Dysregulation of adipokines and inflammatory biomarkers in patients with metabolic syndrome and chronic kidney disease: A case-control study

Abstract

Objective: Metabolic syndrome (MS) frequently coexists with chronic kidney disease (CKD), yet the integrated role of adipokines and inflammatory markers in this dual condition remains poorly defined. This study aimed to compare circulating levels of key adipokines (adiponectin, leptin, resistin), the inflammatory cytokine TNF-α, and parathyroid hormone (PTH) between patients with MS-CKD and healthy controls, and to evaluate their diagnostic utility.

Methods: A case–control study enrolled 60 patients with confirmed MS-CKD and 60 age- and sex-matched healthy controls. Fasting blood samples were analysed for glycaemic indices (FBS, HbA1c, insulin, HOMA-IR), renal function (urea, creatinine, eGFR, albumin–creatinine ratio), lipid profile, liver enzymes, electrolytes, and minerals. Adiponectin, leptin, resistin, TNF-α, and PTH were measured using ELISA or chemiluminescence. Statistical comparisons used independent t‑tests and receiver operating characteristic (ROC) curve analysis.

Results: MS-CKD patients showed severe metabolic dysregulation (FBS 241.4±30.4 vs 92.7±7.8 mg/dL; HOMA-IR 3.54±0.68 vs 0.99±0.2; both p<0.001) and advanced renal impairment (eGFR 16.6±3.1 vs 108.7±12.1 mL/min/1.73 m²; urea 137.6±15.2 vs 23.2±3.0 mg/dL; both p<0.001). Adiponectin was lower (3.45±1.85 vs 5.12±2.15 mg/L), while leptin, resistin, TNF-α, and PTH were significantly higher in patients (all p<0.001). ROC analysis revealed excellent diagnostic performance for resistin (AUC=0.98) and TNF-α (AUC=0.95).

Conclusions: MS-CKD is characterised by profound adipokine imbalance and systemic inflammation. Resistin and TNF-α show strong potential as non‑invasive biomarkers for identifying MS‑CKD, supporting their clinical utility in risk stratification.