Introduction: Chronic kidney disease (CKD) is associated with significantly increased risk of cardiovascular morbidity and mortality. In the general population, adiponectin, a hormone produced by adipocytes with effects on insulin sensitivity, is associated with improved cardiovascular health. In chronic kidney disease, however, adiponectin levels are higher than in the general population despite increased cardiovascular risk. The current analysis determines adiponectin levels in association with left ventricular mass index (LVMI), an earlier indicator of cardiovascular risk.
Methods: A cross-sectional analysis was undertaken using blood samples and clinical data from the Chronic Kidney Disease in Kids cohort. Adiponectin was measured using ELISA. Associations between adiponectin, additional cofactors, and LVMI were tested by univariate analysis. Factors with p<0.2 were entered into multivariable models using multiple methods.
Results: Contrary to the general population, increased adiponectin was associated with increased LVMI, but this relationship was not significant until race was taken into effect. In non-African-American subjects, there was a positive relationship after adjusting for age, systolic blood pressure, and body mass index. In African-Americans, there was a non-significant negative relationship.
Conclusions: In pediatric CKD, adiponectin may be differentially associated with increasing LVMI according to race. This relationship was significant after adjusting for common predictors of LVMI.