Can we exploit ADPN to diagnose and treat obesity- related nephropathy and diabetic nephropathy?
It was suggested that hypoadiponectinaemia might be taken as a biomarker of the renal risk associated with obesity and predisposition to or frank diabetes mellitus [27]. However, this possibility seems very unlikely. In reality, the relationship between ADPN and proteinuria is not so compelling as it appeared to be in the Sharma study. As a matter of fact, the ADPN–proteinuria link is direct rather than inverse in the vast majority of patients with progressive nephropathies [22,24] as well as in Pima Indians, a population at high risk for obesity and type 2 diabetes [28]. Undoubtedly, the most intriguing perspective alimented by Sharma’s observations is that of exploiting the potential of this protein as a reno-protective cytokine. Weight loss apart, ADPN synthesis and/or secretion can be stimulated by a variety of drugs [29]. ACE inhibitors, sartans (telmisartan in particular), oral hypoglycaemic agents like metformin and glimepiride, a beta blocker which functions also as a stimulant
