recherche des Cordeliers UMR-S 1138, Université de Paris, INSERM, Paris, France.,UMR-S 1138, Sorbonne Université, Paris, France
| | | | - Ronan Roussel
- Centre de Recherche des Cordeliers UMR-S 1138, Université de Paris, INSERM, Paris, France.,Department of Diabetology, Endocrinology, Nutrition, AP-HP, Bichat Hospital, Paris, France
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3
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Bai Y, Chen Z, Wen Z, Long X, Mo Z, Xu J. Adiponectin affects estimated glomerular filtration rate: A two-sample bidirectional Mendelian randomization study. Nephrology (Carlton) 2021; 26:227-233. [PMID: 33484075 DOI: 10.1111/nep.13836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/02/2020] [Accepted: 11/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The causal relationship between adiponectin (ADPN) and estimated glomerular filtration rate (eGFR) is unclear. This study adopts a two-sample bidirectional Mendelian randomization (MR) study to explore the causal relationship between ADPN and eGFR. METHODS Using eight single nucleotide polymorphisms (SNP) of ADPN and 26 SNP of eGFR as instrumental variables, the study performs a two-sample bidirectional MR study using MR inverse-variance weighted (IVW), MR-Egger and weighted median approach to evaluate the causal relationship between ADPN and eGFR. Using the genetic risk score (GRS) of ADPN and eGFR as instrumental variables, the study performs a second MR analysis to assess the association between ADPN and eGFR. RESULTS In ADPN to eGFR MR analysis, the IVW, weighted median and GRS analysis all showed that ADPN had a causal effect on eGFR after removing potential confounders of the ADPN-eGFR relation (IVW: β = .016, P = .002; weighted median: β = .012, P = .022; GRS: β = .016, P = 1.48E-05). As both ADPN and eGFR were natural log-transformed in the corresponding GWAS, eGFR increased by 0.15% for any 10% increase in ADPN. In eGFR to ADPN MR analysis, eGFR had no causal effect on ADPN after removing potential confounders of the eGFR-ADPN relation (All P values > 0.05). The heterogeneity test and sensitivity analysis indicated some heterogeneity, but no directional pleiotropy. CONCLUSION Adiponectin has a causal effect on eGFR, while eGFR has no causal effect on ADPN. ADPN may be a clinical target for improving eGFR and treating chronic kidney disease caused by decreased eGFR.
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Affiliation(s)
- Yulan Bai
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, China.,School of Public Health of Guangxi Medical University, Nanning, China
| | - Zefeng Chen
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, China.,School of Public Health of Guangxi Medical University, Nanning, China
| | - Zheng Wen
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, China.,School of Public Health of Guangxi Medical University, Nanning, China
| | - Xinyang Long
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, China.,School of Public Health of Guangxi Medical University, Nanning, China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, China.,Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jianfeng Xu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, China.,School of Public Health of Guangxi Medical University, Nanning, China.,Program for Personalized Cancer Care, NorthShore University Health System, Evanston, Illinois, USA
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4
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Zhao D, Zhu X, Jiang L, Huang X, Zhang Y, Wei X, Zhao X, Du Y. Advances in understanding the role of adiponectin in renal fibrosis. Nephrology (Carlton) 2020; 26:197-203. [PMID: 33073881 DOI: 10.1111/nep.13808] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/20/2020] [Accepted: 10/11/2020] [Indexed: 12/25/2022]
Abstract
Renal fibrosis is characterized by the proliferation of renal intrinsic cells, activation of renal interstitial fibroblasts and deposition of extracellular matrix (ECM), processes that lead to the progressive loss of renal function. Renal fibrosis is characterized by the proliferation of renal intrinsic cells, activation of renal interstitial fibroblasts, and septal fibrosis is recognized as a marker for the progression of chronic kidney disease, a condition that is associated with high morbidity and mortality and is a significant public health burden. Despite extensive studies, there are no effective treatments for renal fibrosis. Adiponectin (APN) is a protein mainly produced by adipocytes that has anti-inflammatory and anti-atherosclerotic effects, improves insulin resistance and provides other salutary effects. Recent studies found that APN can inhibit ECM deposition by inhibiting inflammation and oxidative stress, and by regulating the TGF-β, AMPK, MCP-1 and other signalling pathways. Many recent studies have examined the roles of these pathways in the pathogenesis of renal fibrosis. In this article, we review the pathogenic mechanism of APN in renal fibrosis and provide a theoretical basis for delaying and blocking renal fibrosis by alteration of APN activity.
