Background. Hyperleptinemia is a common feature in hemodialysis (HD) patients. The role of increased serum leptin levels in the pathogenesis of HD-related anorexia is, however, still controversial. The purpose of the present prospective study was to ascertain whether hyperleptinemia is casually implicated in the pathogenesis of HD-related anorexia. Methods. We measured serum leptin levels and the serum leptin/Body Mass Index (BMI) ratio in 24 healthy subjects and in 49 end-stage renal disease patients on maintenance HD. Results. HD patients were subdivided into anorexic (A) (14/49, 28.5%) and non-anorexic (NA) (35/49, 71.5%) according to a questionnaire discriminating for the presence of anorexia-related symptoms. Calorie (Kcal/kg/day) and protein (grams/kg/day) intakes were significantly lower in A than in NA patients (20.1±1.1 vs. 27.9±1.3, p=0.004 and 0.82±0.05 vs. 1.19±0.05, p=0.001, respectively). Accordingly, serum albumin, total lymphocytes count, mid arm muscle circumference, and the protein equivalence of nitrogen appearance (PNA) were significantly lower in A patients. Serum leptin concentration (ng/mL) was significantly higher in HD patients than in controls, both in males (15.33±3.4 vs. 3.7±0.3, p=0.003) and in females (42.31±7.2 vs. 10.5±1.3, p=0.03). Similarly, the serum leptin/BMI ratio was significantly higher in HD patients than in controls, both in males (0.56±0.1 vs. 0.16±0.02, p=0.0028) and in females (1.82±0.2 vs. 0.47±0.04, p<0.0001). However, serum leptin levels were similar in A and NA patients, whether male (15.3±5.6 vs. 16.9±4.2, p=0.85) or female (46.6±12.9 vs. 47.4±9.4, p=0.96). No differences were also observed between the two groups in the serum leptin/BMI ratio, either in males (0.59±0.2 vs. 0.58±0.14, p=0.92) or in females (1.58±0.4 vs. 1.83±0.3, p=0.94). No significant correlations were found between serum leptin levels and PNA, albumin, cholesterol, total lymphocytes number, weight change, C-reactive protein, fibrinogen, ferritin, and complement. Conclusions. The present results would indicate that mechanisms other than increases in serum leptin levels might be involved in the pathogenesis of HD-related anorexia.
Anorexia and serum leptin in chronic hemodialysis patients / Bossola, M.; Muscaritoli, Maurizio; Valenza, V.; Panocchia, N.; Tazza, L.; Cascino, Antonia; Liberatori, M.; ROSSI FANELLI, Filippo; Luciani, G.. - In: RIVISTA ITALIANA DI NUTRIZIONE PARENTERALE ED ENTERALE. - ISSN 0393-5582. - STAMPA. - 21:(2003), pp. 112-117.
Anorexia and serum leptin in chronic hemodialysis patients
MUSCARITOLI, Maurizio;CASCINO, Antonia;ROSSI FANELLI, Filippo;
2003
Abstract
Background. Hyperleptinemia is a common feature in hemodialysis (HD) patients. The role of increased serum leptin levels in the pathogenesis of HD-related anorexia is, however, still controversial. The purpose of the present prospective study was to ascertain whether hyperleptinemia is casually implicated in the pathogenesis of HD-related anorexia. Methods. We measured serum leptin levels and the serum leptin/Body Mass Index (BMI) ratio in 24 healthy subjects and in 49 end-stage renal disease patients on maintenance HD. Results. HD patients were subdivided into anorexic (A) (14/49, 28.5%) and non-anorexic (NA) (35/49, 71.5%) according to a questionnaire discriminating for the presence of anorexia-related symptoms. Calorie (Kcal/kg/day) and protein (grams/kg/day) intakes were significantly lower in A than in NA patients (20.1±1.1 vs. 27.9±1.3, p=0.004 and 0.82±0.05 vs. 1.19±0.05, p=0.001, respectively). Accordingly, serum albumin, total lymphocytes count, mid arm muscle circumference, and the protein equivalence of nitrogen appearance (PNA) were significantly lower in A patients. Serum leptin concentration (ng/mL) was significantly higher in HD patients than in controls, both in males (15.33±3.4 vs. 3.7±0.3, p=0.003) and in females (42.31±7.2 vs. 10.5±1.3, p=0.03). Similarly, the serum leptin/BMI ratio was significantly higher in HD patients than in controls, both in males (0.56±0.1 vs. 0.16±0.02, p=0.0028) and in females (1.82±0.2 vs. 0.47±0.04, p<0.0001). However, serum leptin levels were similar in A and NA patients, whether male (15.3±5.6 vs. 16.9±4.2, p=0.85) or female (46.6±12.9 vs. 47.4±9.4, p=0.96). No differences were also observed between the two groups in the serum leptin/BMI ratio, either in males (0.59±0.2 vs. 0.58±0.14, p=0.92) or in females (1.58±0.4 vs. 1.83±0.3, p=0.94). No significant correlations were found between serum leptin levels and PNA, albumin, cholesterol, total lymphocytes number, weight change, C-reactive protein, fibrinogen, ferritin, and complement. Conclusions. The present results would indicate that mechanisms other than increases in serum leptin levels might be involved in the pathogenesis of HD-related anorexia.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
