Is adiponectin in children with immunoglobulin A vasculitis a suitable biomarker of nephritis in the course of the disease?
, 2, 3, 2, 2
Abstract
Introduction: Immunoglobulin A vasculitis (IgAV) is the most common form of vasculitis in children. Nephritis in the course of this disease (IgAVN) is observed in 30–50% of patients and might lead to chronic kidney disease (CKD) and end-stage renal disease (ESRD). Finding a non-invasive biomarker to distinguish initially between patients with and without nephritis and to facilitate a therapeutic decision to reduce the risk of long-term renal impairment is currently the target of much research. The aim of this study was to evaluate the adiponectin concentration in children with IgAV and estimate whether it might be used as a marker of IgAVN.
Material and methods: The study involved 29 IgAV children and 34 healthy controls. Eleven (38%) patients had renal involvement (IgAV-N) and 18 (62%) did not exhibit nephritis (IgAV-noN). The serum adiponectin level was estimated in children in an acute phase of IgAV and after 2–6 months during a follow-up visit. The relationship between the concentration of adiponectin and anthropometric measurements, epidemiological data and laboratory parameters were evaluated.
Results: The concentration of adiponectin in serum was significantly higher in children with acute phase of IgAV as compared to the control group (p < 0.001), and in patients without renal involvement in comparison with IgAV-N children (p < 0.049). In analysis of correlation we found a negative relationship between adiponectin level and serum creatinine concentration (r = –0.437, p = 0.02). The logistic regression evaluation demonstrated that a low adiponectin level increased the risk of nephritis in the course of IgAV.
Conclusions: Our study revealed that the serum adiponectin level increased markedly in patients with IgAV. We also documented that higher risk of nephritis in the course of the disease was associated with lower concentration of this hormone.
Keywords: IgA vasculitisnephritischildrenadiponectin
References
- Piram M, Mahr A. Epidemiology of immunoglobulin A vasculitis (Henoch-Schönlein): current state of knowledge. Curr Opin Rheumatol. 2013; 25(2): 171–178.
- Pohl M. Henoch-Schönlein purpura nephritis. Pediatr Nephrol. 2015; 30(2): 245–252.
- Inoue T, Sugiyama H, Kitagawa M, et al. Suppression of adiponectin by aberrantly glycosylated IgA1 in glomerular mesangial cells in vitro and in vivo. PLoS One. 2012; 7(3): e33965.
- Uchida HA, Nakamura Y, Kaihara M, et al. Steroid pulse therapy impaired endothelial function while increasing plasma high molecule adiponectin concentration in patients with IgA nephropathy. Nephrol Dial Transplant. 2006; 21(12): 3475–3480.
- Iwasa Y, Otsubo S, Ishizuka T, et al. Influence of serum high-molecular-weight and total adiponectin on arteriosclerosis in IgA nephropathy patients. Nephron Clin Pract. 2008; 108(3): c226–c232.
- Ozen S, Pistorio A, Iusan SM, et al. Paediatric Rheumatology International Trials Organisation (PRINTO). EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis. 2010; 69(5): 798–806.
- Robinson K, Prins J, Venkatesh B. Clinical review: adiponectin biology and its role in inflammation and critical illness. Crit Care. 2011; 15(2): 221.
- Goldstein BJ, Scalia RG, Ma XL. Protective vascular and myocardial effects of adiponectin. Nat Clin Pract Cardiovasc Med. 2009; 6(1): 27–35.
- Otero M, Lago R, Gomez R, et al. Changes in plasma levels of fat-derived hormones adiponectin, leptin, resistin and visfatin in patients with rheumatoid arthritis. Ann Rheum Dis. 2006; 65(9): 1198–1201.
- Panagopoulou P, Fotoulaki M, Manolitsas A, et al. Adiponectin and body composition in cystic fibrosis. J Cyst Fibros. 2008; 7(3): 244–251.
- Karmiris K, Koutroubakis IE, Xidakis C, et al. Circulating levels of leptin, adiponectin, resistin, and ghrelin in inflammatory bowel disease. Inflamm Bowel Dis. 2006; 12(2): 100–105.
- Diaz-Rizo V, Bonilla-Lara D, Gonzalez-Lopez L, et al. Serum levels of adiponectin and leptin as biomarkers of proteinuria in lupus nephritis. PLoS One. 2017; 12(9): e0184056.
- Machura E, Szczepańska M, Świętochowska E, et al. Evaluation of adipokines in children with cystic fibrosis. Endokrynol Pol. 2018; 69(2): 128–134.
- Olszanecka-Glinianowicz M, Handzlik-Orlik G, Orlik B, et al. Adipokines in the pathogenesis of idiopathic inflammatory bowel disease. Endokrynol Pol. 2013; 64(3): 226–231.
- Ouchi N, Ohishi M, Kihara S, et al. Association of hypoadiponectinemia with impaired vasoreactivity. Hypertension. 2003; 42(3): 231–234.
- Shimabukuro M, Higa N, Asahi T, et al. Hypoadiponectinemia is closely linked to endothelial dysfunction in man. J Clin Endocrinol Metab. 2003; 88(7): 3236–3240.
- Sharma K, Ramachandrarao S, Qiu G, et al. Adiponectin regulates albuminuria and podocyte function in mice. J Clin Invest. 2008; 118(5): 1645–1656.
- Ohashi K, Iwatani H, Kihara S, et al. Exacerbation of albuminuria and renal fibrosis in subtotal renal ablation model of adiponectin-knockout mice. Arterioscler Thromb Vasc Biol. 2007; 27(9): 1910–1917.
- Fang F, Liu GC, Kim C, et al. Adiponectin attenuates angiotensin II-induced oxidative stress in renal tubular cells through AMPK and cAMP-Epac signal transduction pathways. Am J Physiol Renal Physiol. 2013; 304(11): F1366–F1374.
- Sharma K. The link between obesity and albuminuria: adiponectin and podocyte dysfunction. Kidney Int. 2009; 76(2): 145–148.
- Chan H, Tang YL, Lv XH, et al. Risk Factors Associated with Renal Involvement in Childhood Henoch-Schönlein Purpura: A Meta-Analysis. PLoS One. 2016; 11(11): e0167346.
- Xu A, Chan KW, Hoo RLC, et al. Testosterone selectively reduces the high molecular weight form of adiponectin by inhibiting its secretion from adipocytes. J Biol Chem. 2005; 280(18): 18073–18080.
