Elevated serum leptin levels are associated with good nutritional status in non-obese chronic hemodialysis patients

Kara, Ekrem; Ahbap, Elbis; Şahutoğlu, Tuncay; Şakacı, Tamer; Baştürk, Taner; Koç, Yener; Sevinc, Mustafa; Akgol, Cuneyt; Uçar, Zuhal Atan; Kayalar, Arzu Ozdemır; Bayraktar, Feyza; Ünsal, Abdülkadir

doi:10.5414/cn108409

Cited by 11 publications

(9 citation statements)

References 19 publications

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“…However, low serum leptin levels predicted mortality in HD patients 42 . Elevated serum leptin levels were associated with good nutritional status in non-obese chronic HD patients 43 . In the present study we found a significant negative correlation of serum Alb, a nutrition marker, with serum lnleptin/BMI in controls.…”

Section: Discussionmentioning

confidence: 96%

Association of Increased Serum Leptin with Ameliorated Anemia and Malnutrition in Stage 5 Chronic Kidney Disease Patients after Parathyroidectomy

Jiang

Zhang

Yuan

et al. 2016

Sci Rep

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Leptin is an adipokine that regulates various metabolism, but its association with secondary hyperparathyroidism (SHPT), a clinical manifestation of chronic kidney disease-mineral and bone disorder (CKD-MBD), remains obscure. Parathyroidectomy (PTX) is recommended for severe SHPT patients. Here, the associations between circulating leptin and clinical characteristics in CKD patients were investigated. Effects of PTX on leptin production were analyzed in vivo and in vitro. Controls and CKD patients had approximate serum leptin levels in that a larger proportion of CKD patients with body mass index (BMI) <23 kg/m2. Serum leptin was related to anemia, albumin, and bone metabolism disorders in CKD patients. Lower intact parathyroid hormone (PTH) was related with higher leptin in PTX patients group. Severe SHPT inhibited uremia-enhanced leptin production in 3T3-L1 adipocytes, which was attenuated after PTX. High levels of PTH were found to reduce Akt phosphorylation and leptin production in vitro but high levels of calcium and phosphorus were not. Successful PTX was found to improve anemia and malnutrition in severe SHPT patients, and this was correlated with increased circulating leptin levels via up-regulated Akt signaling in adipocytes. These findings indicated the therapeutic potential of leptin and related target pathway for improving survival and quality of life in CKD.

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Section: Discussionmentioning

confidence: 96%

Association of Increased Serum Leptin with Ameliorated Anemia and Malnutrition in Stage 5 Chronic Kidney Disease Patients after Parathyroidectomy

Jiang

Zhang

Yuan

et al. 2016

Sci Rep

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“…Dervisoglu et al reported a negative correlation between serum leptin level and MIS . Kara et al separated patients without obesity who were undergoing MHD into three groups according to serum leptin level and determined that patients with high serum leptin levels had higher albumin and prealbumin levels and greater total iron binding capacity but significantly lower MIS . The results of a study conducted by Koo et al revealed positive correlations between serum leptin level and normalized protein catabolic rate, subjective global assessment score, triceps skinfold thickness, subscapular skinfold thickness, and mid‐arm muscle circumference, respectively .…”

Section: Discussionmentioning

confidence: 99%

“…Some researchers have suggested that leptin potentially acts as a uremic toxin by contributing to the cachexia of uraemia . In contrast, other studies have reported a positive association between serum leptin levels and nutritional status in patients on maintenance hemodialysis (MHD) …”

Section: Introductionmentioning

confidence: 99%

Low serum leptin levels are associated with malnutrition status according to malnutrition‐inflammation score in patients undergoing chronic hemodialysis

Lin

Kuo

et al. 2019

Hemodialysis International

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Introduction: Leptin is an adipokine secreted from adipocytes that mediate lipid metabolism and inflammation. This cross-sectional study investigated the relationship between serum leptin level and nutrition status evaluated by malnutrition-inflammation score (MIS) among patients undergoing hemodialysis (HD). Methods:This study included 100 patients on HD. Nutritional status was based on MIS (malnutrition ≥7 points). Body composition, biochemistry data, and serum leptin level were evaluated.Findings: Of 100 subjects, 33 (33.0%) were categorized as having malnutrition. Compared with subjects in the well-nourished group, those in the malnutrition group had on average an older age, longer HD duration, and lower height, weight, body mass index, waist circumference, body fat mass, serum triglyceride level, and creatinine level. Serum leptin levels were also significantly lower in the malnutrition group (P < 0.001), whereas C-reactive protein (CRP) levels were higher (P = 0.002). Multivariable linear regression analysis revealed that HD duration (β = 2.06, P = 0.009), serum leptin level (β = −5.16, P < 0.001), CRP level (β = 3.33, P < 0.001), and albumin level (β = −1.95, P = 0.008) were factors independently associated with MIS. The discriminative power of serum leptin level to predict malnutrition was 0.834 (95% confidence interval: 0.747-0.901, P < 0.001).Discussion: Low serum leptin level was associated with malnutrition, and serum leptin level may be a valuable marker for nutrition assessment in patients undergoing HD.

