Leptin Parameters are Associated with Inflammation and Both Anthropometric and Serum Markers of Protein-Energy Wasting in Hemodialysis Patients

Abstract

OBJECTIVE: Protein-energy wasting (PEW) and inflammation are common and related to increased cardiovascular mortality in hemodialysis (HD) patients. Herein, we aimed to investigate the relationships between adipocytokines, inflammation and serum and anthropometric markers of PEW syndrome in HD patients. MATERIAL and MET HODS : Seventy-four HD patients (mean age=62 +/- 13 years, male/female= 44/30) were enrolled. Serum leptin, adiponectin and IL-6 levels were measured by ELISA. Anthropometric measurements such as triceps skin fold thickness (TSFT), mid-arm circumference (MAC) were performed. Bioelectrical impedance analysis was also done. The degree of malnutrition was evaluated with subjective global assessment (SGA). RESULTS : The leptin/fat ratio was associated with serum IL-6 (r= 0.32, p= 0.008), serum albumin (r= -0.37, p= 0.002) and TSFT (r= -0.41, p= 0.001). Serum adiponectin levels were positively correlated with serum albumin (r= 0.29, p= 0.01) and negatively associated with the leptin/fat ratio (r= -0.30, p= 0.01). Serum CRP levels were significantly lower in the high adiponectin group (1.20 +/- 0.92 vs 2.02 +/- 2.18 mu g/mL, p= 0.042). On linear regression analysis for predicting the leptin/fat ratio, gender and serum albumin were retained as significant in the model. CONCLUSION: Serum leptin parameters are associated with inflammation and both anthropometric and serum markers of protein-energy wasting. Adipocytokines may be the link between PEW and inflammation in uremia.