Correlation of serum leptin concentrations with body composition and gender in Taiwanese hemodialysis patients without diabetes.
OBJECTIVE
(1) To evaluate the impact of body composition and gender on serum leptin concentration in hemodialysis patients. (2) To study which marker of adiposity is most appropriate in Taiwanese hemodialysis patients without diabetes. (3) To compare the nutrition status between nonlean and lean subjects.


METHODS
Serum leptin concentrations were measured by radioimmunoassay collected in 88 hemodialysis patients without diabetes. Bioimpedance analysis was performed to determine percent fat mass (%FM), lean body mass (LM), and total body water (TBW). Body mass index (BMI) was calculated as weight/height2. Albumin and transferrin were measured by standard laboratory methods.


RESULTS
Serum leptin levels were more correlated with percent fat mass (r = 0.697; P < 0.001) than with body fat mass (r = 0.672; P < 0.001) or with BMI (r = 0.594; P < 0.001) in the group as a whole and in each subgroup when analyzed separately by gender. The mean (+/- SD) serum leptin levels were 32.5 +/- 34.3 ng mL(-1) in women subjects and 13.6 +/- 15.5 ng mL(-1) in men subjects (P < 0.001). Multiple regression analysis in all subjects revealed that serum leptin levels were independently affected by percent fat mass and gender. Adiposity corrected serum leptin, such as leptin/BMI, leptin/percent fat mass, and leptin/body fat mass was significantly different between sexes (P < 0.001). The significantly higher serum leptin concentrations in women than in men were observed in obese subjects with BMI > 25 kg/m2 (P < 0.001) as well as nonobese subjects with BMI < 25 kg/m2 (P < 0.05). There were no differences in lean mass and albumin between nonlean and lean subjects.


CONCLUSIONS
Gender and adiposity had impact on serum leptin levels in hemodialysis patients without diabetes. In terms of adiposity, serum leptin levels had stronger correlation with percent fat mass than with body fat mass (FM) or BMI in Taiwanese hemodialysis patients. Steady-state serum leptin levels could serve as valuable clinical markers for the body adiposity in stable hemodialysis patients without diabetes. Protein malnutrition markers and lean mass should be checked in lean subjects for the evaluation of the protein stores of hemodialysis patients.
Wang
Jenn Yeu
JY
Department of Medicine, Taipei Municipal Chung Hsiao Hospital, Taiwan, ROC. nephrol@ms19.hinet.net
Lu
Kuo Cheng
KC
Lin
Yuh Feng
YF
Hu
Wei-Ming
WM
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D003928:Diabetic Nephropathies / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011336:Probability; D011863:Radioimmunoassay; D012016:Reference Values; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013624:Taiwan; D016896:Treatment Outcome
D015415:Biomarkers; D020738:Leptin