The clinical impact of plasma leptin levels in a cohort of chronic kidney disease patients.
BACKGROUND
Recent research has clarified the relationship between adipokines, metabolic syndrome (MS) and cardiovascular disease (CVD). The results of animal and clinical studies have revealed a positive relationship between leptin and vascular smooth muscle cell counts and calcification, arterial rigidity, carotid thickness and the incidence of CVD. However, despite leptin fulfilling the definition of a uremic toxin, its exact role in chronic kidney disease (CKD) has yet to be determined.


METHODS
One hundred and forty-two CKD patients (stages 2-5D) participated in this study, and were followed for a minimum of 20 months at Amiens University Medical Center.


RESULTS
Leptin was negatively correlated with the glomerular filtration rate (GFR), total adiponectin (TAdip) and high-molecular weight adiponectin and positively correlated with age, waist circumference, body mass index (BMI), aortic calcification score (ACS), C-reactive protein (CRP), triglycerides, insulin and parathormone (PTH). Leptin and insulin were significantly correlated with the MS score. The BMI, insulin, MS score and PTH were independent predictors of leptin levels (P = 0.002, 0.016, 0.028 and 0.017, respectively). Leptin, insulin and TAdip were independent predictors of the presence of MS (P = 0.05, 0.04 and 0.04). However, leptin levels were not significantly predictive of the clinical outcomes.


CONCLUSIONS
Our study was the first to demonstrate a significant, independent link between leptin and MS (but not clinical outcomes) and PTH in patients at different CKD stages. Future studies will have to assess the involvement of leptin in MS and clinical outcomes in CKD, and the potential modulation of leptin by PTH.
INSERM U-1088, The Jules Verne University of Picardy , Amiens , France.
Rodrigo Bueno
RB
de Oliveira
INSERM U-1088, The Jules Verne University of Picardy, Amiens, France; Clinical Research Center, Division of Clinical Pharmacology, Amiens University Medical Center, Amiens, France; The Jules Verne University of Picardy, Amiens, France.
Sophie
S
Liabeuf
INSERM U-1088, The Jules Verne University of Picardy , Amiens , France.
Hirokazu
H
Okazaki
INSERM U-1088, The Jules Verne University of Picardy, Amiens, France; Clinical Research Center, Division of Clinical Pharmacology, Amiens University Medical Center, Amiens, France; The Jules Verne University of Picardy, Amiens, France.
Aurelie
A
Lenglet
Clinical Research Center, Division of Clinical Pharmacology, Amiens University Medical Center, Amiens, France; The Jules Verne University of Picardy, Amiens, France.
Lucie
L
Desjardins
eXcorLab GmbH , Obernburg , Germany.
Horst-Dieter
HD
Lemke
Nephrology-Dialysis-Transplantation Department, Department of Internal Medicine , University Hospital , Ghent , Belgium.
Raymond
R
Vanholder
Division of Nephrology , Amiens University Medical Center , Amiens , France.
Gabriel
G
Choukroun
INSERM U-1088, The Jules Verne University of Picardy, Amiens, France; Clinical Research Center, Division of Clinical Pharmacology, Amiens University Medical Center, Amiens, France; The Jules Verne University of Picardy, Amiens, France; Division of Nephrology, Ambroise Paré Hospital, Paris Ile de France Ouest (UVSQ) University, Paris-Boulogne Billancourt, France.
Ziad A
ZA
Massy
adiponectin; chronic kidney disease; leptin; metabolic syndrome; parathormone