Serum leptin and IGF-I during growth hormone treatment in chronic renal failure

Abstract

Serum leptin decreases during growth hormone (hGH) treatment and pre-treatment values have been suggested as a predictor of the response to hGH in GH deficiency (GHD) but not in non-GHD syndromes. To investigate whether this holds true in children with chronic renal failure (CRF), we evaluated changes in serum leptin, insulin-like growth factor-I (IGF-I) and height before(b) and during the 1st year (3 months, 6 months, 9 months, 12 months) of hGH treatment (1 IU/kg per week) in 11 children (median age(b) 10.1 years, mean height(b) -2.9 SDS) with CRF. Serum leptin and IGF-I were compared with values from healthy children. Each patient also served as his/her own control, with values during treatment compared with those before treatment. Growth improved in all patients during treatment (mean change(12 m) +7.2 cm, change in height SDS(12 m) +0.5, P=0.001). Weight decreased (median decrease(12 m) 0.3 SDS, P=0.02) but body mass index (BMI) and serum leptin did not change during treatment. Serum IGF-I levels were low before (mean -1.1 SDS) but increased during hGH treatment, the increment being greatest at 10 days (mean increment +1.9 SDS, P<0.0001). Serum leptin(b) did not correlate with change in serum IGF-I(10d), height(12 m) or weight(12 m). Serum IGF-I SDS(b) correlated with height SDS at 12 months ( r=0.80, P=0.006) of hGH treatment. Serum leptin(b) correlated with BMI ( r(s)=0.75, P=0.01). Levels adjusted for BMI did not differ from values in healthy children and did not change during treatment. Despite an IGF-I and growth response during hGH treatment, serum leptin did not change and pre-treatment values did not predict the growth response in these children with CRF.

Improvement in Growth After 1 Year of Growth Hormone Therapy in Well-Nourished Infants with Growth Retardation Secondary to Chronic Renal Failure

“…In our study, mean leptin and ghrelin values remained steady over time and did not change during GH therapy. Patel et al (34) reported that GH treatment did not modify serum leptin levels in 11 prepubertal children with CRF. Our study confirms these results and shows for the first time that circulating values of ghrelin are not influenced by GH therapy in children with CRF.…”

Insuficiência renal crônica e hormônio de crescimento: efeitos no eixo GH-IGF e na leptina

“…(28) e Patel e cols. (29). A ausência de hiperleptinemia neste grupo estudado talvez tenha ocorrido devido ao fato de não terem sido incluídas crianças em diálise peritoneal, as que mais apresentam aumento da leptina sérica nos estudos encontrados na literatura (3).…”

Συσχέτιση Ποσότητας Λεπτίνης Στο Πλάσμα Εγκύου Γυναίκας Και Κινδύνου Εμφάνισης Προεκλαμψίας

“…Τα επίπεδα της λεπτίνης είναι αυξημένα σε ασθενείς με τελικού σταδίου νεφρική ανεπάρκεια [50]. Ασθενείς που κάνουν θεραπεία με περιτοναϊκή κάθαρση έχουν μεγαλύτερα επίπεδα λεπτίνης σε σχέση με ασθενείς που κάνουν αιμοκάθαρση, γεγονός που μπορεί να οφείλεται στη μεγάλη αύξηση του σωματικού λίπους λόγω της συνεχούς χορήγησης υδατανθράκων .…”