title: Hyperleptinaemia, insulin resistance and survival in peritoneal dialysis patients.
abstract: OBJECTIVE
  The aim of this study was to clarify the relationship between insulin resistance (IR) and glucose and lipid metabolism in peritoneal dialysis (PD) patients. The study also investigated the prognostic factors for survival in long-term peritoneal dialysis patients.
  
  
  METHODS
  Participants were recruited from July 1 to August 1, 2011, based on selection criteria. Patients were divided into two groups, high (H) and low (L) group according to the median value of homeostasis model assessment of IR (HOMA-IR). Type 2 diabetes mellitus (DM) patients were chosen as positive controls. Clinical, plasma biochemical and metabolic parameters were observed and recorded at the outset and follow-up of this study. Mortality related factors were also detected, and statistical analyses were performed.
  
  
  RESULTS
  A total of 157 cases with an average age of 55 ± 15 years were included. There were 26, 66 and 65 cases in the DM, H and L groups, respectively. Younger age, lower body mass index, high sensitive C-reactive protein (hsCRP) level, higher normalized protein catabolic rate (nPCR) were found in the L group compared with the other two groups. HOMA-IR positively correlated with age, leptin and triglyceride levels, and it negatively correlated with BMI. L group had better survival rate than H and DM groups. Dialysis duration, serum leptin level, nPCR and hsCRP were statistically associated with mortality.
  
  
  CONCLUSIONS
  Insulin resistance may play an important role in the pathophysiology of glucose and lipid metabolism. Dialysis duration, leptin, nPCR and hsCRP may be risk factors for mortality in PD patients.
authors.affiliation: Department of Nephrology, Molecular Cell Laboratory for Kidney Disease, Shanghai Center for Peritoneal Dialysis Research, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Liou
authors.initials: L
authors.lastname: Cao
authors.affiliation: Department of Nephrology, Molecular Cell Laboratory for Kidney Disease, Shanghai Center for Peritoneal Dialysis Research, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Mou
authors.affiliation: Department of Nephrology, Molecular Cell Laboratory for Kidney Disease, Shanghai Center for Peritoneal Dialysis Research, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
authors.affiliation: Department of Nephrology, Molecular Cell Laboratory for Kidney Disease, Shanghai Center for Peritoneal Dialysis Research, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Leyi
authors.initials: L
authors.lastname: Gu
authors.affiliation: Department of Nephrology, Molecular Cell Laboratory for Kidney Disease, Shanghai Center for Peritoneal Dialysis Research, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Jiaying
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Nephrology, Molecular Cell Laboratory for Kidney Disease, Shanghai Center for Peritoneal Dialysis Research, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Aiping
authors.initials: A
authors.lastname: Gu
authors.affiliation: Department of Nephrology, Molecular Cell Laboratory for Kidney Disease, Shanghai Center for Peritoneal Dialysis Research, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Jiaqi
authors.initials: J
authors.lastname: Qian
authors.affiliation: Department of Nephrology, Molecular Cell Laboratory for Kidney Disease, Shanghai Center for Peritoneal Dialysis Research, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Ni
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002423:Cause of Death; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D020738:Leptin / Q000097:blood*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000401:mortality; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D008055:Lipids; D002097:C-Reactive Protein
keywords: hyperleptinaemia; insulin resistance; leptin; mortality; peritoneal dialysis