Low serum concentration of obestatin as a predictor of mortality in maintenance hemodialysis patients.

BioMed research international

PubMedID: 24102059

Beberashvili I, Sinuani I, Azar A, Kadoshi H, Shapiro G, Feldman L, Sandbank J, Averbukh Z. Low serum concentration of obestatin as a predictor of mortality in maintenance hemodialysis patients. Biomed Res Int. 2013;2013796586.
Obestatin, a proposed anorexigenic gut hormone, has been shown to have a number of beneficial cardiotropic effects in experimental studies. We hypothesized that obestatin alteration in hemodialysis patients may link to clinical outcomes. This cross-sectional study with prospective followup for almost 4 years was performed on 94 prevalent hemodialysis patients. Obestatin, leptin, proinflammatory cytokines (tumor necrosis factor-a [TNF-a], interleukin-6, and various nutritional markers were measured. PATIENTS
with low obestatin levels, defined as a level less than median, had a worse all-cause mortality and cardiovascular mortality.The crude all-cause (HR 2. 23, 95% CI 1. 17 to 4. 24) and cardiovascular mortality hazard ratios (HR 4. 03, 95% CI 1. 27 to 12. 76) in these patients continued to be significant after adjustment for various confounders for all-cause mortality. Across the four obestatin-TNF-a categories, the group with low obestatin and high TNF-a (above median level) exhibited a worse outcome in both all-cause mortality and cardiovascular mortality.

CLINICAL
characteristics of patients in low obestatin high TNF-a group did not differ from other obestatin-TNF-a categorized groups.In summary, low serum obestatin concentration is an independent predictor of mortality in prevalent hemodialysis patients. Novel interactions were observed between obestatin and TNF-a, which were associated with mortality risk, especially those due to cardiovascular causes.