title: Are ghrelin and leptin involved in food intake and body mass index in maintenance hemodialysis?
abstract: 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.
authors.affiliation: Department of Clinical Nutrition, Nutrition Faculty, Federal University Fluminense, Niterói, Brazil.
authors.forename: Denise
authors.initials: D
authors.lastname: Mafra
authors.forename: Anne
authors.initials: A
authors.lastname: Jolivot
authors.forename: Philippe
authors.initials: P
authors.lastname: Chauveau
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Drai
authors.forename: Raymond
authors.initials: R
authors.lastname: Azar
authors.forename: Catherine
authors.initials: C
authors.lastname: Michel
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D004044:Dietary Proteins; D054439:Ghrelin; D020738:Leptin; C422650:ghrelin, des-n-octanoyl; D002097:C-Reactive Protein