Determinants of Plasma Adiponectin Levels in Nondiabetic Subjects With Moderate to Severe Chronic Kidney Disease

Objective: Our objective was to determine factors associated with adiponectin levels in subjects with stage III to IV chronic kidney disease (CKD). Design: We used a cross-sectional analysis. Setting: All kidney-disease subjects and controls were recruited at Vanderbilt University Medical Center (Nashville, TN) and Maine Medical Center (Portland, ME). Patients: We recruited 95 stage III to IV CKD subjects. Kidney-disease subjects with history of diabetes mellitus were excluded from the study. Interventions: There were no interventions. Results: Subjects with stage IV CKD had significantly higher adiponectin levels compared with those with stage III CKD (30.6 +/- 22.8 mu g/mL vs. 21.1 +/- 14.6 mu g/mL mean +/- SD, P = .05). Adiponectin was significantly correlated with gender (P - .01), high-density lipoproteins (P < .001), triglycerides (P - .004), and weight (P - .04) upon unadjusted analysis. Using multiple linear regression analysis, gender (P = .03), high-density lipoproteins (P = .001), triglycerides (P = .04), and high-sensitivity C-reactive protein (P = .004) were independently associated with adiponectin. Conclusions: Gender, high-density lipoproteins, triglycerides, and high-sensitivity C-reactive protein are major determinants of adiponectin levels in nondiabetic stage III to IV CKD. Insulin resistance, body mass index, and body fat percentage were not associated with adiponectin levels. Plasma adiponectin levels are difficult to interpret in the setting of CKD because of multiple confounders that may influence the relationship between adiponectin, adiposity, and insulin resistance. (C) 2009 by the National Kidney Foundation, Inc. All rights reserved.