Progression of atherosclerosis in hemodialysis patients: effect of adiponectin on carotid intima media thickness.

Aim: We investigated the parameters related to the progression of common carotid artery intima media thickness (IMT) in hemodialysis (HD) patients.

Methods: IMT was examined in 85 patients by ultrasonography at baseline and after 12 months. The difference in IMT between these two time points was calculated (DeltaIMT). We defined DeltaIMT< or =0.00 as 'progression', and DeltaIMT0.00 as 'stable'. Body fat distribution was calculated on computed tomography. Total adiponectin (T-Ad) and high molecular weight adiponectin (H-Ad) were measured by ELISA.

Results: There were no significant differences between the two groups in all profiles except for the ratio of H-Ad to T-Ad (HMWR) at baseline. In the 'progression' group, IMT increased from 1.56+/-0.89 to 1.77+/-0.94 mm (p<0.001) and visceral fat area (60.3+/-30.7 to 69.2+/-37.5, cm2; p<0.01) increased. In the 'stable' group, HMWR increased from 31.3+/-5.4 to 37.6+/-7.3% (p<0.001). Multiple logistic regression analysis selected DeltaHMWR (p=0.031, odds ratio=0.928) independently of IMT progression. The correlation coefficient was -0.254 (p=0.019) between DeltaIMT and DeltaHMWR.

Conclusions: We found that an increase in HMWR was related to the stable state of IMT in HD patients.