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Affiliation(s)
- Dan Zhao
- The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xiaoyu Zhu
- The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Lili Jiang
- The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xiu Huang
- The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Yangyang Zhang
- The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xuejiao Wei
- The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xiaoxia Zhao
- The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Yujun Du
- The First Hospital of Jilin University, Jilin University, Changchun, China
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5
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Araújo LS, da Silva MV, da Silva CA, Borges MDF, Palhares HMDC, Rocha LP, Corrêa RRM, Rodrigues Júnior V, dos Reis MA, Machado JR. Analysis of serum inflammatory mediators in type 2 diabetic patients and their influence on renal function. PLoS One 2020; 15:e0229765. [PMID: 32130282 PMCID: PMC7055870 DOI: 10.1371/journal.pone.0229765] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/14/2020] [Indexed: 02/07/2023] Open
Abstract
Aim To evaluate the serum concentrations of inflammatory mediators in patients with type 2 diabetes mellitus (T2DM) with or without renal alteration (RA) function. Methods Serum samples from 76 patients with T2DM and 24 healthy individuals were selected. Patients with T2DM were divided into two groups according to eGFR (> or < 60mL/min/1.73m2). Cytokines, chemokines and adipokines levels were evaluated using the Multiplex immunoassay and ELISA. Results TNFR1 and leptin were higher in the T2DM group with RA than in the T2DM group without RA and control group. All patients with T2DM showed increased resistin, IL-8, and MIP-1α compared to the control group. Adiponectin were higher and IL-4 decreased in the T2DM group with RA compared to the control group. eGFR positively correlated with IL-4 and negatively with TNFR1, TNFR2, and leptin in patients with T2DM. In the T2DM group with RA, eGFR was negatively correlated with TNFR1 and resistin. TNFR1 was positively correlated with resistin and leptin, as well as resistin with IL-8 and leptin. Conclusion Increased levels of TNFR1, adipokines, chemokines and decrease of IL-4 play important role in the inflammatory process developed in T2DM and decreased renal function. We also suggest that TNFR1 is a strong predictor of renal dysfunction in patients with T2DM.
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Affiliation(s)
- Liliane Silvano Araújo
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Marcos Vinícius da Silva
- Department of Microbiology, Immunology and Parasitology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Crislaine Aparecida da Silva
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Maria de Fátima Borges
- Discipline of Endocrinology and Metabolism, Health Sciences Institute of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Heloísa Marcelina da Cunha Palhares
- Discipline of Endocrinology and Metabolism, Health Sciences Institute of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Laura Penna Rocha
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Rosana Rosa Miranda Corrêa
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Virmondes Rodrigues Júnior
- Department of Microbiology, Immunology and Parasitology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Marlene Antônia dos Reis
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Juliana Reis Machado
- Discipline of General Pathology, Institute of Biological and Natural Sciences of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
- * E-mail:
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6
