๐ค Authors: Hye-Sun Park, Sang Ho Park, Yeseul Seong, Hyo Jeong Kim, Hoon Young Choi, Yumie Rhee, Hyeong Cheon Park, Jong Hyun Jhee
Adiponectin-to-leptin ratio and incident chronic kidney disease: Sex and body composition-dependent association.
The association between the adiponectin-to-leptin ratio (A/L ratio) and the risk of incident chronic kidney disease (CKD) is poorly understood. This study aimed to investigate the association between A/L ratio and the risk of incident CKD and to examine whether such a relationship varied according to sex and body composition.
In this prospective community-based cohort, participants with normal kidney function were analysed (Nย =ย 5192). The association between the A/L ratio at baseline and the risk of incident CKD, defined as two or more occasions with an estimated glomerular filtration rate of <60ย mL/min/m or proteinuria of โฅ1+ on a dipstick test during the follow-up period, was evaluated using multivariable Cox proportional hazards analyses.
Subgroup analyses were conducted based on sex, body mass index (BMI) and the presence of sarcopenia. The participants' mean age was 57.2ย ยฑย 8.3ย years, and 53.2% were women.
The A/L ratio was higher in men compared with women (1.5 [0.8-3.2] and 0.5 [0.3-0.9] ฮผg/ng, Pย <ย 0.001). During a median follow-up of 9.8 [9.5-10.0] years, 417 incident CKD events occurred (8.7 per 1000 person-years).
Men in the highest quartile of A/L ratio had a lower risk of incident CKD (adjusted hazard ratio [aHR], 0.57; 95% confidence interval [CI], 0.33-0.99) than those in the lowest quartile. Additionally, a 1.0 increase in A/L ratio was associated with a 12% decreased risk of incident CKD in men (aHR, 0.88; 95% CI, 0.80-0.97).
However, no significant association was observed in women. In subgroup analysis stratified by BMI and the presence of sarcopenia, the association between a high A/L ratio and a reduced risk of incident CKD was consistent in men with a BMIย <ย 23.0ย kg/m and those with sarcopenia.
However, no significant association was observed between men with a BMIย โฅย 23.0ย kg/m and those without sarcopenia. A high A/L ratio is an independent marker of a reduced risk of incident CKD in men, especially in those with a BMIย <ย 23.0ย kg/m and sarcopenia.
