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Correlates of leptin in children with chronic kidney disease

Edward Nehus1, Susan Furth2, Bradley Warady3

  • 1Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

The Journal of Pediatrics
|July 29, 2014
PubMed

Insights

In children with chronic kidney disease (CKD), higher leptin levels are linked to obesity and older age, not kidney function. Adiposity is a key factor in elevated leptin in pediatric CKD patients.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Leptin, a hormone produced by adipocytes, plays a crucial role in regulating appetite and energy balance.
  • Children with chronic kidney disease (CKD) often exhibit altered metabolic profiles, including dysregulation of adipokines like leptin.
  • Understanding factors associated with leptin levels in pediatric CKD is essential for managing associated comorbidities.

Purpose of the Study:

  • To examine the relationship between serum leptin levels and renal function, obesity, and inflammation in children diagnosed with stages II-IV CKD.
  • To identify key determinants of elevated leptin in a pediatric CKD cohort.

Main Methods:

  • Cross-sectional analysis of 317 children with stage II-IV CKD from the Chronic Kidney Disease in Children study.
  • Linear regression models assessed associations between serum leptin and glomerular filtration rate (GFR), body mass index (BMI), age, sex, inflammatory markers, insulin resistance, and lipids.
  • GFR was determined using plasma iohexol disappearance curve measurements.

Main Results:

  • Serum leptin levels were significantly associated with increased BMI, older age, and female sex in univariate analyses.
  • Leptin correlated positively with triglycerides and insulin resistance, and negatively with high-density lipoprotein cholesterol.
  • No significant association was found between leptin levels and GFR or inflammatory cytokines. Multivariate analysis confirmed BMI, age, sex, and triglycerides as significant predictors of leptin.

Conclusions:

  • Adiposity, older age, and female sex are associated with increased leptin production in children with mild to moderate CKD.
  • Renal function, as measured by GFR, does not appear to be directly associated with elevated serum leptin levels in this pediatric population.
  • These findings suggest that factors related to obesity and demographic characteristics, rather than impaired renal clearance, primarily drive higher leptin levels in children with CKD.
Abstract

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