TY - JOUR
T1 - Increased plasma leptin concentration in end-stage renal disease
AU - Merabet, Eddine
AU - Dagogo-Jack, Samuel
AU - Coyne, Daniel W.
AU - Klein, Samuel
AU - Santiago, Julio V.
AU - Hmiel, S. Paul
AU - Landt, Michael
PY - 1997
Y1 - 1997
N2 - Leptin is a 16-kDa protein recently identified as the obese gene product involved in body weight regulation. Administration of recombinant leptin to ob/ob mice, which have a genetic defect in leptin production, reduces food intake and increases energy expenditure. Leptin is synthesized by fat cells, and in normal humans, plasma concentrations are proportional to adiposity. The physiological actions and the degradation pathways of leptin in humans are unknown. We investigated renal elimination of leptin by comparing plasma leptin concentrations in end-stage renal disease (ESRD) patients with normal controls. Our hypothesis was that if renal filtration is a significant route of elimination, the hormone would accumulate in ESRD patients. Mean plasma levels in 141 ESRD patients (26.8 ± 5.7 and 38.3 ± 5.6 μg/L for males and females, respectively) were significantly higher (P < 0.001) than mean values obtained in normal controls (11.9 ± 3.1 and 21.2 ± 3.0 μg/L for males and females, respectively). Leptin concentrations in ESRD patients correlated directly with body mass index (BMI, r = 0.77 for men and 0.78 for women). The rate of increase in leptin concentrations with BMI was significantly greater in ESRD patients (5.5 and 6.6 μg/L/U BMI for men and women, respectively) than in normal controls (1.4 and 2.6 μg/L/U for men and women, respectively). Pre- and postdialysis leptin levels in hemodialysis patients were similar. Western blot of plasma from ESRD patients with high leptin levels showed bands corresponding to the intact protein (16 kDa) with no lesser or greater molecular mass species observed. Leptin concentrations in patients with ESRD did not correlate with measures of residual renal function (serum creatinine, β2-microglobulin, PTH, or GH levels). Similarly, we found no correlation between leptin levels and the number of years patients had been on dialysis or with recent weight changes. We conclude that intact leptin is increased in ESRD patients, but does not appear to cause decreased weight. As leptin levels did not correlate with residual renal function, increased production may account for the high levels observed.
AB - Leptin is a 16-kDa protein recently identified as the obese gene product involved in body weight regulation. Administration of recombinant leptin to ob/ob mice, which have a genetic defect in leptin production, reduces food intake and increases energy expenditure. Leptin is synthesized by fat cells, and in normal humans, plasma concentrations are proportional to adiposity. The physiological actions and the degradation pathways of leptin in humans are unknown. We investigated renal elimination of leptin by comparing plasma leptin concentrations in end-stage renal disease (ESRD) patients with normal controls. Our hypothesis was that if renal filtration is a significant route of elimination, the hormone would accumulate in ESRD patients. Mean plasma levels in 141 ESRD patients (26.8 ± 5.7 and 38.3 ± 5.6 μg/L for males and females, respectively) were significantly higher (P < 0.001) than mean values obtained in normal controls (11.9 ± 3.1 and 21.2 ± 3.0 μg/L for males and females, respectively). Leptin concentrations in ESRD patients correlated directly with body mass index (BMI, r = 0.77 for men and 0.78 for women). The rate of increase in leptin concentrations with BMI was significantly greater in ESRD patients (5.5 and 6.6 μg/L/U BMI for men and women, respectively) than in normal controls (1.4 and 2.6 μg/L/U for men and women, respectively). Pre- and postdialysis leptin levels in hemodialysis patients were similar. Western blot of plasma from ESRD patients with high leptin levels showed bands corresponding to the intact protein (16 kDa) with no lesser or greater molecular mass species observed. Leptin concentrations in patients with ESRD did not correlate with measures of residual renal function (serum creatinine, β2-microglobulin, PTH, or GH levels). Similarly, we found no correlation between leptin levels and the number of years patients had been on dialysis or with recent weight changes. We conclude that intact leptin is increased in ESRD patients, but does not appear to cause decreased weight. As leptin levels did not correlate with residual renal function, increased production may account for the high levels observed.
UR - http://www.scopus.com/inward/record.url?scp=0031017938&partnerID=8YFLogxK
U2 - 10.1210/jc.82.3.847
DO - 10.1210/jc.82.3.847
M3 - Article
C2 - 9062494
AN - SCOPUS:0031017938
SN - 0021-972X
VL - 82
SP - 847
EP - 850
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 3
ER -