{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:47:06Z","timestamp":1786978026191,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association between the adiponectin\u2010to\u2010leptin ratio (A\/L ratio) and the risk of incident chronic kidney disease (CKD) is poorly understood. This study aimed to investigate the association between A\/L ratio and the risk of incident CKD and to examine whether such a relationship varied according to sex and body composition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective community\u2010based cohort, participants with normal kidney function were analysed (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a05192). The association between the A\/L ratio at baseline and the risk of incident CKD, defined as two or more occasions with an estimated glomerular filtration rate of &lt;60\u00a0mL\/min\/m\n                      <jats:sup>2<\/jats:sup>\n                      or proteinuria of \u22651+ on a dipstick test during the follow\u2010up period, was evaluated using multivariable Cox proportional hazards analyses. Subgroup analyses were conducted based on sex, body mass index (BMI) and the presence of sarcopenia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The participants' mean age was 57.2\u00a0\u00b1\u00a08.3\u00a0years, and 53.2% were women. The A\/L ratio was higher in men compared with women (1.5 [0.8\u20133.2] and 0.5 [0.3\u20130.9] \u03bcg\/ng,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). During a median follow\u2010up of 9.8 [9.5\u201310.0] years, 417 incident CKD events occurred (8.7 per 1000 person\u2010years). Men in the highest quartile of A\/L ratio had a lower risk of incident CKD (adjusted hazard ratio [aHR], 0.57; 95% confidence interval [CI], 0.33\u20130.99) than those in the lowest quartile. Additionally, a 1.0 increase in A\/L ratio was associated with a 12% decreased risk of incident CKD in men (aHR, 0.88; 95% CI, 0.80\u20130.97). However, no significant association was observed in women. In subgroup analysis stratified by BMI and the presence of sarcopenia, the association between a high A\/L ratio and a reduced risk of incident CKD was consistent in men with a BMI\u00a0&lt;\u00a023.0\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and those with sarcopenia. However, no significant association was observed between men with a BMI\u00a0\u2265\u00a023.0\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and those without sarcopenia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      A high A\/L ratio is an independent marker of a reduced risk of incident CKD in men, especially in those with a BMI\u00a0&lt;\u00a023.0\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and sarcopenia.\n                    <\/jats:p>\n                  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University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeseul","family":"Seong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Gangnam Severance Hospital, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Jeong","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Gangnam Severance Hospital, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoon Young","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Gangnam Severance Hospital, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumie","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Endocrine Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong Cheon","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Gangnam Severance Hospital, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1255-1323","authenticated-orcid":false,"given":"Jong Hyun","family":"Jhee","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Gangnam Severance Hospital, Yonsei University College of Medicine  Seoul Republic of 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