International Medical Journal, Vol. 21., Iss. 2, 2015, P. 24−28.
ADIPOKINES OF ADIPOSE TISSUE AND THEIR ROLE IN PROGRESSION OF RENAL DISEASE
Kharkiv Medical Academy of Postgraduate Education, Ukraine
This review analyzes modern scientific data on the role of some factors produced by adipocytes in renal tissue damage. The most significant, active substances of adipose tissue include leptin, adiponectin, visfatin, TNF−alpha, IL−6, resistin. Leptin is synthesized by adipocytes in proportion to the mass of adipose tissue. In the kidney, leptin receptors are found in the cells of tubular epithelium. In obesity, leptin can induce production of type I collagen by mesangial cells and fibrogenesis in renal tissue, stimulate proliferation of endothelial cells and vascular smooth muscle cells, causing glomerular hypertrophy. Adipose tissue is the site of synthesis of another hormone, adiponectin. Serum adiponectin is increased in CKD. Visfatin is adipocytokine that is considered as a new pro−inflammatory cytokine. A hormone associated with energy metabolism, immunity, insulin action, it affects cellular energy metabolism. Resistin is another hormone of adipose tissue, the level of which increases with progression of renal disease and inversely correlated with glomerular filtration. Tumor necrosis factor−? (TNF−?) stimulates production of endothelin−1 in renal mesangial cells, indirectly involved in the regulation of vascular tone and proliferative activation and sclerotic processes in the kidney tissue. Another pro−inflammatory cytokine is IL−6. The concentration of IL−6 in the blood is usually considered as a reliable predictor of mortality in patients with end−stage renal failure. Thus the discussed in the review adipose tissue adipokines have both direct and indirect impact on renal function, renal damage progression processes and structures of vascular complications in CKD of different origin. The end result of the impact on this stage kidney disorders is development of glomerulosclerosis and tubulointerstitial fibrosis of the kidney tissue.
Key words: adipokines, obesity, chronic kidney diseases, leptin, visfatin, adiponectin, resistin, interlekin−6, tumor necrosis factor−α.