Longitudinal Association between Serum Leptin Concentration and Glomerular Filtration Rate in Humans

PLoS One

Kushang V. Patel¹  Baback Roshanravan²  Luigi Ferrucci³  Raffaele Antonelli Incalzi⁴  Simone Scarlata⁴  Claudio Pedone⁴ 

[1]Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, United States of America

[2]Department of Medicine, Division of Nephrology, University of Washington—Kidney Research Institute, Seattle, Washington, United States of America

[3]Longitudinal Study Section, Clinical research Branch, National Institute of Aging, Baltimore, Maryland, United States of America

[4]Unit of Geriatrics, “Campus Biomedico” University, Rome, Italy

关键词: Leptin;    Obesity;    Renal system;    Diabetes mellitus;    Hypertension;    Glomerular filtration rate;    Cholesterol;    Chronic kidney disease;   

DOI  :  10.1371/journal.pone.0117828

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Background Obesity is a risk factor for decline in glomerular filtration rate (GFR). One proposed mechanism leading to glomerulopathy is an increase in leptin levels. However, the association between leptin and GFR has never been demonstrated. The aim of this study is to verify whether higher levels of leptin are associated with longitudinal changes of estimated GFR (eGFR). Methods and findings We selected 744 participants in the InCHIANTI study (416 women). The association between eGFR and leptin changes over a 6-years follow-up was assessed using random effect models including leptin as a time-varying covariate and adjusted for potential confounders. We also compared the proportion of patients with rapid decline of renal function across tertiles of change in serum leptin between baseline and 6-years follow-up. Mean baseline eGFR was 82.2 ml/min/1.73 m, 78.7 ml/min/1.73 m, and 75.4 ml/min/1.73 m in the first, second and third tertile of baseline serum leptin concentration, respectively. After adjustment for potential confounders, leptin concentration was inversely associated with changes of eGFR over time (β for log-leptin: -1.288, 95% CI: -2.079 – -0.497). Relative to baseline levels, the estimated change in eGFR for unit-increase in log-leptin was -1.9% (95% CI: -2.977 – -0.761). After stratification by sex, the results were confirmed in women only. In women we also found an association between increasing leptin concentration over time and rapid decline of renal function. Conclusions In women, serum leptin may contribute to eGFR decline independently from obesity and diabetes mellitus, although a cause-effect relationship cannot be established due to the observational nature of our study. A better characterization of adipokine profile of obese individuals may shed light on the accelerated renal function decline reported in a proportion of high-risk obese individuals.

【 授权许可】

CC BY