Plasma leptin is partly cleared by the kidney and is elevated in hemodialysis patients

Sharma, Kumar; Considine, Robert V.; Michael, Beckie; Dunn, Stephen; Weisberg, Lawrence S.; Kurnik, Brenda R.C.; Kurnik, Peter B.; O’Connor, John F.; Sinha, Madhur K.; José, F.

doi:10.1038/ki.1997.269

Cited by 239 publications

(181 citation statements)

References 28 publications

Supporting

Mentioning

167

Contrasting

Unclassified

Order By: Relevance

“…We demonstrated that elevation in plasma leptin due to impaired renal function occurred independently of other metabolic and endocrinological factors. The kidney may play a physiological role in leptin clearance [23]. If the intact leptin molecules are accumulated due to renal failure, hyperleptinaemia might account, at least in part, for malnutrition of patients with chronic renal failure.…”

Section: Discussionmentioning

confidence: 99%

Renal function and insulin resistance as determinants of plasma leptin levels in patients with NIDDM

et al. 1997

View full text Add to dashboard Cite

Leptin is a newly found hormone secreted by adipocytes [1]. It is the ob gene product which regulates food intake and thermogenesis [2][3][4]. The ob/ob mouse has a mutation in the ob gene [1], and db/db mice have a mutation in the gene coding for the leptin receptor [5,6]. Therefore, leptin could play an important role in the pathogenesis of obesity and diabetes mellitus. In humans, however, the majority of obese subjects have elevated plasma leptin concentrations [7][8][9], suggesting the presence of leptin resistance [10]. The mechanisms regulating plasma leptin level or leptin resistance are not fully understood. Body fatness was one of the important determinants of plasma leptin levels [7][8][9]. Some studies showed that insulin infusion increased plasma leptin concentration [11,12], although other studies [13] did not. One report [13] indicated that insulin resistance was associated with elevated plasma leptin concentrations independent of body fat, whereas more recent studies [14,15] failed to detect the independent contribution of insulin sensitivity or body fat distribution, an indicator of insulin resistance [16], to plasma leptin concentration. In addition, there is a possibility that renal function may play an important role in the regulation of plasma leptin concentration. Renal impairment results in insulin resistance and hyperinsulinaemia [17]. Also, the kidney is among the organs expressing leptin receptors [18], although their functions are unknown at present. To answer these controversies and to evaluate the possible impact of renal function on leptin, we performed the euglycaemic hyperinsulinaemic clamp in 57 patients with non-insulin-dependent diabetes mellitus (NIDDM). The results suggest that: 1) both total mass and distribution of body fat are important determinants of leptin levels; 2) leptin Diabetologia (1997) 40: 676-679 Renal function and insulin resistance as determinants of plasma leptin levels in patients with NIDDM Summary Plasma leptin level is known to correlate with the degree of obesity. To determine the influences of renal fuction and insulin resistance on plasma leptin concentrations, we measured plasma leptin concentrations and performed the euglycaemic hyperinsulinaemic clamp studies in 57 patients with non-insulin-dependent diabetes mellitus with a wide range of renal function. In simple regression analyses, plasma leptin concentration showed significant positive correlations with percentage of body fat measured by dual energy X-ray absorptiometry, body mass index, waist to hip ratio and fasting plasma insulin. Leptin level was higher in females than males.Multiple regression analyses indicated that percent body fat, waist to hip ratio, plasma insulin, gender and renal function (1/creatinine), but not insulin sensitivity, were significant and independent determinants of plasma leptin level. These results suggest that plasma leptin level is regulated or affected by multiple factors including renal function. Insulin resistance appeared to increase leptin levels indirectl...

