title: Effects of short-term recombinant human growth hormone therapy on plasma leptin concentrations in dialysis patients.
abstract: BACKGROUND
  Hyperleptinaemia is a well-known biochemical feature found in uraemic patients. However, little is known about the hormonal regulation of leptin in chronic renal disease. Recent studies have shown that circulating leptin levels are modified by treatment with recombinant human growth hormone (rhGH), by recombinant insulin-like growth factor I (rhIGF I), or by a combination of rhIGF I plus rhGH in patients with chronic renal failure. We performed a prospective study to assess plasma leptin concentrations in a group of dialysis patients both before and during short-term rhGH therapy.
  
  
  METHODS
  We studied eight dialysis patients (four haemodialysis (HD) and four on continuous ambulatory peritoneal dialysis (CAPD); three female, five male; mean age 63.9 +/- 3.1 years). All patients were instructed to maintain a stable diet (35 kcal/kg/day and 1 g protein/kg/day ideal body weight) and were treated with rhGH (0.2 IU/kg/day s.c.) for 4 weeks. Blood samples were taken at 0, 2, 4, and 8 weeks for determination of leptin, GH, and IGF I. Serum insulin concentrations were assessed at 0 and 4 weeks.
  
  
  RESULTS
  Mean plasma leptin concentrations were elevated (36.2 +/- 12.8 ng/ml) at study outset and increased progressively throughout the 4 weeks of rhGH therapy (43.7 +/- 13.5 ng/ml (2 weeks, NS) and 70.6 +/- 18.4 ng/ml (4 weeks, P<0.0001)). These values returned to baseline levels (38.0 +/- 12.0 ng/ml, NS) at 1 month after rhGH withdrawal. rhGH therapy was accompanied by the development of direct correlations between leptin and IGF I concentrations at 2 weeks (r=0.86, P<0.01), and with correlations between leptin and IGF I (r=0.84, P<0.01) and between leptin and insulin (r=0.88, P<0.01) after 4 weeks of rhGH administration.
  
  
  CONCLUSIONS
  These results confirm the presence of high circulating plasma leptin in dialysis patients and show that these levels are further increased by exogenous rhGH administration. The increase in plasma leptin after rhGH therapy may be related to the rhGH-induced changes in insulin in these patients.
authors.affiliation: Department of Endocrinology, Hospital General de Segovia, C/Maria Sevilla Diago, 9, 3o dcha, E-28022 Madrid, Spain. piglesias@mi.madritel.es
authors.forename: Pedro
authors.initials: P
authors.lastname: Iglesias
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Díez
authors.forename: Ma José
authors.initials: MJ
authors.lastname: Fernández-Reyes
authors.forename: Mc Auxiliadore
authors.initials: MA
authors.lastname: Bajo
authors.forename: Abelardo
authors.initials: A
authors.lastname: Aguilera
authors.forename: Javier
authors.initials: J
authors.lastname: Méndez
authors.forename: Rosa
authors.initials: R
authors.lastname: Codoceo
authors.forename: Rafael
authors.initials: R
authors.lastname: Selgas
mesh_terms: D000368:Aged; D018592:Cross-Over Studies; D004334:Drug Administration Schedule; D005260:Female; D013006:Growth Hormone / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D006435:Renal Dialysis
chemical_list: D020738:Leptin; D011994:Recombinant Proteins; D013006:Growth Hormone