Distribution of Serum Adiponectin Isoforms in Pediatric Patients with Steroid-Sensitive Nephrotic Syndrome

Abstract

Background Serum adiponectin circulates in three multimeric isoforms: high-molecular-weight (HMW), middle-molecular-weight (MMW), and low-molecular-weight (LMW) isoforms. Potential change in the circulating adiponectin levels in patients with nephrotic syndrome (NS) remain unknown. Therefore, this study aimed to assess the levels of total adiponectin and the distribution of its isoforms in pediatric patients with NS.Methods We measured total adiponectin and each adiponectin isoform levels at the onset of NS, initial remission, and during the remission period of the disease in 31 patient with NS. We also calculated the ratios of HMW (%HMW), MMW (%MMW), and LMW (%LMW) to total adiponectin and all values in 31 with those of 51 control subjects.Results The mean total serum adiponectin levels in patients were 40.6 ± 16.0 µg/mL, 41.1 ± 18.5 µg/mL, and 25.5 ± 16.6 µg/mL at the onset of NS, at initial remission, and during the remission period of NS, respectively. These values were significantly higher than those in control subjects (12.6 ± 8.5 µg/mL). The mean values of %HMW, %MMW, and %LMW values were 57.0/28.0/14.2 at the onset of NS, 61.6/23.8/14.0 at the initial remission, and 58.1/21.7/17.7 at during the remission period, respectively. Compared with control subjects, %HMW at initial remission and %MMW at the onset of NS were high, and the %LMW values at the onset of NS and at initial remission were low.Conclusions In patients with NS, total serum adiponectin levels increase at the onset of the disease, and the ratio of adiponectin isoforms changes during the course of the disease. Further studies are needed to delineate the mechanisms between proteinuria and adiponectin isoforms.