Pediatr Nephrol (2005) 20:474–477 DOI 10.1007/s00467-004-1770-z ORIGINAL ARTICLE Sevcan A. Bakkaloglu · Oguz Soylemezoglu · Necla Buyan · Tohru Funahashi · Atilla H. Elhan · Harun Peru · Kibriya Fidan · Sebahat Yılmaz · Enver Hasanoglu High serum adiponectin levels during steroid-responsive nephrotic syndrome relapse Received: 28 May 2004 / Revised: 11 November 2004 / Accepted: 11 November 2004 / Published online: 3 February 2005  IPNA 2005 Abstract Adiponectin (ADPN), exclusively expressed and secreted from adipocytes, is a recently discovered protein hormone with anti-atherogenic and anti-inflam- matory properties in contrast to other well-known adipocytokines. It has independent negative associations with obesity and hyperinsulinemia/insulin resistance. Apart from chronic renal failure, nephrotic syndrome was suggested as the only renal disease condition associated with raised plasma ADPN levels in adults. We aimed to evaluate the effect of nephrotic state on serum adipo- nectin (ADPN) levels in pediatric patients with steroid- responsive nephrotic syndrome (SRNS) by comparing the levels in relapse and remission as well as in control subjects and documenting possible relationships between ADPN and proteinuria as well as serum protein/lipid pa- rameters. 34 patients with SRNS and 22 healthy age, sex and BMI-matched control subjects were enrolled into the study. 15 of the 34 SRNS patients had active diseases, and these were known as the SRNS-relapse group (ten re- lapsed and five newly-diagnosed patients), while the re- maining 19 were in complete remission (the SRNS-re- mission group). Serum ADPN levels, blood chemistry (protein/albumin, triglyceride (TG), cholesterol (Cho) and lipoprotein levels) and 24-hour proteinuria were studied. ADPN levels were determined by ELISA. As expectedly, there were significant alterations in serum protein-lipid parameters and 24-hour proteinuria levels in SRNS pa- tients consistent with their disease activity. SRNS-relapse patients had substantially higher ADPN levels (36.77€15.06 (5.61–59.41, median 39.84) mg/ml), com- pared to those in SRNS-remission and control groups (14.17€6.02 (3.28–29.40, median 12.80) mg/ml and 11.84€7.53 (2.81–31.46, median 10.85) mg/ml, respec- tively, p=0.001). There were strong positive correlations between serum ADPN levels and Cho (r=0.637, p=0.000), TG (r=0.516, p=0.002), low density lipoprotein (r=0.614, p=0.000) levels and 24-hour proteinuria (r=0.828, p=0.000) levels, whereas protein (r=0.695, p=0.000) and albumin (r=0.732, p=0.000) levels were inversely corre- lated with ADPN levels. Regression analysis showed a significant correlation between ADPN and proteinuria (p=0.000). In conclusion, remarkably increased serum ADPN levels were detected in SRNS-relapse compared to those in SRNS-remission. This phenomenon might be the reflection of a compensatory response to nephrotic state characterized by massive proteinuria, hypoalbuminemia and hyperlipidemia. Keywords Steroid-responsive nephrotic syndrome · Adiponectin · Children · Hyperlipidemia Introduction Adiponectin (ADPN), a recently discovered protein hor- mone, is exclusively expressed and secreted from adipo- cytes [1]. Although the physiological role of ADPN has not been explicitly established, experimental data suggest that it may have anti-atherogenic [2, 3] and anti-inflam- matory [4] properties in contrast to other well-known adipocytokines like tumor necrosis factor-a, plasminogen activator inhibitor-1 and interleukin-6 [5, 6]. Plasma ADPN concentration is independently and negatively associated with obesity and hyperinsulinemia/insulin re- sistance in adults [7, 8, 9] as well as in children [10]. In addition, Zoccali et al. reported that plasma ADPN con- S. A. Bakkaloglu ( ) ) · O. Soylemezoglu · N. Buyan · H. Peru · K. Fidan · S. Yılmaz · E. Hasanoglu Department of Pediatric Nephrology, Gazi University, Besevler, 06540 Ankara, Turkey e-mail: sevcan@gazi.edu.tr Tel.: +90-312-2025233 Fax: +90-312-2129006 T. Funahashi Department of Internal Medicine & Molecular Science, Osaka University, Osaka, Japan A. H. Elhan Department of Biostatistics, Ankara University, Ankara, Turkey