Vol.:(0123456789) 1 3
International Urology and Nephrology
https://doi.org/10.1007/s11255-020-02582-z
NEPHROLOGY - ORIGINAL PAPER
The relationship between serum adipokines and glucose homeostasis
in normal‑weight and obese patients on hemodialysis: a preliminary
study
Elham Alipoor
1,2
· Mehdi Yaseri
3
· Parvaneh Mehrdadi
2
· Mitra Mahdavi‑Mazdeh
4
· Tim Murphy
5
·
Mohammad Javad Hosseinzadeh‑Attar
1,6
Received: 28 March 2020 / Accepted: 25 July 2020
© Springer Nature B.V. 2020
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-α
2
-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/m
2
, and 30 OB; BMI ≥ 30 kg/m
2
) 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 signifcant diferences 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 signifcantly lower, and FFAs (228.1 ± 112.6 vs. 185 ± 119 ng/mL, P = 0.014) were signifcantly higher
in the OB than NW group. No signifcant diferences 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) concentra-
tions 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. Under-
standing potential causative, diagnostic or therapeutic roles of adipokines in IR require further studies.
Keywords Obesity · Insulin resistance · Hemodialysis · Adipokine
* Mohammad Javad Hosseinzadeh-Attar
hosseinzadeh.md.phd@gmail.com;
mhosseinzadeh@tums.ac.ir
1
Cardiac Primary Prevention Research Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical
Sciences, Tehran, Iran
2
Department of Nutrition, School of Public Health, Iran
University of Medical Sciences, Tehran, Iran
3
Department of Epidemiology and Biostatistics, School
of Public Health, Tehran University of Medical Sciences,
Tehran, Iran
4
Iranian Tissue Bank and Research Center, Tehran University
of Medical Sciences, Tehran, Iran
5
Centre of Research Excellence in Translating Nutritional
Science to Good Health, The University of Adelaide,
Adelaide, Australia
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