The Changes Of Serum And Urinary Leptin Levels In Uremic Patients And The Correlativity Analysis

The Changes of Serum and Urinary Leptin Levels in UremicPatients and the Correlativity AnalysisAbstractObjective:1.To study serum leptin concentrations in undialysed uremic patients, and the relationship between serum leptin level and renal function , body mass index (BMI) and gender.2.To study the urinary leptin concentrations in healthy control and undialysed uremic patients and the relationship between urinary leptin concentration and serum leptin concentration. To study the relationship between urinary leptin concentration and amount of urinary protein in 24 hours, urinary C3, a 2-rnicroglobulin( a 2-M) and Lysozyme(LYZ) conentrations in uremic patients.Methods:1. Part 1(1)We studied 46 undialysed uremic patients (24 males, 22 females, mean age 43.3?0.0 years). Their creatinine clearance rate (Ccr) was 8.33?.39mlImin. There were 32 healthy people (16 males, 16 females, mean age 44.6?0.3 years) for control. The BMI of all subjects were from 16.5 to 25.5 kg/rn2 . There were no difference between controls and patients in BMI and age.(2)The serum leptin level was detected by ELISA.(3)The BMI, fat percentage (%Fat), body weight, upper arm circumference, skin-fold depth on musculus deltoideus were measured in all subjects.(4)The serum potassium, serum sodium, serum chlorinum, Ccr, BUN,UA were detCcted in uremic patients.(5) The plasma insulin concentration was detected in uremic patients.2 Part 2(l) 24 tmdialysed uremic patients (l2 males, l2 females, mean age43.6t8.l years) were studied. Their Ccr was 7.75l7.30 ml/min. There were22 healthy people (l2 males, l2 females)for control. Their mean age was44.bel0.6 years.(2) The serum and urinary leptin levels were detected by ELISA.(3) The urinary protein arnount in 24 hours, and urinary Q 2-M, urinaryCa and urinmp LYZ concelltTations in patienis were detected.3. Statistical analysis was performed by using the softwar packages ofSPSS 10.0.Results:l. The serum lePtin concentration in undialysed uremic patients wasl2.976l9.752ng/ml, significantly higher than that in healthy controls(5. l48t3.398ng/ml, P=0.000).2. It was fOund that the serum leptin level was strongly positivecorrelation with BMI and %Fat(r=0.62l, P=0.000; and rr0.525, P=0.000,resPectively). Meanwhile the serum leptin levels significanly correlated withbody weight, uPper arm circumference, skin-fold depth on musculusdeltoideus.3. The serum leptin levels in uremic patients were not correlation withCcr, SCr, BUN and UA.4. The serum leptin levels in female uremic patients(15.090tl0.654ng/ml) were significantly higher than that in male uremic patients(l l .038t8.6l6ng/ml, P=0.0l4) after excluding the influence of BMI.- 7 -5. The sean leptin levels in uremic patientS were inverse correlation(r=-0.462, P=0.035) with high insulin concentrations.6. There were significamly positive correlation betWeen serum leptinlevels and serum sodium concentrations (re0.354, P=0.0l6). and not wthserum potassium concentrations and arterial bIood pH value.7. The mean urinary leptin concentraions in uremic patients was 0.297t0.287ng/ml that it was sigrtificantly higher than that in healthy controls(0.026 l 0.0l9ng/ml, P=0.000).8. There were significantly positive correlation between the urinaryleptin levels in uremic patients and urinary protein axnowt in 24 hours(re0.542, P=0.008), urinare C3 concentrations(pe0.574, P=0.003) and urinaryLyZ concentrations (re0.497, P=0.0l3).ConcIusion:l. There was a hyPerlePtinemia in tmdialyed uremic patients.2. There was a significantly correlation betwCen serm leptin levels andthe body fat coulent in uremic patients. Serum leptin level could serve as auseful clinical marker of body fat content in uremic patients.3. The serum leptin levels in female uremic patients were higher thanthat in male uremic patients. The influence of gender on serum leptin levels isindependent of BMl.4. The serum leptin levels were no...