Are ghrelin and leptin involved in food intake and body mass index in maintenance hemodialysis?
OBJECTIVE
Both leptin and ghrelin (in the forms of acyl ghrelin and des-acyl ghrelin) are involved in food intake, and appear to be dysregulated in chronic kidney disease. This study describes plasma leptin, acyl, and des-acyl ghrelin concentrations in relation to protein intake and body mass index (BMI) in hemodialysis (HD) patients.


METHODS
This was a cross-sectional study.


METHODS
This study was conducted during the baseline phase of the French multicenter Influence of a High-Flux Dialyzer on Long-Term Leptin Levels Study.


METHODS
We studied 125 HD patients (aged 72.5+/-11.7 years; 59% males).


METHODS
Blood samples were collected during fasting, and before a regular HD session. Plasma ghrelin and leptin were evaluated. The protein equivalents of total nitrogen appearance and BMI were calculated.


RESULTS
Patients demonstrated elevated serum leptin (48.0+/-49.0 ng/mL) and des-acyl ghrelin (646.6+/-489.5 pg/mL) levels, and low acyl ghrelin levels (29.8+/-58.5 pg/mL), according to normal values. Acyl ghrelin was negatively correlated with C-reactive protein (r=-0.34, P < .001). The des-acyl to acyl ghrelin ratio was negatively correlated with protein intake, as estimated by normalized Protein Nitrogen Appearance (r=-0.22, P=.01). Serum leptin exhibited its well-described positive correlation with BMI and waist circumference, but the other hormones did not.


CONCLUSIONS
This study reports high des-acyl ghrelin and leptin levels and low acyl ghrelin levels in HD patients, a finding potentially associated with inflammation and food intake.
Mafra
Denise
D
Department of Clinical Nutrition, Nutrition Faculty, Federal University Fluminense, Niterói, Brazil.
Jolivot
Anne
A
Chauveau
Philippe
P
Drai
Jocelyne
J
Azar
Raymond
R
Michel
Catherine
C
Fouque
Denis
D
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D004044:Dietary Proteins / Q000008:administration & dosage; D004435:Eating / Q000502:physiology*; D005260:Female; D054439:Ghrelin / Q000097:blood / Q000502:physiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D020738:Leptin / Q000097:blood / Q000502:physiology*; D008297:Male; D006435:Renal Dialysis; D012737:Sex Factors; D055105:Waist Circumference
D001786:Blood Glucose; D004044:Dietary Proteins; D054439:Ghrelin; D020738:Leptin; C422650:ghrelin, des-n-octanoyl; D002097:C-Reactive Protein