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Calcitriol and FGF-23, but neither PTH nor sclerostin, are associated with calciuria in CKD. Int Urol Nephrol 2019; 51:1823-1829. [PMID: 31368056 DOI: 10.1007/s11255-019-02215-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/18/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE The recent observation that urinary calcium excretion (UCE) drops considerably with CKD and that this effect may occur beyond compensation for reduced intestinal calcium absorption suggests that CKD per se is a state of sustained positive calcium balance, a mechanism likely to contribute to vascular calcification and CVD in CKD. However, the determinants of UCE reduction in CKD are not well understood and there is a lack of clinical studies, particularly in the CKD population. Therefore, in this study, we aimed to evaluate variables associated with UCE in a CKD cohort. METHODS Baseline data on 356 participants of the Progredir Study, Sao Paulo, Brazil, essentially composed of CKD G3a-G4, were analyzed according to UCE (24 h urine collection). RESULTS Median 24 h UCE was 38 mg/day (IQR 21-68 mg/day) and 0.48 mg/kg/day (IQR 0.28-0.82 mg/kg/day). In univariate analysis, UCE was inversely related to age, phosphorus, 1-84 PTH, FGF-23 and sclerostin, and positively associated with eGFR, DBP, 1,25(OH)2-vitamin D, calcium, bicarbonate, total calorie intake and spironolactone use. After adjustments for age, sex and eGFR, only 1,25(OH)2-vitamin D, calcium, FGF-23, bicarbonate and total calorie intake remained associated with it, but not PTH nor sclerostin. Lastly, in a multivariable model, eGFR, serum 1,25(OH)2-vitamin D, calcium, and FGF-23 remained associated with UCE. Similar results were observed when calcium fractional excretion was used instead of UCE, with eGFR, 1-25-vitamin D and FGF-23 remaining as independent associations. CONCLUSION Our results showed that CKD is associated with very low levels of UCE and that 1,25(OH)2-vitamin D, serum calcium and FGF-23 were independently associated with UCE in this population, raising the question whether these factors are modulators of the tubular handling of calcium in CKD.
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7
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Kuo IC, Wu PH, Lin HYH, Niu SW, Huang JC, Hung CC, Chiu YW, Chen HC. The association of adiponectin with metabolic syndrome and clinical outcome in patients with non-diabetic chronic kidney disease. PLoS One 2019; 14:e0220158. [PMID: 31323071 PMCID: PMC6641197 DOI: 10.1371/journal.pone.0220158] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/09/2019] [Indexed: 02/07/2023] Open
Abstract
Adiponectin is the most abundant circulating adipokine, and it has insulin-sensitizing and anti-inflammatory properties. Although it has been speculated that kidney function decline associated with elevated adiponectin is attributable to decreased renal clearance and compensatory responses to adiponectin resistance, it is unclear how elevated adiponectin affects clinical outcomes in chronic kidney disease (CKD) patients and whether the effects are the same as those in the general population. Therefore, the aim of this study is to examine whether the association between serum adiponectin levels and clinical outcomes in non-diabetic CKD patients is independent of adiposity and metabolic syndrome. We enrolled 196 non-diabetic CKD patients with eGFR ranging between 10 and 60 mL/min/1.73 m2, these patients were divided into two groups based on the presence of metabolic syndrome. The primary endpoint was all-cause mortality or renal events (renal failure requiring renal replacement therapy [RRT] or 50% reduction in eGFR). During the mean follow-up period of 5 years, 48 (24.5%) incident cases of end-stage renal disease (ESRD) were observed, and 33 (16.8%) deaths occurred. The mean eGFR was 29.8 ± 12.8 mL/min/1.73m2. The baseline median adiponectin concentration in the cohort was 29.4(interquartile range, 13.3-108.7) μg/ml. Adiponectin levels were inversely related to body mass index (BMI) (r = -0.29; P < 0.001) and waist circumference (r = -0.35; P < 0.001). In the fully adjusted Cox regression model, the hazard ratios (HRs) were 2.08 (95% confidence interval [CI], 1.08-4.02; P = 0.03) for RRT and 1.66 (95% CI, 1.03-2.65; P = 0.04) for composite renal outcome. The risks remained consistent within different subgroups. However, no association was observed with mortality risk. In conclusion, higher adiponectin levels are associated with a higher risk of ESRD independent of conventional risk factors, BMI, and metabolic syndrome components.
