Plasma adiponectin is associated with ankle-brachial index in patients on haemodialysis

Background: Peripheral arterial disease (PAD) is a leading cause of morbidity in haemodialysis (HD) patients. Recent evidence suggests that adiponectin, an adipose-derived cytokine, may play a role in atherosclerosis. However, the association between plasma levels of the adiponectin and the ankle-brachial index (ABI), an indicator of the presence and severity of PAD, has not been thoroughly studied in HD patients. Methods: The present cross-sectional study attempted to examine the relationship between plasma adiponectin and PAD in a cohort of 136 chronic HD patients. The ABI was used as an estimate of the presence of PAD. Plasma adiponectin, high-sensitivity C-reactive protein (hsCRP), tumour necrosis factor-alpha and lipid profiles were measured. Logistic regression was used to estimate the association between presence of PAD and adiponectin as well as other potential risk factors. Results: Plasma levels of adiponectin were significantly lower among patients with evidence of PAD than among those without (8.51 +/- 5.75 vs 17.15 +/- 11.53; P < 0.001). Univariate analysis showed a positive correlation between ABI values and plasma adiponectin levels (r = 0.369, P < 0.001), high-density lipoprotein cholesterol levels, diastolic blood pressure, Kt/V and serum phosphate. On the other hand, negative correlations between ABI and log-transformed triglyceride, hsCRP, fasting blood sugar, girth circumference and white blood cell counts were noted. Using logistic regression, plasma adiponectin was found to be associated with PAD independently of classical risk factors for atherosclerosis. In addition, models that incorporated plasma adiponectin were significantly better at predicting PAD than models limited to classical confounding factors. Conclusion: We conclude that there was a significant inverse correlation between plasma adiponectin levels and the presence of PAD in dialysis patients. This suggests that plasma adiponectin level may have a role in the atherosclerotic process of PAD.