بررسی ارتباط لپتین سرم با شاخص‌های آزمایشگاهی و انتروپومتریک سوء تغذیه در بیماران تحت همودیالیز

  Background and Aim: Protein- energy malnutrition is a major problem and one of the risk factors in increasing mortality in hemodialysis patients. Since there is not any single index in the evaluation of nutritional status in these patients, leptin can be used as one of the parameters in this process. In this study, the correlation between serum leptin and biochemical and anthropometric parameters of malnutrition has been evaluated.   Patients and Methods: This cross- sectional study was performed on 60 hemodialysis patients(32 males and 28 females) in 2006. Patients with hemodialysis duration of less than one year, history of consumption of lipid reducing drugs or glucocorticoids or an infectious or inflammatory disease were excluded. Malnutrition laboratory parameters and serum leptin levels were measured before hemodialysis. Serum leptin was measured by ELISA method with direct dbc kit and malnutrition laboratory parameters were measured with standard laboratory methods patients anthropometric parameters were evaluated after hemodialysis. All of the measured datas were compared with serum leptin. The data were analyzed by SPSS V. 11.5. Parametric (T-test, ANOVA and Pearson Tests) and non-parametric (Spearman’s rho test, Mann Whitney test) tests were used for the evaluation of the results.   Results: The mean age of patients was 47.5±16.1 years and the range of serum leptin level was 0.6-64.8 ng/mL. Mean serum leptin level was 22.64±19.54 ng/ml in females and 16.74±20.16ng/ml in males on hemodialysis. Inspite of higher levels of leptin in females, there was not any statistically significant difference between females and males serum leptin. Absolute value of correlation coefficient of serum leptin with anthropometric parameters was lower than 0.25 (except height and weight in males which was between 0.25-0.50). It was also lower than 0.25 with most laboratory parameters (except ferritin, iron and phosphorous in males and total protein, hemoglobin, urea and creatinin in females which was between 0.25-0.50).   Conclusion: Our results suggest that increased serum leptin level does not have a major and first role in the cause and diagnosis of malnutrition in hemodialysis patients and there is a poor correlation between malnutrition parameters and serum leptin level.