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The relationship between serum adipokines and glucose homeostasis in normal-weight and obese patients on hemodialysis: a preliminary study

  • Nephrology - Original Paper
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Abstract

Purpose

Insulin resistance (IR) is a prevalent disorder in advanced renal failure irrespective of diabetes. Adipokines might play a role in IR, which has not been well-documented in uremic conditions. This study investigated the relationship of Zinc-α2-glycoprotein (ZAG), adipose triglyceride lipase (ATGL), and adipolin with glucose–insulin homeostasis in normal weight (NW) and obese (OB) patients with hemodialysis.

Methods

In this cross-sectional study, 59 patients (29 NW; 18.5 ≤ BMI < 25 kg/m2, and 30 OB; BMI ≥ 30 kg/m2) were studied. Anthropometries, circulating ZAG, adipolin, ATGL, free fatty acids (FFAs), fasting blood glucose (FBG), insulin, and homeostasis model assessment of IR (HOMA)-IR were assessed.

Results

There were no significant differences in age, gender, hemodialysis duration, dialysis adequacy and diabetes between the two groups. ZAG (100.9 ± 37.1 vs. 107.5 ± 30.5 ng/mL, P = 0.03) and adipolin (12.4 ± 1.6 vs. 13.2 ± 2.8 ng/mL, P = 0.002) concentrations were significantly lower, and FFAs (228.1 ± 112.6 vs. 185 ± 119 ng/mL, P = 0.014) were significantly higher in the OB than NW group. No significant differences were observed in ATGL, FBG, insulin and HOMA-IR between the two groups. Patients with lower IR had higher ZAG (112.9 ± 31.7 vs. 94.9 ± 34.5 ng/mL; P = 0.046), lower FFAs (167.8 ± 98.4 vs. 249.9 ± 120.8 ng/mL; P = 0.004), and marginally lower ATGL (9.1 ± 5.2 vs. 12.3 ± 9.6 mIU/mL; P = 0.079) concentrations than those with higher IR. ZAG was negatively (r =  − 0.323, P = 0.018 and r =  − 0.266, P = 0.054) and FFAs were positively (r = 0.321, P = 0.019 and r = 0.353, P = 0.009) correlated with insulin and HOMA-IR, respectively. ATGL was directly correlated with FFAs (r = 0.314, P = 0.018).

Conclusions

Novel adipokines, ZAG and ATGL, might contribute to glucose–insulin homeostasis in hemodialysis. Understanding potential causative, diagnostic or therapeutic roles of adipokines in IR require further studies.

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Acknowledgements

This research has been supported by Tehran University of Medical Sciences and Health Services Grant 37227.

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Authors and Affiliations

  1. Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran

    Elham Alipoor & Mohammad Javad Hosseinzadeh-Attar

  2. Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    Elham Alipoor & Parvaneh Mehrdadi

  3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mehdi Yaseri

  4. Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Mitra Mahdavi-Mazdeh

  5. Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia

    Tim Murphy

  6. Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No#44, Hojjatdoust St., Naderi St., Keshavarz Blvd., Tehran, Iran

    Mohammad Javad Hosseinzadeh-Attar

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  1. Elham Alipoor
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Correspondence to Mohammad Javad Hosseinzadeh-Attar.

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The ethics committee of the Tehran University of Medical Sciences approved this study and all patients completed a written informed consent. The study has been performed in accordance with the ethical standards of 1964 Declaration of Helsinki.

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Alipoor, E., Yaseri, M., Mehrdadi, P. et al. The relationship between serum adipokines and glucose homeostasis in normal-weight and obese patients on hemodialysis: a preliminary study. Int Urol Nephrol 52, 2179–2187 (2020). https://doi.org/10.1007/s11255-020-02582-z

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