Association of Increased Serum Leptin with Ameliorated Anemia and Malnutrition in Stage 5 Chronic Kidney Disease Patients after Parathyroidectomy.
Leptin is an adipokine that regulates various metabolism, but its association with secondary hyperparathyroidism (SHPT), a clinical manifestation of chronic kidney disease-mineral and bone disorder (CKD-MBD), remains obscure. Parathyroidectomy (PTX) is recommended for severe SHPT patients. Here, the associations between circulating leptin and clinical characteristics in CKD patients were investigated. Effects of PTX on leptin production were analyzed in vivo and in vitro. Controls and CKD patients had approximate serum leptin levels in that a larger proportion of CKD patients with body mass index (BMI) <23 kg/m(2). Serum leptin was related to anemia, albumin, and bone metabolism disorders in CKD patients. Lower intact parathyroid hormone (PTH) was related with higher leptin in PTX patients group. Severe SHPT inhibited uremia-enhanced leptin production in 3T3-L1 adipocytes, which was attenuated after PTX. High levels of PTH were found to reduce Akt phosphorylation and leptin production in vitro but high levels of calcium and phosphorus were not. Successful PTX was found to improve anemia and malnutrition in severe SHPT patients, and this was correlated with increased circulating leptin levels via up-regulated Akt signaling in adipocytes. These findings indicated the therapeutic potential of leptin and related target pathway for improving survival and quality of life in CKD.
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Yao
Y
Jiang
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Jingjing
J
Zhang
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Yanggang
Y
Yuan
Department of General Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Xiaoming
X
Zha
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Changying
C
Xing
Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Chong
C
Shen
Department of Nephrology, Jiangsu Province Geriatric Hospital, Nanjing, Jiangsu Province, 210024, China.
Zhixiang
Z
Shen
Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Chao
C
Qin
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Ming
M
Zeng
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Guang
G
Yang
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Huijuan
H
Mao
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Bo
B
Zhang
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Xiangbao
X
Yu
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Bin
B
Sun
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Chun
C
Ouyang
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Xueqiang
X
Xu
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Yifei
Y
Ge
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Jing
J
Wang
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Lina
L
Zhang
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Chen
C
Cheng
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Caixia
C
Yin
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Jing
J
Zhang
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Huimin
H
Chen
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Haoyang
H
Ma
Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China.
Ningning
N
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood* / Q000628:therapy; D001847:Bone Diseases / Q000097:blood* / Q000601:surgery; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D044342:Malnutrition / Q000097:blood* / Q000628:therapy; D008875:Middle Aged; D016105:Parathyroidectomy; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000601:surgery
D020738:Leptin