leptin and Glomerulonephritis--IGA

This study was conducted to examine the effects of weight reduction on proteinuria, adipokines, and renal function in overweight immunoglobulin A nephropathy (IgAN) patients (body mass index > 23 kg/m2) with chronic proteinuria more than 6 months.. This was a single-center, prospective, randomized controlled trial. The study was performed at the outpatient clinic at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from July 2012 to February 2013.. Twenty-six overweight patients with chronic proteinuric biopsy-proven IgAN were randomized into a control group (n = 13) or a low-calorie normal protein diet group (n = 13). All patients received the maximum dosage of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and other antihypertensive agents to achieve a blood pressure less than 125/75 mmHg.. The study intervention was a low-calorie diet (target energy per day as 500-kcal subtraction from total energy requirement) for a 6-month period.. At baseline and after 6 months of a low-calorie diet, body weight, body content, and clinical and laboratory parameters were determined and compared.. After initiating a low-calorie diet for 6 months, the normalized protein nitrogen appearance values were not different, indicating comparable protein intake. The low-calorie group had lower total daily calorie intake (1,307.1 ± 171.8 vs. 1,772.2 ± 315.4 kcal/d, P < .01) and significant reductions in body weight (-5.1 ± 3.3%, P < .001), fat content (-12.7 ± 14.1%, P < .05), and 24-hour urine protein (-45.2 ± 15.4%, P < .001). Blood pressure and renal function parameters were unaltered. The low-calorie group had approximately 20% lower plasma levels of leptin but unchanged adiponectin. There were positive correlations between the amount of protein reduction and the changes of body weight, fat mass, and leptin.. A 6-month low-calorie diet leads to weight reduction and results in diminished fat content and decreased proteinuria in overweight IgAN patients with chronic proteinuria. This beneficial effect might be mediated by changes in adipokines.

Topics: Adiponectin; Adult; Blood Pressure; Body Composition; Caloric Restriction; Dietary Proteins; Female; Glomerulonephritis, IGA; Humans; Leptin; Male; Middle Aged; Overweight; Prospective Studies; Proteinuria; Thailand; Weight Loss

To explore the change of serum leptin level and its clinical significance in the patients with IgA nephropathy.. A total of 40 IgA nephropathy patients were divided into group A (unnecessary for hemodialysis regimen) and B group (requisite for hemodialysis regimen). Other 20 healthy people for health examination homeochronously in our hospital were used as the control group (C group). The radioimmunoassay(RIA) was performed to detect the serum leptin contents of all the individuals and to analyze its clinical significance.. The mean serum concentrations (MSCs) of A, B and C group were (4.98 ± 0.78) μg/L, (6.45 ± 0.76) μg/L and (3.96 ± 0.56) μg/L, respectively. And the MSCs before and after dialysis of group B patients were (6.50 ± 0.86) μg/L and (5.21 ± 0.66) μg/L, respectively. Statistical analysis indicated that the MSCs of group A and B were significantly higher than that of group C, and group B was obviously higher than that of group A (P<0.05). The MSC before dialysis was statistically higher than that after dialysis in group B (P<0.05).. The serum leptin was significantly increased in IgA nephropathy patients, which may be significant in the progression of IgA nephropathy.

Topics: Adolescent; Adult; Disease Progression; Female; Glomerulonephritis, IGA; Humans; Leptin; Male; Middle Aged; Renal Dialysis; Young Adult

Resistin is a newly discovered insulin inhibitor secreted by adipocytes. We explored the potential role of resistin in the pathophysiological process of insulin resistance encountered in patients with renal disease.. Resistin blood concentrations, insulin sensitivity index (by intravenous glucose tolerance test), and glomerular filtration rate (GFR; by inulin clearance) were assessed in 30 male patients with immunoglobulin A glomerulonephritis in different stages of renal disease.. Patients with increased resistin blood concentrations had more advanced renal failure and were significantly older. Plasma resistin levels correlated significantly with GFR (r = -0.82; P < 0.0001), plasma homocysteine concentration (r = 0.68; P < 0.001), and age (r = 0.42; P = 0.05), but not with fasted plasma insulin (r = -0.34; P = 0.12), glucose (r = 0.25; P = 0.19), and leptin (r = -0.24; P = 0.21) concentrations; body mass index (r = -0.06; P = 0.75), waist-hip ratio (r = 0.09; P = 0.63), or insulin sensitivity (r = -0.05; P = 0.79). In multiple regression analysis, GFR was the only independent predictor of plasma resistin concentrations in renal patients (r = -0.812; P < 0.0001).. Resistin blood concentrations increase with progressive impairment of renal function. Thus, the kidney seems to be an important site of resistin elimination. However, the greater than 5-fold increase in resistin blood levels apparently is not associated with deterioration in insulin sensitivity in patients with renal disease.

Topics: Adipocytes; Adult; Biomarkers; Blood Glucose; Body Mass Index; Glomerular Filtration Rate; Glomerulonephritis, IGA; Glucose Tolerance Test; Hormones, Ectopic; Humans; Insulin Resistance; Kidney; Kidney Failure, Chronic; Leptin; Lipids; Male; Predictive Value of Tests; Resistin