Association Between Serum Adropin Levels and Carotid Intima–Media Thickness in Patients with Hemodialysis: A Cross-Sectional Study

Abstract

Purpose: Cardiovascular disease (CVD) is highly prevalent among patients with chronic kidney disease (CKD undergoing maintenance hemodialysis. Adropin is a peptide hormone implicated in cardiometabolic regulation and endothelial function; however, its association with subclinical atherosclerosis in hemodialysis populations remains unclear. This study primarily aimed to evaluate the association between serum adropin levels and carotid intima–media thickness (CIMT) in patients undergoing maintenance hemodialysis. Material and Methods: This single-center, cross-sectional observational study included 118 adult patients receiving maintenance hemodialysis, of whom 107 were included in the final analysis. Clinical characteristics, biochemical parameters, Malnutrition–Inflammation Score (MIS), and CIMT measurements were collected. Serum adropin levels were measured using an enzyme-linked immunosorbent assay (ELISA). Extreme adropin values were identified using the interquartile range (IQR) method and excluded in sensitivity analyses. Associations between adropin levels, CIMT, and clinical variables were evaluated using unadjusted analyses, and receiver operating characteristic (ROC) analysis was performed to assess the discriminative ability of CIMT for prevalent CVD. Results: Among the 107 patients analyzed, 64 (59.8%) had established CVD. CIMT values were significantly higher in patients with CVD compared with those without CVD (1.06 ± 0.23 mm vs. 0.97 ± 0.34 mm; p = 0.007). CIMT demonstrated modest discriminative ability for prevalent CVD, with an area under the curve (AUC) of 0.653 and an optimal cut-off value of 0.94 mm. Serum adropin levels showed substantial interindividual variability and were not significantly associated with CIMT, the presence of CVD, or MIS in unadjusted analyses. Findings were qualitatively similar in sensitivity analyses including and excluding extreme adropin values. Conclusion: In patients undergoing maintenance hemodialysis, higher CIMT values were associated with the presence of CVD, supporting its role as a marker of vascular burden in this high-risk population. In contrast, no statistically significant association was observed between serum adropin levels and CIMT or prevalent CVD in this cross-sectional analysis. Given the study design and limited sample size, these findings should be interpreted cautiously, and larger, hypothesis-driven studies are warranted to further clarify the potential role of adropin in hemodialysis populations.

Keywords

• Adropin
• carotid intima–media thickness
• cardiovascular disease
• hemodialysis
• chronic kidney disease

Supporting Institution

None

Ethical Statement

The study was approved by the Non-Interventional Clinical Research Ethics Committee of Samsun University (approval number: GOKAEK 2025/21/32). Written informed consent was obtained from all participants in accordance with the principles of the Declaration of Helsinki.

Thanks

None

Hemodiyaliz Tedavisi Alan Hastalarda Serum Adropin Düzeyleri ile Karotis İntima–Medya Kalınlığı Arasındaki İlişki: Kesitsel Bir Çalışma

Abstract

Amaç: Kardiyovasküler hastalık (KVH), idame hemodiyaliz tedavisi alan kronik böbrek hastalığı (KBH) olan hastalarda oldukça yaygındır. Adropin, kardiyometabolik düzenleme ve endotelyal fonksiyonla ilişkili bir peptid hormondur; ancak hemodiyaliz popülasyonunda subklinik ateroskleroz ile ilişkisi net olarak ortaya konmamıştır. Bu çalışmanın birincil amacı, idame hemodiyaliz tedavisi alan hastalarda serum adropin düzeyleri ile karotis intima–medya kalınlığı (KİMK) arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntemler: Bu tek merkezli, kesitsel ve gözlemsel çalışmaya idame hemodiyaliz tedavisi alan 118 erişkin hasta dâhil edildi; bunların 107’si nihai analize alındı. Hastaların klinik özellikleri, biyokimyasal parametreleri, Malnütrisyon–İnflamasyon Skoru (MİS) ve KİMK ölçümleri kaydedildi. Serum adropin düzeyleri, enzim bağlı immünosorbent analiz (ELISA) yöntemi kullanılarak ölçüldü. Aşırı adropin değerleri, interkuartil aralık (IQR) yöntemiyle belirlendi ve duyarlılık analizlerinde dışlandı. Adropin düzeyleri, KİMK ve klinik değişkenler arasındaki ilişkiler düzeltilmemiş analizlerle değerlendirildi; ayrıca KİMK’nin mevcut KVH’yi ayırt etme performansını değerlendirmek amacıyla alıcı işletim karakteristiği (ROC) analizi yapıldı. Bulgular: Analize alınan 107 hastanın 64’ünde (%59,8) mevcut KVH saptandı. KVH’si olan hastalarda KİMK değerleri, KVH’si olmayanlara kıyasla anlamlı olarak daha yüksekti (1,06 ± 0,23 mm’ye karşı 0,97 ± 0,34 mm; p = 0,007). KİMK, mevcut KVH’yi ayırt etmede sınırlı bir ayırt edici performans gösterdi (eğri altındaki alan [AUC] = 0,653) ve optimal kesim değeri 0,94 mm olarak belirlendi. Serum adropin düzeyleri belirgin bireyler arası değişkenlik gösterdi ve düzeltilmemiş analizlerde KİMK, KVH varlığı veya MİS ile anlamlı bir ilişki saptanmadı. Aşırı adropin değerlerinin dâhil edildiği ve dışlandığı duyarlılık analizlerinde bulgular niteliksel olarak benzerdi. Sonuç: İdame hemodiyaliz tedavisi alan hastalarda daha yüksek KİMK değerleri, KVH varlığı ile ilişkili olup, bu bulgu KİMK’nin bu yüksek riskli popülasyonda vasküler yükün bir göstergesi olabileceğini desteklemektedir. Buna karşılık, bu kesitsel analizde serum adropin düzeyleri ile KİMK veya mevcut KVH arasında istatistiksel olarak anlamlı bir ilişki saptanmamıştır. Çalışma tasarımı ve sınırlı örneklem büyüklüğü göz önünde bulundurulduğunda, bu bulgular temkinli şekilde yorumlanmalı ve hemodiyaliz popülasyonlarında adropinin olası rolünü daha iyi aydınlatmak için daha büyük, hipotez odaklı çalışmalara ihtiyaç vardır.

Keywords

• Adropin
• Karotis intima–media kalınlığı
• kardiovasküler hastalık
• hemodiyaliz
• kronik böbrek hastalığı

Supporting Institution

Yok

Ethical Statement

Çalışma, Samsun Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (onay numarası: GOKAEK 2025/21/32). Tüm katılımcılardan, Helsinki Bildirgesi ilkelerine uygun olarak yazılı bilgilendirilmiş onam alınmıştır.

Thanks

Yok

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