Relationship between atherogenic index of plasma, asprosin, and metrnl levels in hemodialysis patients

Relationship between atherogenic index of plasma, asprosin, and metrnl levels in hemodialysis patients H emodialysis (HD) patients are more vulnerable to the risk of cardiovascular and metabolic disorders, depending on the underlying disease causing chronic kidney disease and the adverse effects of HD.In HD patients, changes in the visceral and subcutaneous fat tissue, first in the form of adiposity and then in the form of lipodystrophy, may lead to insulin metabolism disorders, which in turn may lead to changes in adipokine synthesis and release [1].Fat cells try to control the risk of cardio-metabolic diseases by reregulating the synthesis of many different adipokines to prevent adiposity-related adverse effects.Meteorin-like protein (metrnl) and asprosin are two important adipokines involved in insulin resistance, hepatic glucose release, and inflammation regulation [2,3].Objectives: This study aimed to evaluate the relationship between the atherogenic index of plasma (AIP) and plasma asprosin and metrnl levels in hemodialysis (HD) patients.Methods: Forty-eight patients receiving HD treatment with a diagnosis of end-stage renal disease (ESRD) were included.The control group comprised 34 age-, sex-, and body mass index-matched healthy volunteers without a history of renal disease.ESRD patients were divided into two groups: high-risk (AIP≥0.24)and low-moderate risk (AIP<0.24).Asprosin and metrnl levels in the plasma of blood samples taken just before dialysis were studied by enzyme-linked immunosorbent assay.Results: A significant difference was found between the control group [23.3(19.9-27.7 ng/mL)], the low-moderate risk group [39.3(34.9-40.8ng/mL)], and the high-risk group [48.1(44.5-49.9ng/mL)] in terms of asprosin levels (for each p<0.001).Asprosin values of both low-moderate risk and high-risk groups were significantly higher than the controls.In the high-risk group, plasma asprosin levels were higher than in the low-moderate risk group (p=0.012).Metrnl levels of the high-risk group were found to be lower than both the control and low-risk groups (p<0.001 and p=0.003, respectively).AIP showed a positive relation to asprosin and a negative relation to metrnl.Conclusion: Logistic regression analysis has revealed important insights into the independent relationships between metrnl, asprosin, and high AIP values in HD patients.These findings support the anti-atherogenic potential of metrnl and suggest the potential atherogenic effects of asprosin, highlighting the complex interplay between adipokines and cardiovascular risk in this patient population.