title: Comparison of Appetite-regulating Hormones and Body Composition in Pediatric Patients in Predialysis Stage of Chronic Kidney Disease and Healthy Control Group.
abstract: BACKGROUND
  Protein-energy malnutrition (PEM) is a common complication in pediatric patients with chronic kidney disease (CKD). Components incorporated in the regulation of appetite and body composition appear to be of the focus in renal insufficiency and may influence the CKD-associated PEM. The purpose of this study was to investigate plasma levels of appetite-regulating hormones and their correlation with the body composition variables in a pediatric in predialysis stage of CKD.
  
  
  METHODS
  Thirty children with CKD in predialysis stage were selected and compared with 30 healthy sex- and age-matched controls. Blood samples were collected in fasting. Serum total ghrelin, leptin, and obestatin levels were measured using enzyme immunometric assay methods. Anthropometric parameters measurement and body composition analysis were done using the bioelectric impedance analysis (BIA) method.
  
  
  RESULTS
  Patients showed insignificant elevated total ghrelin (105.40±30.83 ng/l), leptin (5.32±1.17 ng/ml) and obestatin (5.07±1.09 ng/ml) levels in comparison with healthy participants. By using BIA, patients had significantly different Dry Lean Weight (P=0.048), Extra Cellular Water (P=0.045), Body Cell Mass (BCM) (P=0.021), Basal Metabolic Rate (P=0.033) and Body Mass Index (P=0.029) compared with controls. Furthermore, the total body water was slightly and the ECW was significantly higher in CKD participants. There were significant negative correlation between obestatin and BCM (r=-0.40, P=0.03) and fat free mass index (FFMI) (r=-0.40, P=0.029) in patients.
  
  
  CONCLUSIONS
  It seems that our results are insufficient to clarify the role of appetite-regulating hormones in PEM in CKD patients. It is apparent that there are still many unknown parameters related to both appetite regulating and CKD-associated PEM.
authors: Department of Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran;
authors: Mohammad Hassan
authors: MH
authors: Eftekhari
authors: Department of Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran;
authors: Maryam
authors: M
authors: Ranjbar-Zahedani
authors: Department of Nephrology Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;
authors: Mitra
authors: M
authors: Basiratnia
authors: Department of Epidemiology, Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Abbas
authors: A
authors: Rezaianzadeh
authors: Department of Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran;
authors: Shiva
authors: S
authors: Faghih
keywords: Chronic renal insufficiency; Ghrelin; Leptin; Obestatin
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