show abstract

Section: Discussionmentioning

confidence: 99%

Renal function and insulin resistance as determinants of plasma leptin levels in patients with NIDDM

et al. 1997

View full text Add to dashboard Cite

show abstract

“…Yapılan çalışmalar serum leptin düzeylerinin sağ-lıklı yetişkin ve çocuklarda olduğu gibi KBY hastalarında da VKİ ile anlamlı korelasyona sahip olduğunu göstermiştir (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) . Çalışmamızda, KBY hasta grubunda cinsiyet ayırımı yapmaksızın kontrol grubunda olduğu gibi VKİ ile serum leptin düzeyleri arasında anlamlı pozitif korelasyon olduğunu bulduk.…”

Section: Discussionunclassified

“…Leptinin büyük çoğunluğunun dolaşımda bağlı olmayan formda bulunması ve moleküler büyüklüğü sıradan sentetik diyaliz zarından geçemeyeceğini düşündürmektedir (23) . Bununla ilgili birçok çalışma hemodiyaliz ile leptin düzeylerinin azalmadığını göstermiştir (15,17,(24)(25)(26)(27) . Hemodiyaliz uygulanan hasta sayımız az olduğu için PD uygulananlarla leptin düzeyleri açısından istatistiksel bir karşılaştırma yapamadık.…”

Section: Prediyaliz Hasta Grubuunclassified

“…İlginç olarak, erkeklerde diyaliz tedavisi uygulanan grup ve tüm KBY erkek hasta grubunun leptin düzeylerini sağlıklı gruba göre 3,5 kat düşük olarak bulduk. Bu durum literatürde diğer çalışmaların sonucu ile benzer değildi (7,15,16,26,32,33) . Ayrıca sağlıklı erkek çocuklarda leptin ile VKİ arasında anlamlı pozitif korelasyon varken, hasta erkek grubumuzda anlamlı korelasyonun olmayışı, bu hastalarda leptinin atılım yetersizliği nedeniyle serumda birikiminden farklı olarak leptinin sentezini etkileyen başka unsurlar olabileceğini düşündürmektedir.…”

Section: Prediyaliz Hasta Grubuunclassified

See 1 more Smart Citation

Serum Leptin Concentration In Children With Chronic Renal Failure

Berksoy¹,

Alpay²,

Yıldız³

et al. 2018

BUCH

View full text Add to dashboard Cite

ÖZAmaç: Üremik iştahsızlıkta çeşitli faktörler sorumlu tutulmaktadır. Serum leptin düzeylerinde artış ve üremik toksinler melanokortin hormon reseptörlerini uyararak enerji tüketimini artırıp, yiyecek alımını azaltırlar. Bu çalışmada, kronik böbrek yetmezliği olan çocuklar ile sağlıklı kontrollerin serum leptin konsantrasyonlarını karşılaştırarak leptinin böbrek yolu ile atılımını araştırdık. Yöntem: Kronik böbrek yetmezliği nedeniyle takip edilen toplam 33 çocuk hasta ve kontrol grubunu oluşturan 29 sağlıklı çocuğun serum leptin, leptin/VKİ, albümin, glikoz, kreatinin, üre, trigliserid ve kolesterol düzeylerini değerlendirdik. Bulgular: Kız hastalarda ortalama serum leptin düzeyi (18,49±28,55), leptin/VKİ (0,94±1,36) kontrol grubu leptin (7,73±5,65) ve leptin/VKİI (0,94±1,36) değerlerine göre yüksekti (p>0,05). Erkek hastalarda ise serum leptin düzeyi (1,48±1,36; 4,88±3,70) ve leptin/VKİ kontrole göre (0,08±0,081; 0,25±0,16) düşük bulundu (p<0,01). Kızlarda hasta ve sağlıklı grupta serum leptin düzeyi VKİ ile anlamlı pozitif korelasyon gösterir-ken, erkek hasta grubunda leptin ile VKİ arasında korelasyon bulunmadı. Diyaliz erkek hasta grubu dışındaki tüm hastalarda leptin ile glomeruler filtrasyon hızı ve serum kreatin düzeyleri arasında korelasyon yoktu. Serum leptin düzeyleri ile yaş, hastalık tanı süresi, diyaliz süresi arasında da korelasyon bulamadık. Sonuç: Serum leptin düzeyleri ile böbrek fonksiyonları arasında bir ilişkinin saptanmaması ve renal yetmezliği olan erkek hastalarda serum leptin konsantrasyonlarının sağlıklı erkek çocuklardan anlamlı olarak düşük bulunması, leptinin veya reseptör proteinlerinin sentezi veya etkinliğinde ya da böbrek dışı atılımında rol oynayan başka etkenlerin de bulunduğunu düşündürmektedir.Anahtar kelimeler: Çocuk, kronik böbrek yetmezliği, leptin ABSTRACT Objective: Various factors are responsible for uremic anorexia. Increase in serum leptin levels and uremic toxins stimulate melanocortin hormone receptors to increase energy consumption and reduce food intake. In this study, we investigated renal excretion of leptin by comparing serum leptin concentrations of healthy controls, and children with chronic renal failure. Methods: Serum leptin, leptin / BMI, albumin, glucose, creatinine, urea, triglyceride and cholesterol levels were eveluated in a total of 33 pediatric patients followed up for chronic renal failure and 29 healthy children in the control group. Results: Serum leptin levels (18.49±28.55) and leptin / BMI (0.94±1.36) in female patients were higher than leptin (7.73±5.65) and leptin / BMI (0.39±0.25) in the control group (p>0.05). In male patients, serum leptin levels (1.48±1.36; 4.88±3.70) and leptin/ BMI (0.08±0.081; 0.25±0.16) were found to be lower than those of the control group (p<0,01). Serum leptin levels showed a significant positive correlation with BMI in female patients with chronic renal failure and, healthy women; whilethere was no correlation between leptin and BMI in the male patient group. There was no correlation between leptin and glomerular ...

