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Published on: January 29, 2018
Correlation between serum leptin and bone mineral density in hemodialysis patients
Mahin Ghorban-Sabbagh1, Fatemeh Nazemian2, Massih Naghibi2
1Kidney Transplantation Complications Research Center, Montaseriyeh Organ Transplantation Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Serum leptin influences bone density in hemodialysis patients, showing a bimodal effect. Further research into cortical bone assessment is recommended for improved diagnostics.
Area of Science:
- Nephrology
- Endocrinology
- Bone Metabolism
Background:
- Bone biopsies are invasive for diagnosing bone lesions in hemodialysis (HD) patients.
- HD patients have an 80-fold higher hip fracture rate and doubled mortality.
- Current alternative markers for bone density lack definitive selection.
Purpose of the Study:
- To investigate serum leptin as a potential marker for bone density in HD patients.
- To confirm or refute the proposed role of serum leptin in bone density assessment.
Main Methods:
- 104 hemodialysis patients (53.8% male, 46.2% female, avg age 38.28±7.89) were enrolled.
- Assessed serum leptin, bone alkaline phosphatase, iPTH, 25(OH)D, calcium, phosphorus, and BMD (femoral neck, lumbar spine via DXA).
Main Results:
- No direct correlation found between serum leptin and BMD Z-scores.
- A threshold of 25 ng/mL for serum leptin was identified in this cohort.
- Leptin demonstrated a negative effect on bone mass below 25 ng/mL and a positive effect above this threshold.
Conclusions:
- Serum leptin exhibits a bimodal effect on bone mass in HD patients.
- Cortical bone assessment may offer a more effective approach for evaluating bone health in this population.
Introduction:
For diagnosing of specific types of bone lesions in hemodialysis (HD) patients, it is necessary to conduct a bone biopsy as the gold standard method. However, it is an invasive procedure. While different markers have been suggested as alternative methods, none of them has been selected. The frequency of hip fractures is 80 fold in HD patients who have two-fold mortality as compared with general population.
Objectives:
Recently, serum leptin has been suggested as a bone density marker. This study tries to confirm this proposal.
Patients And Methods:
In this study about 104 HD patients (53.8% male and 46.2% female) were enrolled. The average age was 38.28±7.89 years. Serum leptin, bone alkaline phosphatase, intact parathyroid hormone (iPTH), 25(OH)D, calcium, phosphorus and bone mineral density (BMD) (at the femoral neck and lumbar spine, as measured by dual-energy x-ray absorptiometry [DXA]) were assessed.
Results:
Analysis by polynomial regression revealed no correlation between BMD Z-score at two points and serum leptin level. According to the thresholds of 25 ng/mL and 18-24 ng/mL in some studies, we detected 25 ng/mL as the threshold in our patients. Under this threshold, the leptin effect on bone mass was negative, and above the threshold of 25 ng/mL, we found leptin had positive effect on bone mass.
Conclusion:
In this investigation, we found, leptin has a bimodal effect on bone mass. Cortical bones assessment may be a better option for assessment.
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