Hyperleptinemia positively associated with central arterial stiffness in hemodialysis patients

Chiu-Huang Kuo,Chung-Jen Lee,Hung-Hsiang Liou,Yu-Li Lin,Yu-Hsien Lai,Chih-Hsien Wang,Bang-Gee Hsu

doi:10.1371/journal.pone.0190694

Chiu-Huang Kuo, Chung-Jen Lee + Show 5 more

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https://doi.org/10.1371/journal.pone.0190694

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Abstract

ObjectiveLeptin plays a role in stimulating vascular inflammation, vascular smooth muscle hypertrophy, and augmenting blood pressure, which contributes to the pathogenesis of atherosclerosis and leads to arterial stiffness. This vascular damage, measured by carotid-femoral pulse wave velocity (cfPWV), is recognized as an independent predictor of cardiovascular mortality in hemodialysis (HD) patients. The aim of this study was to evaluate the relationship between serum leptin and arterial stiffness in HD patients.Patients and methodsIn 112 of the 126 HD patients were eligible and their biochemical data were collected for analysis. Serum leptin level was measured using a commercial enzyme-linked immunosorbent assay kit. Carotid-femoral pulse wave velocity was measured by a validated tonometry system (SphygmoCor). Those have cfPWV values above 10 m/s are defined as the high arterial stiffness group.ResultsAmong the participants, thirty-eight of them who were in the high arterial stiffness group, had a higher prevalence of diabetes mellitus (p = 0.002), age (p = 0.029), body mass index (BMI, p = 0.018), body fat mass (p = 0.001), hemoglobin (p = 0.040), and serum leptin levels (P<0.001). Multivariable logistic regression analysis showed that leptin (odds ratio [OR] 1.09; 95% confidence interval [CI] 1.04–1.14; p <0.001), diabetes (OR 7.17; CI 1.39–37.00; p = 0.019), body fat mass (OR 1.16; CI 1.02–1.33; p = 0.027); and hemoglobin (OR 2.11; CI 1.15–3.87; p = 0.015) were independently associated with arterial stiffness in HD patients.ConclusionIn our study, hyperleptinemia was positively correlated to the high cfPWV and thus was related to high arterial stiffness in HD patients.

Highlights

Advanced chronic kidney disease provides several mechanisms responsible for the exacerbation of cardiovascular disease, which includes the activation of the renin-angiotensin system, oxidative stress, elevated asymmetric dimethylarginine (ADMA), inflammation, dyslipidemia and vascular calcification
Thirty-eight of them who were in the high arterial stiffness group, had a higher prevalence of diabetes mellitus (p = 0.002), age (p = 0.029), body mass index (BMI, p = 0.018), body fat mass (p = 0.001), hemoglobin (p = 0.040), and serum leptin levels (P
Multivariable logistic regression analysis showed that leptin, diabetes, body fat mass; and hemoglobin were independently associated with arterial stiffness in HD patients

Summary

Introduction

Advanced chronic kidney disease provides several mechanisms responsible for the exacerbation of cardiovascular disease, which includes the activation of the renin-angiotensin system, oxidative stress, elevated asymmetric dimethylarginine (ADMA), inflammation, dyslipidemia and vascular calcification. Vascular calcification, caused by increased calcium and phosphate loading, can lead to arterial stiffness. Carotid and aortic stiffness independently predict death in adult patients with end-stage renal disease (ESRD) [1,2]. This accelerated cardiovascular disease accounted for more than one -half of death in these patients. It is important to explore this central arterial stiffness in ESRD patients. Carotid-femoral pulse wave velocity (cfPWV) is applied as one of the measurements for arterial stiffness and higher pulse wave velocity value predicts poor cardiovascular outcomes [3,4]

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