SERUM IMMUNOREACTIVE LEPTIN CONCENTRATION AND ITS RELATION TO THE BODY-FAT CONTENT IN CHRONIC-RENAL-FAILURE

Citation
O. Heimburger et al., SERUM IMMUNOREACTIVE LEPTIN CONCENTRATION AND ITS RELATION TO THE BODY-FAT CONTENT IN CHRONIC-RENAL-FAILURE, Journal of the American Society of Nephrology, 8(9), 1997, pp. 1423-1430
Citations number
34
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology
ISSN journal
1046-6673
Volume
8
Issue
9
Year of publication
1997
Pages
1423 - 1430
Database
ISI
SICI code
1046-6673(1997)8:9<1423:SILCAI>2.0.ZU;2-W
Abstract
Leptin, secreted from fat cells, functions as a lipostat mechanism thr ough modulation of satiety signals. The role of leptin in humans has b een only partly revealed. However, obese patients have markedly elevat ed levels of this hormone, and in both normal-weight and obese subject s there is a direct correlation between serum leptin levels and the pe rcentage of body fat. The aim of the present study was to investigate the role of leptin and its relation to body fat content in chronic ren al failure (CRF), a disorder associated with decreased appetite. Serum leptin levels and body composition (dual-energy x-ray absorptiometry) were measured in a cohort of 59 patients with terminal CRF (creatinin e clearance rate, 8 +/- 1 ml/min). Sixteen of the patients were re-eva luated after 12 mo of peritoneal dialysis treatment, and eight patient s were re-evaluated after 12 mo of hemodialysis treatment. The mean se rum leptin concentrations were markedly higher (mean +/- SEM) in patie nts with CRF than in healthy control subjects matched for gender and b ody mass index (25.7 +/- 5.2 ng/ml versus 8.4 +/- 0.9 ng/ml; P < 0.001 ). Patients with ongoing signs of inflammation (C-reactive protein > 1 0 mg/L) demonstrated higher serum leptin levels (41.9 +/- 13.7 ng/ml v ersus 18.6 +/- 4.2 ng/ml; P < 0.05) than patients with normal C-reacti ve protein. A strong positive correlation (p = 0.83; P < 0.0001) was f ound between serum leptin concentrations and the percentage of body fa t. After 12 mo of peritoneal dialysis, the amount of body fat increase d markedly (19.0 +/- 1.5 to 25.1 +/- 2.2 kg; P < 0.001), and the chang es in serum leptin concentrations correlated significantly (p = 0.69; P < 0.01) to the changes in the body fat content. In contrast, no sign ificant changes in either body fat content or serum leptin levels were recorded in the eight patients that were re-evaluated after 12 mo of hemodialysis. Serum leptin concentrations are approximately three time s higher in patients with CRF compared with healthy control subjects w ith a similar body mass index. In this study, it is also demonstrated that serum leptin is a good marker for the body fat content in CRF pat ients and correlates strongly to changes in body fat during 12 mo of p eritoneal dialysis. These findings suggest that serum leptin could ser ve as a valuable clinical marker for the body fat content in patients with CRF. Further studies are needed to verify the hypothesis that inc reased serum leptin concentrations may contribute to uremic anorexia.