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Affiliation(s)
- I-Ching Kuo
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ping-Hsun Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hugo You-Hsien Lin
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Wen Niu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Chi Huang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Chih Hung
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (CCH); (YWC)
| | - Yi-Wen Chiu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (CCH); (YWC)
| | - Hung-Chun Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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8
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Alnaggar ARLR, Sayed M, El-Deena KE, Gomaa M, Hamed Y. Evaluation of serum adiponectin levels in diabetic nephropathy. Diabetes Metab Syndr 2019; 13:128-131. [PMID: 30641684 DOI: 10.1016/j.dsx.2018.04.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/23/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Diabetic nephropathy is one of the major microvascular complications of diabetes mellitus. Adiponectin is an adipose tissue-derived cytokine that was identified in a human adipose tissue cDNA library. Serum adiponectin levels are found to be reduced in various pathological states including obesity, diabetes mellitus, ischaemic heart disease and arteriosclerosis obliterans and elevated in end stage renal diseases. OBJECTIVE to assess the level of plasma adiponectin as an early predictor of microvascular complications in patients with type 2 diabetes mellitus. METHODS 44 patients with type 2 diabetes recruited from outpatient diabetes clinic in Kasr Alainy hospital. All patients were subjected to full laboratory work-up including: Fasting blood glucose and Post prandial blood glucose, Glycated haemoglobin A1C, Serum creatinine, Serum total cholesterol, Triglycerides, Low density lipoprotein, High density lipoprotein, C-reactive protein titre, serum adiponectin and Urinary albumin/creatinine (UAC) ratio. RESULTS The present study demonstrated that serum adiponectin concentrations had significant positive correlation with UAC ratio (r = 0.534, p = 0.0001). Adiponectin levels showed significant positive correlation in patients with diabetes and hypertension with microalbumiuria (p = .001) or normoalbumiuria (p = 0.004). CONCLUSION Serum adiponectin level can be a good predictor of diabetic nephropathy in patients with type 2 diabetes mellitus.
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Affiliation(s)
| | - Mohamed Sayed
- Internal Medicine Department, Kasr Alainy Hospital, Cairo University, Egypt
| | | | - Mohamed Gomaa
- Internal Medicine Department, Kasr Alainy Hospital, Cairo University, Egypt
| | - Yousra Hamed
- New Kasr Alainy Hospital, Cairo University, Egypt
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9
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Nicolas A, Mohammedi K, Bastard JP, Fellahi S, Bellili-Muñoz N, Roussel R, Hadjadj S, Marre M, Velho G, Fumeron F. T-cadherin gene variants are associated with nephropathy in subjects with type 1 diabetes. Nephrol Dial Transplant 2018; 32:1987-1993. [PMID: 28499019 DOI: 10.1093/ndt/gfx071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/16/2017] [Indexed: 01/08/2023] Open
Abstract
Background High plasma adiponectin levels are associated with diabetic nephropathy (DN). T-cadherin gene (CDH13) variants have been shown to be associated with adiponectin levels. We investigated associations between allelic variations of CDH13 and DN in subjects with type 1 diabetes. Methods Two CDH13 polymorphisms were analysed in 1297 Caucasian subjects with type 1 diabetes from the 'Survival Genetic Nephropathy' (SURGENE) (n = 340, 10-year follow-up), 'Genesis France-Belgium' (GENESIS) (n = 501, 5-year follow-up for n = 462) and 'Génétique de la Néphropathie Diabétique' (GENEDIAB) (n = 456, 9-year follow-up for n = 283) cohorts. Adiponectin levels were measured in plasma samples from GENESIS and GENEDIAB cohorts. Results Pooled analysis of GENEDIAB and GENESIS studies showed that baseline plasma adiponectin levels were higher in subjects with established/advanced DN at inclusion (P < 0.0001) and in subjects who developed end-stage renal disease (ESRD) at follow-up (P < 0.0001). The minor allele of rs3865188 was associated with lower adiponectin levels (P = 0.006). rs11646213 [odds ratio (OR) 1.47; 95% confidence interval (CI) 1.18-1.85; P = 0.0009] and rs3865188 (OR 0.71; 95% CI 0.57-0.90; P = 0.004) were associated with baseline prevalence of established/advanced DN. These polymorphisms were also associated with the risk of ESRD (0.006 < P < 0.03). The association between rs11646213 (but not rs3865188) and renal function remained significant after adjustment for plasma adiponectin. In SURGENE, rs11646213 [hazard ratio (HR) 1.69; 95% CI 1.01-2.71; P = 0.04] and rs3865188 (HR 0.74; 95% CI 0.55-0.99; P = 0.04) were associated with risk of renal events (defined as progression to more severe DN stages). Conclusions Plasma adiponectin levels are associated with the prevalence of DN and the incidence of ESRD in patients with type 1 diabetes. CDH13 polymorphisms are also associated with the prevalence and incidence of DN, and with the incidence of ESRD in these patients. The association between CDH13 and DN may be due to pleiotropic effects, both dependent and independent of plasma adiponectin levels.
