Resistin in early diabetic chronic kidney disease: exploring the link with nutritional status and cardiovascular outcome

Abstract

High resistin levels have been associated with malnutrition, inflammation, and cardiovascular risk in patients with chronic kidney disease (CKD). This study aimed to elucidate the relationship between serum resistin levels and the Patient-Generated Subjective Global Assessment (PG-SGA), a validated nutritional assessment tool in this population. It also investigates the role of resistin as a potential predictor of cardiovascular mortality in early-stage diabetic CKD. Prospective observational study that included 217 type 2 diabetic patients with mild to moderate CKD. Patients were divided into three groups according to PG-SGA: well-nourished (category A), moderately malnourished or suspected of being malnourished (category B), or severely malnourished (category C). The severely malnourished group had higher resistin levels, and resistin was positively correlated with IL-6, PG-SGA score, left ventricular mass index, and pulse pressure, while negatively correlating with vitamin D and estimated glomerular filtration rate (eGFR). We found that high resistin levels (HR = 1.350; 95% CI 1.187–1.535), PG-SGA greater than 10 (HR = 4.858; 95% CI 1.664–14.185), and higher HOMA-IR (HR = 1.099; 95% CI 1.007–4.001) were significant independent predictors of cardiovascular mortality. The study suggests that high resistin levels are associated with malnutrition in mild to moderate CKD and independently predict cardiovascular mortality in this population.