Relationship of leptin and insulin-like growth factor I to nutritional status in hemodialyzed children
| Autor: | Turgay Coşkun, Fatih Ozaltin, Sıla Özalp, U. Saatci, Aysin Bakkaloglu, Nesrin Besbas, A. Meguid El Nahas |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Leptin
Male Nephrology medicine.medical_specialty Adolescent medicine.medical_treatment Nutritional Status Renal function Anorexia Protein-Energy Malnutrition Blood Urea Nitrogen Body Mass Index Renal Dialysis Interquartile range Internal medicine Humans Insulin Medicine Insulin-Like Growth Factor I Child Anthropometry business.industry Body Weight Case-control study Skinfold Thickness Endocrinology Creatinine Pediatrics Perinatology and Child Health Arm Kidney Failure Chronic Female Hemodialysis medicine.symptom business Body mass index Biomarkers |
| Zdroj: | Pediatric Nephrology. 18:1255-1259 |
| ISSN: | 1432-198X 0931-041X |
| DOI: | 10.1007/s00467-003-1264-4 |
| Popis: | Malnutrition is prevalent in patients with end-stage renal disease (ESRD). Elevated serum leptin levels were thought to contribute to the anorexia and poor nutrition in renal failure. However, studies of the relationship between nutritional status and leptin concentration in chronic renal failure have yielded conflicting results. Plasma insulin-like growth factor I (IGF-I) level has been used as an indicator of nutritional status in patients with renal failure. The relationship between leptin and IGF-I is controversial. The present study was conducted with the aim of assessing the relationship between nutritional status, hyperleptinemia, and serum IGF-I. Seventeen ESRD patients (8 male, 9 female), aged 8-18 years (mean 15.3+/-3.3 years) and undergoing standard hemodialysis for 58.8+/-23.1 months were enrolled. Nine age-matched healthy children served as controls. In all patients, energy and protein intakes were 40-70 kcal/kg per day and 1-1.54 g/kg per day, respectively. Predialysis serum leptin and IGF-I levels were measured by radioimmunoassay. Body mass index was decreased in 13 (76%) patients. Triceps skinfold thickness (TST) was reduced (below the 5th percentile) in 7 (41%), whereas mid arm circumference and mid arm muscle circumference were reduced in 14 (82.5%) and 13 (76.5%), respectively. The median serum leptin level was significantly higher in patients than in controls [13.7 interquartile range (IQR) 30.50 pg/ml vs. 6.50 IQR 8.65 pg/ml, P=0.01]. The median serum IGF-I level was lower in the patients (205.1 ng/ml IQR 194.4 ng/l) than controls (418.0 ng/l IQR 310.5 ng/ml) ( P=0.01). IGF-I levels were more decreased in patients with severe malnutrition, defined according to TST (145.0 ng/ml IQR 125.5 ng/l) than patients without malnutrition (301.2 ng/l IQR 218.8 ng/ml) ( P=0.03) and healthy children ( P=0.002). Although statistically not significant, IGF-I levels tended to be decreased, while leptin levels were increased. The median plasma insulin concentration was 15 microU/ml (1.63-45.80) and did not correlate with leptin and IGF-I levels. In conclusion, the results of this study confirm the presence of high circulating plasma leptin levels, which may be one of the many factors involved in the pathogenesis of the malnutrition in children on hemodialysis. |
| Databáze: | OpenAIRE |
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