Association of the circulating adiponectin concentration with coronary in-stent restenosis in haemodialysis patients

Background. Success of coronary stenting is limited by in-stent restenosis. We aimed to determine whether circulating levels of the cytokines, which have antiinflammatory properties such as adiponectin or interleukin-10, could be associated with the occurrence of coronary in-stent restenosis in patients with end-stage renal disease ( ESRD). Methods. We enrolled 71 consecutive ESRD patients undergoing haemodialysis ( mean age: 64.9 +/- 8.9 years; 19 women, 52 men; mean haemodialysis duration: 78.2 +/- 87.5 months), who received stenting for a single coronary lesion. Plasma concentrations of adiponectin and IL-10 were measured within one week before coronary stenting. Results. Of the 71 patients who had received stenting, in-stent restenosis occurred in 37 patients (52.1%) within 6 months after stenting. In univariate logistic analysis, the homeostasis model assessment index of insulin resistance, blood haemoglobin, serum concentrations of high density lipoprotein - cholesterol or triglycerides and plasma concentrations of insulin or adiponectin were significantly associated with coronary in-stent restenosis. In a multiple logistic regression analysis among these variables, however, only the plasma adiponectin concentration was associated with the coronary in-stent restenosis: the odds ratio of the increase in 1 mu g/ml of plasma adiponectin concentration for having restenosis was 0.651 (P = 0.001, 95% confidence interval: 0.506 - 0.839). Patients with restenosis had lower plasma adiponectin concentrations than those without [ 6.2 +/- 2.2 mg/ml (2.1 - 10.4 mg/ml; n 37) vs 27.2 +/- 10.8 mg/ml (17.9 - 79.8 mg/ml; n 34); P 0.0001]. Conclusions. Circulating adiponectin concentrations may be associated with the occurrence of coronary in-stent restenosis in ESRD patients undergoing maintenance haemodialysis.