Low serum adiponectin level is associated with better physical health-related quality of life in chronic kidney disease

Abstract

Hyperadiponectemia is paradoxically associated with renal disease progression and mortality in chronic kidney disease (CKD). Its association with health-related quality of life (HR-QOL) is unknown. This study aimed to verify the association between adiponectin and HR-QOL in Korean pre-dialysis CKD cohort. This cross-sectional study analyzed 1551 pre-dialysis CKD patients from KNOW-CKD (KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease). Participants were categorized into three tertiles (T1-T3) according to adiponectin levels. HR-QOL was assessed using SF-36. High physical component summary (PCS) and mental component summary (MCS) were defined as highest quartile of each score. Multivariate logistic regression was used to analyze odds ratio (OR) and 95% confidence interval (CI) for high PCS and MCS. Prevalence of high PCS were 33.3%, 27.5%, and 17.0% and that of high MCS were 31.7%, 24.8%, and 21.3% for T1, T2, and T3 (both p for trend < 0.001). The adjusted OR [95% CI] of T1 and T2 in reference to T3 were 1.56 [1.09-2.23] and 1.19 [0.85-1.68] for high PCS and 1.19 [0.85-1.68] and 0.94 [0.68-1.29] for high MCS. Serum adiponectin level was inversely associated with physical HR-QOL in Korean pre-dialysis CKD patients. This relationship was independent of various cardiovascular risk factors.

Figure 1

Algorithm for study patient selection from the KNOW-CKD cohort. HR-QOL, health-related quality of life.

Figure 2

Scatter plot of the HR-QOL scores versus serum adiponectin (A; physical component summary, B; mental component summary).

Figure 3

Adjusted predictions of physical component summary and mental component summary according to serum adiponectin tertile. Adjusted for age, sex, body mass index, marriage, economy, education, systolic blood pressure, diabetes, dyslipidemia, cardiovascular disease, estimated glomerular filtration rate, urine protein to creatinine ratio, C-reactive protein, hemoglobin, albumin current smoking, alcohol, and physical activity.