Leptin, adiponectin, and ghrelin dysregulation in chronic kidney disease.
In the past 10 years, 3 new metabolic compounds, leptin, adiponectin, and ghrelin, involved in energy metabolism, body composition, and appetite regulation, have been discovered. We have assessed their characteristics in 46 patients with stage 3 to 4 chronic kidney disease to evaluate the role of decreased renal function in the abnormal handling reported in more severe end-stage renal disease patients. In addition to the usual correlations with body mass index and body fat mass, the results show unexpected positive correlations between leptin and insulin, leptin and adiponectin, a weak inverse relationship between adiponectin and glomerular filtration rate, and no influence of C-reactive protein on either leptin or adiponectin in these noninflamed patients. Serum ghrelin was inversely correlated with body mass index and with glomerular filtration rate as measured by inulin clearance. Thus, ghrelin and leptin, 2 antagonist signals for energy balance, both seem to increase when glomerular filtration rate is reduced, potentially neutralizing their respective biologic effects in severe renal insufficiency.
Guebre-Egziabher
Fitsum
F
Département de Néphrologie, Hôpital E. Herriot, Lyon, France.
Bernhard
Jacques
J
Geelen
Ghislaine
G
Malvoisin
Etienne
E
Hadj-Aissa
Aoumeur
A
Fouque
Denis
D
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D001066:Appetite; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002908:Chronic Disease; D004734:Energy Metabolism; D005215:Fasting; D005260:Female; D054439:Ghrelin; D005919:Glomerular Filtration Rate; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007674:Kidney Diseases / Q000097:blood* / Q000503:physiopathology; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D036361:Peptide Hormones / Q000097:blood*; D012044:Regression Analysis
D052242:Adiponectin; D054439:Ghrelin; D007328:Insulin; D020738:Leptin; D036361:Peptide Hormones; D002097:C-Reactive Protein