Relationship between serum leptin level and cardiovascular, nutrtional risk factors in non-diabetic hemodialysis.

Abstract

Many studies showed that obesity was associated with high level of serum leptin, hyperhomocysteinemia, and insulin resistance in general population. Obesity is associated with various cardiovascular and metabolic complications. However, in end stage renal failure, it has been reported that obesity is associated with a favorable survival of patients. The purpose of this observational study was to investigate the relationship between serum leptin level increased at obesity and cardiovascular, nutritional traditional markers, and the comparison of patient’s survival for 5 years according to obesity in non-diabetic hemodialysis. A cross-sectional study was performed in obese and non-obese subjects according to body mass index. Fifteen obese patients (BMI≥25 kg/m2) and 29 non-obese patients (BMI<25 kg/m2) were studied. For each subject, blood was sampled for measurement of serum leptin, insulin resistance, C-reactive protein (CRP) and nutritional parameters before hemodialysis. Insulin resistance was calculated by HOMA-IR. Linear regression analysis was performed to determine the relationship among insulin resistance, serum leptin level and nutritional parameters. In results, serum leptin level was significant positive correlated with BMI, nPCR, pre-albumin and HOMA-IR (p<0.05). Serum leptin level was significant negative correlated with tCO2 and CRP (p<0.05). Five years survival by Kaplan-Meier analysis was more favorable in obese group but did not show statistical significance (p=0.053). In conclusion, serum leptin level was associated with obesity and good nutrition status. But in view of positive correlation of HOMA-IR, serum leptin level may be associated with cardiovascular complication in non-diabetic hemodialysis patients. Therefore, we thought that serum leptin level may be a good nutritional marker and a cardiovascular risk factor. We thought that the further study for the proper leptin level will be needed and help the improvement of survival in non-diabetic hemodialysis patients.