Abstract
Background. Hypoalbuminemia strongly predicts death in hemodialysis patients and results from both inflammation and malnutrition. One potential link between malnutrition and inflammation is appetite suppression triggered by inflammation. Leptin is secreted by adipose tissue and suppresses appetite, and it is also a positive acute phase protein in the rat. Factored for body weight, leptin is known to be increased in hemodialysis patients, but its relationship to inflammation is unknown. Methods. We examined the relationship between spontaneously occurring activation of the acute phase response and leptin levels in 29 chronic hemodialysis patients. Serum samples were obtained three times weekly for six weeks and then monthly from 29 chronic hemodialysis patients, and the levels of the positive acute phase proteins [C-reactive protein (CRP), α1-acid glycoprotein (α1 AG), serum amyloid A, ceruloplasmin] and the negative acute phase proteins (albumin and transferrin) as well as leptin and interleukin-6 (IL-6) were measured. Results. Positive and negative acute phase proteins were evaluated at the maximum CRP (mean, 9.42 ± 1.14 mg/dL) and minimum values (mean, 0.41 ± 0.09 mg/dL). When CRP was elevated, leptin levels were significantly reduced, as were the negative acute phase proteins albumin and transferrin. Serum amyloid A, ceruloplasmin, α1 acid glycoprotein, and IL-6 were all significantly increased at the maximum CRP level, compatible with general activation of the acute phase response. The change in leptin correlated negatively with the change in CRP (R = 0.437, P = 0.018), as did changes in albumin (R = 0.620, P < 0.001). Conclusions. Leptin is not increased as a consequence of inflammation in hemodialysis patients, but behaves as a negative rather than as a positive acute phase protein. Inflammation is unlikely to reduce appetite in dialysis patients through a leptin-mediated mechanism.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1114-1120 |
| Number of pages | 7 |
| Journal | Kidney International |
| Volume | 59 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2001 |
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Keywords
- α1-acid glycoprotein
- Albumin
- C-reactive protein
- Ceruloplasmin
- Cytokines
- Inflammation
- Interleukin-6
ASJC Scopus subject areas
- Nephrology
Cite this
Leptin is a negative acute phase protein in chronic hemodialysis patients. / Don, Burl R; Rosales, L. M.; Levine, N. W.; Mitch, W.; Kaysen, George.
In: Kidney International, Vol. 59, No. 3, 2001, p. 1114-1120.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Leptin is a negative acute phase protein in chronic hemodialysis patients
AU - Don, Burl R
AU - Rosales, L. M.
AU - Levine, N. W.
AU - Mitch, W.
AU - Kaysen, George
PY - 2001
Y1 - 2001
N2 - Background. Hypoalbuminemia strongly predicts death in hemodialysis patients and results from both inflammation and malnutrition. One potential link between malnutrition and inflammation is appetite suppression triggered by inflammation. Leptin is secreted by adipose tissue and suppresses appetite, and it is also a positive acute phase protein in the rat. Factored for body weight, leptin is known to be increased in hemodialysis patients, but its relationship to inflammation is unknown. Methods. We examined the relationship between spontaneously occurring activation of the acute phase response and leptin levels in 29 chronic hemodialysis patients. Serum samples were obtained three times weekly for six weeks and then monthly from 29 chronic hemodialysis patients, and the levels of the positive acute phase proteins [C-reactive protein (CRP), α1-acid glycoprotein (α1 AG), serum amyloid A, ceruloplasmin] and the negative acute phase proteins (albumin and transferrin) as well as leptin and interleukin-6 (IL-6) were measured. Results. Positive and negative acute phase proteins were evaluated at the maximum CRP (mean, 9.42 ± 1.14 mg/dL) and minimum values (mean, 0.41 ± 0.09 mg/dL). When CRP was elevated, leptin levels were significantly reduced, as were the negative acute phase proteins albumin and transferrin. Serum amyloid A, ceruloplasmin, α1 acid glycoprotein, and IL-6 were all significantly increased at the maximum CRP level, compatible with general activation of the acute phase response. The change in leptin correlated negatively with the change in CRP (R = 0.437, P = 0.018), as did changes in albumin (R = 0.620, P < 0.001). Conclusions. Leptin is not increased as a consequence of inflammation in hemodialysis patients, but behaves as a negative rather than as a positive acute phase protein. Inflammation is unlikely to reduce appetite in dialysis patients through a leptin-mediated mechanism.
AB - Background. Hypoalbuminemia strongly predicts death in hemodialysis patients and results from both inflammation and malnutrition. One potential link between malnutrition and inflammation is appetite suppression triggered by inflammation. Leptin is secreted by adipose tissue and suppresses appetite, and it is also a positive acute phase protein in the rat. Factored for body weight, leptin is known to be increased in hemodialysis patients, but its relationship to inflammation is unknown. Methods. We examined the relationship between spontaneously occurring activation of the acute phase response and leptin levels in 29 chronic hemodialysis patients. Serum samples were obtained three times weekly for six weeks and then monthly from 29 chronic hemodialysis patients, and the levels of the positive acute phase proteins [C-reactive protein (CRP), α1-acid glycoprotein (α1 AG), serum amyloid A, ceruloplasmin] and the negative acute phase proteins (albumin and transferrin) as well as leptin and interleukin-6 (IL-6) were measured. Results. Positive and negative acute phase proteins were evaluated at the maximum CRP (mean, 9.42 ± 1.14 mg/dL) and minimum values (mean, 0.41 ± 0.09 mg/dL). When CRP was elevated, leptin levels were significantly reduced, as were the negative acute phase proteins albumin and transferrin. Serum amyloid A, ceruloplasmin, α1 acid glycoprotein, and IL-6 were all significantly increased at the maximum CRP level, compatible with general activation of the acute phase response. The change in leptin correlated negatively with the change in CRP (R = 0.437, P = 0.018), as did changes in albumin (R = 0.620, P < 0.001). Conclusions. Leptin is not increased as a consequence of inflammation in hemodialysis patients, but behaves as a negative rather than as a positive acute phase protein. Inflammation is unlikely to reduce appetite in dialysis patients through a leptin-mediated mechanism.
KW - α1-acid glycoprotein
KW - Albumin
KW - C-reactive protein
KW - Ceruloplasmin
KW - Cytokines
KW - Inflammation
KW - Interleukin-6
UR - http://www.scopus.com/inward/record.url?scp=0035096596&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035096596&partnerID=8YFLogxK
U2 - 10.1046/j.1523-1755.2001.0590031114.x
DO - 10.1046/j.1523-1755.2001.0590031114.x
M3 - Article
C2 - 11231368
AN - SCOPUS:0035096596
VL - 59
SP - 1114
EP - 1120
JO - Kidney International
JF - Kidney International
SN - 0085-2538
IS - 3
ER -