Comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients

Abstract Despite experimental evidence of beneficial metabolic, antiatherosclerotic and antiinflammatory effects of the 30 kDa adipokine, adiponectin, maintenance hemodialysis (MHD) patients with high adiponectin blood levels have paradoxically high mortality rates. We aimed to examine the direction...

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Autores principales:	Ilia Beberashvili, Tamar Cohen-Cesla, Amin Khatib, Ramzia Abu Hamad, Ada Azar, Kobi Stav, Shai Efrati
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7dff09d1b1f44266b640229fb4757fe7
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spelling	oai:doaj.org-article:7dff09d1b1f44266b640229fb4757fe72021-12-02T13:41:23ZComorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients10.1038/s41598-021-88558-02045-2322https://doaj.org/article/7dff09d1b1f44266b640229fb4757fe72021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88558-0https://doaj.org/toc/2045-2322Abstract Despite experimental evidence of beneficial metabolic, antiatherosclerotic and antiinflammatory effects of the 30 kDa adipokine, adiponectin, maintenance hemodialysis (MHD) patients with high adiponectin blood levels have paradoxically high mortality rates. We aimed to examine the direction of the associations between adiponectin and all-cause and cardiovascular mortality as well as with markers of oxidative stress, inflammation and nutrition in MHD patients with varying degrees of comorbidities. A cohort of 261 MHD patients (mean age 68.6 ± 13.6 years, 38.7% women), grouped according to baseline comorbidity index (CI) and serum adiponectin levels, were followed prospectively for six years. High and low concentrations were established according to median CI and adiponectin levels and cross-classified. Across the four CI-adiponectin categories, the group with low comorbidities and high adiponectin exhibited the best outcomes. Conversely, the high comorbidity group with high adiponectin levels had the lowest survival rate in both all-cause mortality (log rankχ2 = 23.74, p < 0.001) and cardiovascular mortality (log rankχ2 = 34.16, p < 0.001). Further data adjustment for case-mix covariates including fat mass index did not substantially affect these results. In conclusion, the direction of adiponectin’s prognostic associations in MHD patients is inverse in those with few comorbidities and direct in those with many comorbidities.Ilia BeberashviliTamar Cohen-CeslaAmin KhatibRamzia Abu HamadAda AzarKobi StavShai EfratiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ilia Beberashvili Tamar Cohen-Cesla Amin Khatib Ramzia Abu Hamad Ada Azar Kobi Stav Shai Efrati Comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients
description	Abstract Despite experimental evidence of beneficial metabolic, antiatherosclerotic and antiinflammatory effects of the 30 kDa adipokine, adiponectin, maintenance hemodialysis (MHD) patients with high adiponectin blood levels have paradoxically high mortality rates. We aimed to examine the direction of the associations between adiponectin and all-cause and cardiovascular mortality as well as with markers of oxidative stress, inflammation and nutrition in MHD patients with varying degrees of comorbidities. A cohort of 261 MHD patients (mean age 68.6 ± 13.6 years, 38.7% women), grouped according to baseline comorbidity index (CI) and serum adiponectin levels, were followed prospectively for six years. High and low concentrations were established according to median CI and adiponectin levels and cross-classified. Across the four CI-adiponectin categories, the group with low comorbidities and high adiponectin exhibited the best outcomes. Conversely, the high comorbidity group with high adiponectin levels had the lowest survival rate in both all-cause mortality (log rankχ2 = 23.74, p < 0.001) and cardiovascular mortality (log rankχ2 = 34.16, p < 0.001). Further data adjustment for case-mix covariates including fat mass index did not substantially affect these results. In conclusion, the direction of adiponectin’s prognostic associations in MHD patients is inverse in those with few comorbidities and direct in those with many comorbidities.
format	article
author	Ilia Beberashvili Tamar Cohen-Cesla Amin Khatib Ramzia Abu Hamad Ada Azar Kobi Stav Shai Efrati
author_facet	Ilia Beberashvili Tamar Cohen-Cesla Amin Khatib Ramzia Abu Hamad Ada Azar Kobi Stav Shai Efrati
author_sort	Ilia Beberashvili
title	Comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients
title_short	Comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients
title_full	Comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients
title_fullStr	Comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients
title_full_unstemmed	Comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients
title_sort	comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/7dff09d1b1f44266b640229fb4757fe7
work_keys_str_mv	AT iliabeberashvili comorbidityburdenmayexplainadiponectinsparadoxasamarkerofincreasedmortalityriskinhemodialysispatients AT tamarcohencesla comorbidityburdenmayexplainadiponectinsparadoxasamarkerofincreasedmortalityriskinhemodialysispatients AT aminkhatib comorbidityburdenmayexplainadiponectinsparadoxasamarkerofincreasedmortalityriskinhemodialysispatients AT ramziaabuhamad comorbidityburdenmayexplainadiponectinsparadoxasamarkerofincreasedmortalityriskinhemodialysispatients AT adaazar comorbidityburdenmayexplainadiponectinsparadoxasamarkerofincreasedmortalityriskinhemodialysispatients AT kobistav comorbidityburdenmayexplainadiponectinsparadoxasamarkerofincreasedmortalityriskinhemodialysispatients AT shaiefrati comorbidityburdenmayexplainadiponectinsparadoxasamarkerofincreasedmortalityriskinhemodialysispatients
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Comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients

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