Abstract
ABSTRACT Leptin potentially exerts atherogenic effects.This study evaluated the relationship between serum leptin levels and aortic stiffness in patients with stage 3–5 chronic kidney disease (CKD). Totally 205 participants were enrolled. Fasting blood sample were checked and serum leptin were measured by enzyme immunoassay. Aortic stiffness was measured as the carotid–femoral pulse wave velocity (cfPWV). 73 (35.6%) of 205 patients showed cfPWV >10 m/s were defined as aortic stiffness group. Compared with the remaining patients, the aortic stiffness group had high prevalence of diabetes mellitus, older age, higher waist circumference, body fat mass, systolic blood pressure, fasting glucose, and higher serum leptin level. In multivariable logistic regression analysis the independent predictors of cfPWV >10 m/s included leptin levels (odds ratio [OR]: 1.061, 95% confidence interval [CI]: 1.027–1.095, P < 0.001), age (OR: 1.064, 95% CI: 1.033–1.096, P< 0.001), and systolic blood pressure (OR: 1.021, 95% CI: 1.006–1.037, P = 0.006). Multivariable forward stepwise linear regression analysisshowed a positive association between log-transformed leptin levels and log-cfPWV (β = 0.192, adjusted R2 change = 0.042, P = 0.001). Thus, aortic stiffness is positively correlated with serum leptin levels in patients with stage 3–5 CKD. Abbreviations: BUN, blood urea nitrogen; cfPWV, carotid–femoral pulse wave velocity; CI, confidence interval; CKD, chronic kidney disease; Cre, creatinine; DBP, diastolic blood pressure; DM, diabetes mellitus; eGFR, estimated glomerular filtration rate; LDL-C, low-density lipoprotein cholesterol; OR, odds ratio; SBP, systolic blood pressure; TCH, total cholesterol; TG, triglycerides
Highlights
Cardiovascular disease is the primarily aetiology of mortality in chronic kidney disease (CKD) patients[1]
We found that there are three independent predictors of aortic stiffness: age (odds ratio (OR): 1.064, 95% confidence interval (CI): 1.033–1.096, P < 0.001), serum leptin level (OR: 1.061, 95% CI: 1.027–1.095, P < 0.001), and systolic blood pressure (SBP) (OR: 1.021, 95% CI: 1.006–1.037, P = 0.006) (Table 2)
Our results revealed among patients with stage 3–5 CKD, higher serum leptin levels, older age, and higher SBP were independent risk factors of aortic stiffness
Summary
Cardiovascular disease is the primarily aetiology of mortality in chronic kidney disease (CKD) patients[1]. Many clinical researches have reported poor kidney function and proteinuria are significantly related with cardiovascular disease, hospitalization, and mortality, independent of the traditional risk factors[2]. A recent study reported that arterial stiffening was associated with impaired renal function in CKD and that it was predictive of the progression of the kidney disease and of the patient’s cardiovascular outcome[6]. Mainly produced by adipose tissue, is a 167amino acid peptide hormone. It is primarily involved in the regulation of whole body energy homoeostasis and metabolism. Recent studies have suggested its role in increased cardiovascular risk associated with obesity.
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