Serum Leptin in Patients with Chronic Renal Failure on Different Modes of Management

Document Type : Original Article

Authors

1 Departments of Medical Biochemistry Faculty of Medicine (Girls), AL-Azhar University

2 Internal Medicine Faculty of Medicine (Girls), AL-Azhar University

Abstract

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.
The Egyptian Journal of Hospital Medicine
Volume 25, Issue 1
October 2006
Pages 610-619

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