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Affiliation(s)
- Anthony Nicolas
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR-S 1138, Centre de Recherche des Cordeliers, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
| | - Kamel Mohammedi
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Department of Diabetology, Endocrinology and Nutrition, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Philippe Bastard
- Biochemistry and Hormonology Department, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Soraya Fellahi
- Biochemistry and Hormonology Department, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Ronan Roussel
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR-S 1138, Centre de Recherche des Cordeliers, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Department of Diabetology, Endocrinology and Nutrition, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Samy Hadjadj
- Université de Poitiers, UFR Médecine Pharmacie, CIC1402, Poitiers, France.,Department of Diabetology and Endocrinology, Pole DUNE & Centre d'investigation clinique, University Hospital, Poitiers, France.,INSERM, CIC1402, Poitiers, France
| | - Michel Marre
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Department of Diabetology, Endocrinology and Nutrition, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gilberto Velho
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France
| | - Frédéric Fumeron
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR-S 1138, Centre de Recherche des Cordeliers, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
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10
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Cernea S, Blendea C, Roiban AL, Benedek T. Cardio-renal Correlations and Epicardial Adipose Tissue in Patients with Type 2 Diabetes. JOURNAL OF INTERDISCIPLINARY MEDICINE 2018. [DOI: 10.1515/jim-2017-0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Aim: The aim of the study was to evaluate the correlation between renal function and heart function/echocardiographic parameters and epicardial adipose tissue thickness (EATT), respectively.
Material and methods: Fifty patients with type 2 diabetes (T2D) were included in this study. Several laboratory parameters were obtained (HbA1c, fasting blood glucose, LDL-cholesterol, creatinine) and eGFR was calculated. Anthropometric measurements were performed (weight, waist and hip circumferences, 4 skinfolds, based on which % body fat was calculated). Patients underwent echocardiographic assessment to evaluate structural and functional parameters, including EATT. Left ventricular mass (LVM) was calculated and the geometric changes of the left ventricle were evaluated.
Results: Forty-six per cent of the patients had a LV ejection fraction (EF) <55% and 34% had diastolic dysfunction. There were no significant differences between the three eGFR groups with regards to metabolic parameters, but LVEF was lower (53.0 ± 0.8%, 54.4 ± 2.4%, and 55.2 ± 1.5%, respectively) and EATT was higher (11.0 ± 1.0 mm, 8.58 ± 2.2 mm, and 7.63 ± 2.6 mm, respectively) with a lower eGFR (p = 0.04). More patients with eGFR <90 mL/min/1.73 m2 had cardiac hypertrophy compared with those with eGFR ≥90 mL/min/1.73 m2 (p = 0.04). EATT correlated positively with several anthropometric parameters, e.g. weight (r = 0.309, 95% CI: 0.022 to 0.549, p = 0.03), BMI (r = 0.398, 95% CI: 0.123 to 0.616, p = 0.004), and negatively with LVEF (r = −0.496, 95% CI: −0.687 to −0.242, p = 0.0003) and eGFR (r = −0.293, 95% CI: −0.531 to −0.013, p = 0.04). In patients with LVEF <55% vs. ≥55%, the EATT was significantly higher (9.5 ± 1.99 mm vs. 7.33 ± 2.37 mm, p = 0.013).
Conclusion: In patients with T2D decreased renal function was associated with lower LVEF and higher EATT. EATT was also higher in patients with reduced LVEF.
