Serum leptin levels and malnutrition in patients with chronic renal failure

OBJECTIVE: To investigate the correlation between serum leptin levels, body mass index, and triceps skin fold thickness, which are anthropometric measurements, as well as serum albumin levels in patients with chronic renal failure on hemodialysis.

METHODS: We studied 75 patients (48 males, 27 females; ages between 18-82) at the Hemodialysis Unit, Cumhuriyet University Medical School; Private Sivas Dialysis Center; Hemodialysis Unit, Sultan Izzettin Keykavus Hospital; and the Hemodialysis Unit, SSK Sivas Hospital between January 2003 and February 2004. Patients were excluded if they had been on dialysis for less than one year, if they were anuric, or if they had been on dialysis with jugular or subclavian catheter and long-term permanent port catheter. Similarly, patients with diabetes mellitus, chronic pulmonary disorders, and hepatic cirrhosis or hepatitis B, hepatitis C carriers as well as those on active tuberculosis therapy were excluded. C-reactive protein was measured in all patients and those with above normal values were excluded.

RESULTS: While the mean age for the males was 44.52 ± 16.53 years (18-77), it was 48.29 ± 14.32 years (22-82) for the females. The mean triceps skin fold thickness for males was 6 ± 1.81 mm (3-11.3 mm), and for females, it was 14.07 ± 8.79 mm (4.3-33.3 mm). The mean body mass index for males was 20.77 ± 2.61 kg/m2 (14.8-26.6 kg/m2), and for females, it was 25.36 ± 6.47 kg/m2 (17.3-42.2 kg/m2). The mean serum leptin level for males was 4.61 ± 4.20 ngr/dl (0.1-18.7 ngr/dl), and for females, it was 52.06 ± 61.67 ngr/dl (0.6-172.5 ngr/dl). A positive correlation was observed between triceps skin fold thickness and leptin, both in the male group (r=0.478; p<0.05), and in the female group (r=0.876; p<0.05). Body mass index and leptin were also correlated positively both in the male group (r=0.502; p<0.05) and in the female group (r=0.905; p<0.05). No correlation was established between serum albumin levels and leptin. Leptin did not correlate with other measured parameters.

CONCLUSION: Our study demonstrates that serum leptin levels positively correlated with body mass index and triceps skin fold thickness, which are malnutrition parameters. Therefore, the leptin hormone may be utilized in obtaining preliminary information regarding malnutrition.