IJCRR - Vol 07 Issue 04, February, 2015
PROTEIN ENERGY WASTING (PEW) / CACHEXIA IN CHRONIC KIDNEY DISEASE - ROLE OF LEPTIN AND INSULIN
Author: D. Ponnudhali, P. Nagarajan, R. Shankar
Background: The prevalence of protein energy wasting (PEW)/ cachexia is very high among patients with chronic kidney disease (PEW), increasing in severity with the progression of the disease. Among other factors, increased serum Leptin levels and insulin resistance have been implicated in the pathogenesis of PEW/cachexia in CKD
Aim and objectives: To assess the serum leptin & insulin levels along with HOMA IR (Homeostasis model assessment-Insulin Resistance) in non diabetic chronic kidney disease patients and to study the correlation of these parameters with glomerular filtration rate (GFR) & body mass index (BMI).
Materials and methods: Non-diabetic CKD patients (group1; n=45) and healthy non-diabetic individuals (group 2; n=45) with normal renal function were recruited for the study. Serum leptin and Insulin levels were assessed using ELISA kits. Calculated values of HOMA IR & BMI were taken for the analyses.Statistical analysis: The statistical analysis was done using SPSS version 16. The parameters were compared among the 2 groups using Independent t test and correlation coefficient.
Results: Serum Leptin levels (24.15 ± 17.44 ng/ml) were increased significantly (p=.000) in group 1 patients compared to those in group 2 (7.50 ± 1.28 ng/ml). Serum insulin levels (p=.000) were increased in CKD patients (15.49 ± 9.39 μU/ml) from that of the healthy controls (7.50 ± 1.28μU/ml). The HOMA IR was also significantly high (p=0.000) in the CKD group ( 3.69 ± 2.26) than the controls (1.69 ± 0.35). Leptin, insulin & HOMA IR showed a highly significant negative correlation with GFR & BMI .The serum albumin and total cholesterol in the CKD group were 3.20 ± 0.19 g/dl & 127.47 ± 31.75 mg/dl respectively.
Conclusion: Hyperleptinemia and insulin resistance may be responsible for protein energy wasting/cachexia associated with CKD.
Keywords: Leptin, protein energy wasting (PEW), Cachexia, Insulin resistance
D. Ponnudhali, P. Nagarajan, R. Shankar. PROTEIN ENERGY WASTING (PEW) / CACHEXIA IN CHRONIC KIDNEY DISEASE - ROLE OF LEPTIN AND INSULIN International Journal of Current Research and Review. Vol 07 Issue 04, February, 54-59
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