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Affiliation(s)
- Simona Cernea
- Department M3/Internal Medicine IV , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
- Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, County Emergency Clinical Hospital , Tîrgu Mureş , Romania
| | - Ciprian Blendea
- Clinic of Cardiology , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| | - Andrada Larisa Roiban
- Diabetes, Nutrition and Metabolic Diseases, County Emergency Clinical Hospital , Tîrgu Mureş , Romania
| | - Theodora Benedek
- Clinic of Cardiology , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
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11
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Joyce T, Chirino YI, Natalia MT, Jose PC. Renal damage in the metabolic syndrome (MetSx): Disorders implicated. Eur J Pharmacol 2018; 818:554-568. [DOI: 10.1016/j.ejphar.2017.11.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 02/08/2023]
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12
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Zha D, Wu X, Gao P. Adiponectin and Its Receptors in Diabetic Kidney Disease: Molecular Mechanisms and Clinical Potential. Endocrinology 2017; 158:2022-2034. [PMID: 28402446 DOI: 10.1210/en.2016-1765] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 04/04/2017] [Indexed: 12/14/2022]
Abstract
Diabetic kidney disease (DKD) is a major complication for diabetic patients. Adiponectin is an insulin sensitizer and anti-inflammatory adipokine and is mainly secreted by adipocytes. Two types of adiponectin receptors, AdipoR1 and AdipoR2, have been identified. In both type 1 and type 2 diabetes (T2D) patients with DKD, elevated adiponectin serum levels have been observed, and adiponectin serum level is a prognostic factor of end-stage renal disease. Renal insufficiency and tubular injury possibly play a contributory role in increases in serum and urinary adiponectin levels in diabetic nephropathy by either increasing biodegradation or elimination of adiponectin in the kidneys, or enhancing production of adiponectin in adipose tissue. Increases in adiponectin levels resulted in amelioration of albuminuria, glomerular hypertrophy, and reduction of inflammatory response in kidney tissue. The renoprotection of adiponectin is associated with improvement of the endothelial dysfunction, reduction of oxidative stress, and upregulation of endothelial nitric oxide synthase expression through activation of adenosine 5'-monophosphate-activated protein kinase by AdipoR1 and activation of peroxisome proliferator-activated receptor (PPAR)-α signaling pathway by AdipoR2. Several single nucleotide polymorphisms in the AdipoQ gene, including the promoter, are associated with increased risk of the development of T2D and DKD. Renin-angiotensin-aldosterone system blockers, adiponectin receptor agonists, and PPAR agonists (e.g., tesaglitazar, thiazolidinediones, fenofibrate), which increase plasma adiponectin levels and adiponectin receptors expression, may be potential therapeutic drugs for the treatment of DKD.
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Affiliation(s)
- Dongqing Zha
- Division of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Xiaoyan Wu
- Division of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Ping Gao
- Division of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
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13
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Chen JY, Jian DY, Lien CC, Lin YT, Ting CH, Chen LK, Hsu TC, Huang HM, Wu YT, Kuan TT, Chao YW, Wu LY, Huang SW, Juan CC. Adipocytes play an etiological role in the podocytopathy of high-fat diet-fed rats. J Endocrinol 2016; 231:109-120. [PMID: 27539963 DOI: 10.1530/joe-16-0064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 08/18/2016] [Indexed: 12/14/2022]
Abstract
Obesity is a risk factor that promotes progressive kidney disease. Studies have shown that an adipocytokine imbalance contributes to impaired renal function in humans and animals, but the underlying interplay between adipocytokines and renal injury remains to be elucidated. We aimed to investigate the mechanisms linking obesity to chronic kidney disease. We assessed renal function in high-fat (HF) diet-fed and normal diet-fed rats, and the effects of preadipocyte- and adipocyte-conditioned medium on cultured podocytes. HF diet-fed and normal diet-fed Sprague Dawley rats were used to analyze the changes in plasma BUN, creatinine, urine protein and renal histology. Additionally, podocytes were incubated with preadipocyte- or adipocyte-conditioned medium to investigate the effects on podocyte morphology and protein expression. In the HF diet group, 24 h urinary protein excretion (357.5 ± 64.2 mg/day vs 115.9 ± 12.4 mg/day, P < 0.05) and the urine protein/creatinine ratio were significantly higher (1.76 ± 0.22 vs 1.09 ± 0.15, P < 0.05), increased kidney weight (3.54 ± 0.04 g vs 3.38 ± 0.04 g, P < 0.05) and the glomerular volume and podocyte effacement increased by electron microscopy. Increased renal expression of desmin and decreased renal expression of CD2AP and nephrin were also seen in the HF diet group (P < 0.05). Furthermore, we found that adipocyte-conditioned medium-treated podocytes showed increased desmin expression and decreased CD2AP and nephrin expression compared with that in preadipocyte-conditioned medium-treated controls (P < 0.05). These findings show that adipocyte-derived factor(s) can modulate renal function. Adipocyte-derived factors play an important role in obesity-related podocytopathy.
