Are Ghrelin and Leptin Involved in Food Intake and Body Mass Index in Maintenance Hemodialysis?
published online 13 November 2009. Corrected Proof
Objectives
Both leptin and ghrelin (in the forms of acyl ghrelin and des-acyl ghrelin) are involved in food intake, and appear to be dysregulated in chronic kidney disease. This study describes plasma leptin, acyl, and des-acyl ghrelin concentrations in relation to protein intake and body mass index (BMI) in hemodialysis (HD) patients.
Design
This was a cross-sectional study.
Setting
This study was conducted during the baseline phase of the French multicenter Influence of a High-Flux Dialyzer on Long-Term Leptin Levels Study.
Patients
We studied 125 HD patients (aged 72.5±11.7 years; 59% males).
Main Outcome Measure
Blood samples were collected during fasting, and before a regular HD session. Plasma ghrelin and leptin were evaluated. The protein equivalents of total nitrogen appearance and BMI were calculated.
Results
Patients demonstrated elevated serum leptin (48.0±49.0 ng/mL) and des-acyl ghrelin (646.6±489.5 pg/mL) levels, and low acyl ghrelin levels (29.8±58.5 pg/mL), according to normal values. Acyl ghrelin was negatively correlated with C-reactive protein (r=−0.34, P < .001). The des-acyl to acyl ghrelin ratio was negatively correlated with protein intake, as estimated by normalized Protein Nitrogen Appearance (r=−0.22, P=.01). Serum leptin exhibited its well-described positive correlation with BMI and waist circumference, but the other hormones did not.
Conclusions
This study reports high des-acyl ghrelin and leptin levels and low acyl ghrelin levels in HD patients, a finding potentially associated with inflammation and food intake.
∗Department of Clinical Nutrition, Nutrition Faculty, Federal University Fluminense, Niterói, Brazil
†Department of Nephrology, Hôpital Edouard Herriot, and Institut National de la Santé et de la Recherche Médicale U870, University of Lyon 1, Lyon, France
‡Association Utilisation Rein Artificiel à Domicile Bordeaux, Bordeaux, France
§Department of Biochemistry, Centre Hospitalier et Universitaire Lyon Sud, Pierre Bénite, France
ABSTRACT