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PLoS One. 2015 Feb 24;10(2):e0117828. doi: 10.1371/journal.pone.0117828. eCollection 2015.

Longitudinal association between serum leptin concentration and glomerular filtration rate in humans.

Author information

1
Unit of Geriatrics, "Campus Biomedico" University, Rome, Italy.
2
Department of Medicine, Division of Nephrology, University of Washington-Kidney Research Institute, Seattle, Washington, United States of America.
3
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, United States of America.
4
Longitudinal Study Section, Clinical research Branch, National Institute of Aging, Baltimore, Maryland, United States of America.
5
Unit of Geriatrics, "Campus Biomedico" University, Rome, Italy; "S. Raffaele-Cittadella della Carità" Foundation, Taranto, Italy.

Abstract

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.

PMID:
25710704
PMCID:
PMC4339378
DOI:
10.1371/journal.pone.0117828
[Indexed for MEDLINE]
Free PMC Article

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