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MESH Headings
- 3T3-L1 Cells
- Adipocytes, White/metabolism
- Adipocytes, White/pathology
- Adiposity
- Animals
- Biomarkers/blood
- Biomarkers/metabolism
- Biomarkers/urine
- Cell Line
- Culture Media, Conditioned
- Diet, High-Fat/adverse effects
- Disease Models, Animal
- Disease Progression
- Gene Expression Regulation
- Insulin Resistance
- Intra-Abdominal Fat/metabolism
- Intra-Abdominal Fat/pathology
- Kidney Cortex/metabolism
- Kidney Cortex/pathology
- Kidney Cortex/physiopathology
- Kidney Cortex/ultrastructure
- Male
- Mice
- Microscopy, Electron, Transmission
- Obesity/etiology
- Obesity/physiopathology
- Organ Size
- Podocytes/metabolism
- Podocytes/pathology
- Podocytes/ultrastructure
- Rats, Sprague-Dawley
- Renal Insufficiency, Chronic/diagnostic imaging
- Renal Insufficiency, Chronic/metabolism
- Renal Insufficiency, Chronic/pathology
- Renal Insufficiency, Chronic/physiopathology
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Affiliation(s)
- Jinn-Yang Chen
- Division of NephrologyDepartment of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of MedicineNational Yang-Ming University, Taipei, Taiwan
| | - Deng-Yuan Jian
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
- Division of NephrologyWen-Lin Hemodialysis Unit, Taipei, Taiwan
| | - Chih-Chan Lien
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
| | - Yu-Ting Lin
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
| | - Ching-Heng Ting
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
| | - Luen-Kui Chen
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
| | - Ting-Chia Hsu
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
| | - Hsuan-Min Huang
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
| | - Yu-Ting Wu
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
| | - Tse-Ting Kuan
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
| | - Yu-Wen Chao
- Department of Medical Research and EducationTaipei Veterans General Hospital, Taipei, Taiwan
- Section of NephrologyDepartment of Internal Medicine, Heping Branch, Taipei City Hospital, Taipei, Taiwan
| | - Liang-Yi Wu
- Department of Bioscience TechnologyCollege of Science, Chung Yuan Christian University, Chung Li District, Taoyuan City, Taiwan
| | - Seng-Wong Huang
- Faculty of MedicineNational Yang-Ming University, Taipei, Taiwan
| | - Chi-Chang Juan
- Institute of PhysiologyNational Yang-Ming University, Taipei, Taiwan
- Department of Medical Research and EducationTaipei Veterans General Hospital, Taipei, Taiwan
- Department of Education and ResearchTaipei City Hospital, Taipei, Taiwan
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14
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The combined effect of adiponectin and resistin on all-cause mortality in patients with type 2 diabetes: Evidence of synergism with abdominal adiposity. Atherosclerosis 2016; 250:23-9. [DOI: 10.1016/j.atherosclerosis.2016.04.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/22/2016] [Accepted: 04/26/2016] [Indexed: 02/06/2023]
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