Association of Adiponectin with Renal Involvement in Sedentary Obese Individuals.

Author(s): Abdur Rahaman, Omar faroque, Kabir Hossain, Ferdous Jahan, Nourin sultana, Bedar Uddin, Muhammad Nazrul Islam

Background: The global prevalence of chronic kidney disease (CKD) among obese individuals is on the rise, accompanied by a growing economic burden associated with its treatment. Therefore, early detection of renal dysfunction is crucial to prevent CKD progression. Sedentary obesity is a significant risk factor for early renal impairment, often marked by microalbuminuria. Adiponectin, an anti-inflammatory adipokine, serves a protective role in mitigating metabolic and renal disorders. Adiponectin is typically reduced in obese individuals. The study was aimed to evaluate the association of serum adiponectin and renal involvement in sedentary obese individuals without diabetes, hypertension & hypothyroidism. Methods: This observational cross-sectional study was carried out in the Department of Nephrology at BSMMU, Dhaka. The study period ranged from February 2023 to August 2024. The study included 67 sedentary obese individuals, selected according to specific inclusion and exclusion criteria. A purposive sampling approach was employed, and data were gathered using a pre-tested questionnaire, which incorporated patient history and clinical examination. Serum adiponectin levels were measured using the DRG Adiponectin ELISA Kit, which operates on the sandwich principle. Renal involvement was evaluated by determining the urinary albuminto- creatinine ratio (uACR) and estimating the glomerular filtration rate (eGFR) using the MDRD equation. Correlation and ROC curve analyses were conducted to investigate the association between adiponectin levels and microalbuminuria. Results: The study included participants with an average age of 35.88 ± 8.34 years, predominantly male (55.2%), with a significant portion being students (34.3%). Most participants exhibited obesity, with a mean BMI of 34.84 ± 3.47 kg/m², and more than 95% had central obesity. Laboratory results indicated normal glycemic control, with a mean fasting blood sugar of 4.93 ± 0.31 mmol/L and HbA1c of 5.06 ± 0.27%. However, 86.6% of participants had low HDL levels, and a significant number had elevated triglycerides and LDL levels. At enrollment, 8 participants (11.9%) had elevated urinary ACR. After excluding cases of transient microalbuminuria, 7 participants (10.4%) were confirmed to have microalbuminuria, resulting in an overall renal involvement rate of 10.4%. Participants with microalbuminuria had significantly lower serum adiponectin levels (0.93 ± 0.35 μg/ml, p<0.001). A weak inverse correlation was found between BMI and serum adiponectin (r = -0.295, p = 0.013). Adiponectin was found to be a strong predictor of microalbuminuria with a cut-off value of ≤1.0 μg/ ml, exhibiting good sensitivity and specificity. Conclusion: Reduced adiponectin levels were significantly associated with microalbuminuria, underscoring its potential as a biomarker for early renal involvement in sedentary obese individuals

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