Physical activity increases the resistin concentration in hemodialyzed patients without metabolic syndrome

Abstract

Background

Resistin (RES) concentration increases in end-stage renal disease patients. However, there have been no studies defining the role of physical activity in RES concentrations in hemodialyzed (HD) patients. This study was aimed to determine metabolic and inflammatory effects, including RES, of 4-week supervised rehabilitation program in HD patients, with or without metabolic syndrome (MS).

Methods

The study was completed by 28 patients aged 56.9±13.3 years $(\overline{x}\pm \text{SD})$ who were HD for 50.6±73.4 months, and 30 controls aged 61.5±8.3 years with normal renal function. Both the groups were divided into two subgroups with respect to MS. Individualized supervised rehabilitation program based on physiotherapy, including exercises, was provided to each subject for 4 weeks. Baseline and post-intervention complete blood count, glycated hemoglobin (HbA1c) and levels of serum RES, leptin, adiponectin, cystatin C, erythropoietin, high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6, transforming growth factor- β1, plasminogen activator inhibitor-1 homocysteine, insulin, albumin, parathyroid hormone (PTH), and phosphorus were measured.

Results

Compared to controls, HD patients showed higher baseline leucocytes count and higher serum concentrations of RES, leptin, cystatin C, hs-CRP, TNF-α, homocysteine, phosphorus, PTH while hemoglobin, glucose, and albumin concentrations. A positive correlation between serum albumin and RES concentrations was observed in HD patients. Post-intervention RES increase was observed in HD patients without MS (post-intervention 34.22±8.89 vs baseline 30.16±11.04 ng/mL; P=0.046) while no change was observed in patients with MS and in the control group.

Conclusion

MS modifies a RES response to the rehabilitation program in HD patients.

Keywords:

• metabolic syndrome
• hemodialysis
• resistin
• physical activity
• cytokines

Acknowledgments

We wish to acknowledge and thank all physiotherapists, physicians, nurses, and participants for their assistance and contribution to this study. This project was supported by National Science Center, Poland (Project NN 404273740) and by the Medical University of Silesia in Katowice grant to statutory work (contract KNW-1-121/N/7/Z).

Disclosure

The funding body played no role in the formulation of the design, methods, subject recruitment, data collection, analysis, or preparation of this paper. The results presented in this paper have not been published previously in whole or part. The authors report no conflicts of interest in this work.