Beberashvili I, et al. - Authors tested the premise that, in of the maintenance hemodialysis (MHD) population, obestatin is independent of inflammatory mediators and/or acyl-ghrelin in predicting outcomes. In MHD patients, serum obestatin behaved as a biomarker for cardiovascular and all-cause mortality. The prognostic ability of obestatin was independent of inflammation, nutritional status, acyl-ghrelin’s and adipokines’ activity. It was modified by age, being very prominent in patients older than 71 years.

Methods

• Researchers conducted a 6-year cohort study on 261 MHD patients.
• They studied the obestatin, acyl-ghrelin, adipokines (leptin and adiponectin), markers of inflammation and nutrition, prospective all-cause and cardiovascular mortality.

Results

• One hundred and sixty patients died in total, with 74 deaths due to cardiovascular causes, during follow up.
• The hazard for death from all causes was 0.90 (95% CI 0.81–0.99) and for cardiovascular death 0.85 (95% CI 0.73–0.99) for each ng/mL increase in baseline obestatin level in fully adjusted models (including malnutrition-inflammation score, interleukin-6 [IL-6], adipokines and acyl-ghrelin).
• The subgroup of patients aged above 71 years saw more robust associations; the hazard was 0.85 (95% CI 0.73–0.98) for all-cause death and 0.66 (95% CI 0.52–0.85) for cardiovascular death, which were more robust.
• For increased risk of all-cause mortality (synergy index [SI] 5.14, p=0.001) and cardiovascular mortality (SI 4.81,p=0.02), an interaction between high IL-6 (above median) and low obestatin (below median) levels appeared in the development of multivariable adjusted models.
• Experts noted that interactions were also observed between obestatin, tumor necrosis factor-alpha, adipokines and acyl-ghrelin, which were related to mortality risk.