Aim:Tostudyserumleptinlevelinchronicrenalfailure(CRF)patientsondifferent modesofmanagementandtoanalyzetheimpactofthemodeoftherapyonserumleptinlevel.
SubjectsandMethods:Thisstudywasconductedon64patients(33males&31females) withchronicrenalfailuredividedintothreegroups:groupI:Twenty-sixpatientstreated conservativelyanddidnotstartdialysisyet(predialysis),groupII:Twenty-fourpatientstreated byhemodialysis,groupIII:Fourteenpatientstreatedbycontinuousambulatoryperitoneal dialysis(CAPD).Twentyhealthysubjectswereincludedascontrolgroup.Allpatientsand controlsweresubjectedtofullclinicalexaminationincludingheightandweighttocalculate bodymassindex(BMI).Bloodureaandserumcreatinineweremeasuredasrenalfunctiontests. SerumleptinwasmeasuredbyEASIAandsoseruminsulin.
Results:InpredialysisandCAPDgroups,thereisasignificantincreaseinleptin,leptin/ BMIandinsulininpatientsincomparisontocontrolsubjects.Inhemodialysisgroup,thereisa significantincreaseinleptinandleptin/BMIandanon-significantincreaseininsulinlevelin patientsincomparisontocontrolsubjects.Insulinissignificantlycorrelatedwithleptininthe firstgroup,whileinthesecondandthirdgroupsthereisnocorrelation.Thehighestleptinlevel isfoundintheCAPDgroupofpatientsfollowedbythepredialysisonethenthehemodialysis group.
Leptinlevelissignificantlyhigherinfemalesthanmalesinallgroups.Thisdifference remainedafteradjustingleptinleveltoBMI.
Nocorrelationwasfoundbetweenleptinlevelandageorbetweenleptinlevelandrenal functioninthethreegroupsofpatients.Nocorrelationwasfoundbetweenleptinlevelandthe durationofdialysisinthehemodialysisandCAPDgroups.
Conclusion:SerumleptiniselevatedinCRFpatientsirrespectiveofthetypeof managementtheyareundergoing.Dialysis,hasnosignificanteffectonleptinlevel.Thetwo mainpredictorsofserumleptinlevelaresexandBMIinCRFpatientsandinhealthysubjects.
Leptinlevelmayserveasavaluableclinical Introduction
Leptinisa16KDproteinhormone producedmainlybywhiteadiposetissue (Kuwaharaetal.,2003).Itisinvolvedin energyhomeostasisthatactstoinhibitfood intake,tostimulateenergyexpenditureand influenceinsulinsecretion,lipolysisand sugartransport(Mistriketal.,2004).
Theactionofleptinismediated throughtheleptinreceptor(Ob-R),whichis encodedbythediabetes(db)gene.Leptin receptorsisoformshavebeenreportedin widevarietyoftissues:heart,lung,
markerforbodyadiposity.