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“…Kara et al ( 8 ) reported association of elevated serum leptin levels with good nutritional status in non-obese chronic HD patients. However, similar to our findings no correlation between leptin and inflammatory status was observed in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, numerous studies have demonstrated that HD patients with lower Body Mass Index (BMI) have higher relative mortality risk ( 7 ). Kara et al ( 8 ) recently reported negative correlation between increased leptin levels and lower malnutrition inflammation score which remained significant even after adjustments for BMI. However, significance of hyperleptinemia as well as its associations with inflammatory and nutritional status in HD patients is far from being fully elucidated.…”

Section: Introductionmentioning

confidence: 97%

Elevated Serum Leptin Level Is Associated with Body Mass Index But Not with Serum C-reactive Protein and Erythrocyte Sedimentation Rate Values in Hemodialysis Patients

et al. 2015

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Objectives:Aim of the present study was to investigate serum concentration of leptin and its association with values of body mass index (BMI), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in hemodialysis (HD) patients.Methods:This cross-sectional study included 60 HD patients (34 male, 26 female) and 30 age- and sex-matched (4 males, 26 females) apparently healthy subjects. Serum leptin concentration was determined by an enzyme-linked immunosorbent assay (ELISA). Serum CRP concentration was measured by means of particle-enhanced immunonephelometry. ESR value was determined by Western Green method. BMI was calculated as weight (kg) divided by height squared (m2).Results:Results have shown that median serum leptin concentration (30.65 ng/mL; 12.48-86.40 ng/mL) was statistically significantly higher in HD patients compared to median serum leptin concentration (15.75 ng/mL; 9.15-30.65 ng/mL) in the control group of healthy subjects (p<0.05). Likewise, median serum CRP concentration (5.5 mg/L; 1.93-8.9 mg/L) and median ESR value (57.5 mm/h; 40.5-77.0 mm/h) were significantly higher in HD patients compared to median serum CRP concentration (0.8 mg/L; 0.38-1.43 mg/L) (p<0.001) and median ESR value (10.0 mm/h; 6.5-14.0 mm/h) (p<0.001) determined in the control group. Statistically significant positive correlation was found between BMI values and serum leptin concentration in HD patients (rho=0.434; p<0.001). Positive, although not significant, correlation was observed between serum CRP and leptin levels in HD patients (rho=0.171; p>0.05). Negative correlation between ESR values and serum leptin concentrations in HD patients was determined but it was not statistically significant (rho= -0.029; p>0.05).Conclusions:Increased serum concentration of leptin as pro-inflammatory cytokine as well as elevated serum values of CRP and ESR indicate presence of systemic micro inflammation in HD patients. Results of the present study point to possible use of serum leptin concentration as an indicator of nutritional status in HD patients based on observed significant positive correlation between serum leptin concentrations and BMI values. However, absence of significant association between serum leptin and CRP levels as well as between serum leptin concentrations and ESR values in HD patients requires further investigation and clarification.

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Elevated serum leptin levels are associated with good nutritional status in non-obese chronic hemodialysis patients

Abstract: Elevated serum leptin levels seem to be associated with good nutritional status. However, there was no correlation between leptin and inflammatory status.

Cited by 11 publications

References 19 publications

Association of Increased Serum Leptin with Ameliorated Anemia and Malnutrition in Stage 5 Chronic Kidney Disease Patients after Parathyroidectomy

Association of Increased Serum Leptin with Ameliorated Anemia and Malnutrition in Stage 5 Chronic Kidney Disease Patients after Parathyroidectomy

Low serum leptin levels are associated with malnutrition status according to malnutrition‐inflammation score in patients undergoing chronic hemodialysis

Elevated Serum Leptin Level Is Associated with Body Mass Index But Not with Serum C-reactive Protein and Erythrocyte Sedimentation Rate Values in Hemodialysis Patients

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