show abstract

“…Leptin is freely fi ltered into glomerulus but with very little excretion in urine (2). This is probably because it is reabsorbed and destructed in tubules (3). Serum leptin level is higher in chronic renal failure, hemodialysis and CAPD patients compared to general population (4,5).…”

mentioning

confidence: 99%

Serum leptin level has a positive correlation with BMI and creatinine clearance in CAPD patients

Seirafian

Momeni²,

Taheri³

et al. 2012

BLL

View full text Add to dashboard Cite

Abstract:Objective: In a cross sectional study, 75 patients (42 males and 33 females) on continuous ambulatory peritoneal dialysis (CAPD) were enrolled from October 2007 to February 2008. Serum levels of leptin, albumin, triglyceride, dialysis adequacy (total KT/V), renal creatinine clearance (Cr Cl), mid arm circumference and demographic fi ndings were measured in all patients. Results: The mean age of patients was 53±14.76. The history of hemodialysis was seen in 23 patients. Mean serum leptin level in women and men were 27±23μg/l and 16±13μg/l, respectively. A signifi cant correlation of serum leptin level with body mass index (BMI) (p<0.001) and renal Cr Cl (p<0.001) was found. There was no signifi cant correlation of serum leptin level with KT/V, duration of renal failure, serum triglycerides (TG), serum low density lipoprotein (LDL) cholesterol and mid arm circumference (p>0.05). Conclusions: To our knowledge, this is probably the fi rst study to report that serum leptin level has a direct positive correlation with renal Cr Cl in CAPD patients. This may explain the increase in mortality in patients with lower serum leptin levels (Tab. 2, Fig. 2, Ref. 25). Full Text in PDF www.elis.sk.

show abstract

Plasma leptin is partly cleared by the kidney and is elevated in hemodialysis patients

Cited by 239 publications

References 28 publications

Renal function and insulin resistance as determinants of plasma leptin levels in patients with NIDDM

Renal function and insulin resistance as determinants of plasma leptin levels in patients with NIDDM

Serum Leptin Concentration In Children With Chronic Renal Failure

Serum leptin level has a positive correlation with BMI and creatinine clearance in CAPD patients

Contact Info

Product

Resources

About