Adiponectin, resistin and leptin in paediatric chronic renal failure: correlation with auxological and endocrine profiles.
BACKGROUND
Chronic renal failure (CRF) compromises nutrition, growth, puberty, glycometabolic homeostasis, and adipokine secretion (i.e. adiponectin, resistin, and leptin). Adipokines play a role in the clinical outcome, but data in paediatric patients is scant.


OBJECTIVE
To evaluate the link between kidney function, adiponectin, resistin, leptin, hormonal status, nutritional state and late outcome of CRF children.


METHODS
We studied leptin, adiponectin and resistin levels in 31 CRF patients (19 males, 12 females, aged 12.1 ± 4.47 years) managed conservatively, and 30 healthy age- and gender-matched controls. Clinical, auxological, biochemical, hormonal data, glucose and insulin levels were correlated with adipokine levels.


RESULTS
Six percent of patients had glycaemia T0' > 126 mg/dl, 23 % glycaemia T60' > 126, and 23 % glycaemia T120' ≥ 140. Glycated haemoglobin (HbA1c) measured during follow-up was in the normal range in all patients (4-5.6 %). Insulinaemia was significantly higher in CRF patients than controls. Homeostatic model of assessment-insulin resistance (HOMA-IR) levels were more elevated in patients (32 % had HOMA-IR > 2.5) than controls. Leptin levels were significantly higher in CRF patients than controls and differed significantly between males and females. Leptin correlated significantly with creatinine, body mass index (BMI), BA, pubertal stage, insulin-like growth factor 1, and HOMA-IR in females. Adiponectin levels were significantly higher in patients than controls, higher in patients with BMI < 85th centile and significantly inversely correlated to BMI, BA, haemoglobin, ferritin, proteins, albumin, and creatininuria. Resistin levels showed a direct correlation with C-reactive protein and an inverse correlation with haemoglobin.


CONCLUSIONS
Normal resistin levels are an expression of both adequate nutritional state and controlled inflammatory state. Adiponectin could protect against chronic inflammation, atherosclerosis, and cardiovascular diseases. Preventing obesity and ensuring a correct nutritional state are primary goals for physicians following children with CRF. Adipokines could be a useful marker in the follow-up.
Universitary Department "Pro.S.A.M.I.", University of Palermo, Palermo, Italy, mariacristina.maggio@unipa.it.
Maria Cristina
MC
Maggio
Daniela
D
Montaperto
Silvio
S
Maringhini
Ciro
C
Corrado
Eleonora
E
Gucciardino
Giovanni
G
Corsello
D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D020738:Leptin / Q000097:blood*; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D011379:Prognosis; D052243:Resistin / Q000097:blood*; D012307:Risk Factors; D013997:Time Factors
D052242:Adiponectin; D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D020738:Leptin; D052243:Resistin; C499918:ADIPOQ protein, human; C499624:RETN protein, human; C517652:hemoglobin A1c protein, human