Abstract: SA-PO164

Low Leptin Level Is Associated with Poor Nutritional Status in ESRD

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Lee, Jun young, Wonju christian severance hospital, Wonju, Kangwon do, Korea (the Republic of)
  • Kim, Jae seok, Yonsei wonju college of medicine, Won-ju, Korea (the Republic of)
  • Yang, Jae Won, Wonju Christian Hospital, Wonju, GangWon-Do, Korea (the Republic of)
  • Choi, Seung-Ok, Yonsei University Wonju College of Medicine, Wonju, Kangwon, Korea (the Republic of)
  • Han, Byoung Geun, None, Wonju, Korea (the Republic of)
Background

Poor nutritional status is associated with poor prognosis in end stage renal disease (ESRD) patients. Bio-impedance spectroscopy (BIS) is a useful method to estimate body fluid and nutritional status. Particularly, phase angle (PhA, °) is a parameter that represents nutritional status well. In the study, we aim to identify factors related to nutritional status in ESRD patients not undergoing dialysis.

Methods

We enrolled total 91 ESRD patients not undergoing dialysis. We measured routine serum markers including albumin and NT-proBNP, and appetite regulating hormones, leptin and ghrelin. With BIS, we measured OH (overhydration, liter) and OH/ECW (OH/extracellular water ratio) values to estimate body fluid amounts, and PhA to determine nutritional status. We defined poor nutritional status as a PhA <4.5°, and proper nutritional status as a PhA ≥4.5°. Lastly, we evaluated patient’s nutritional status by assessing geriatric nutritional risk index (GNRI).

Results

Forty-one patients (45%) had poor nutritional status. The patients with poor nutrition, compared to proper nutrition, had significantly higher levels of NT-proBNP (14,477.8±12,712 vs. 4,965.2±8,824 pg/mL, p<0.001) and OH/ECW (29.6±12.7 vs. 6.2±10.3 %, p<0.001), and lower levels of albumin (3.0±0.5 vs. 3.7±0.5 g/dL, p<0.001), leptin (3.8±3.1 VS. 7.0±6.2 ng/mL, p=0.004) and GNRI (85.1±7.1 vs. 96.5±7.7, p<0.001). In Pearson’s correlation test, leptin had negative correlations with NT-proBNP (r= -0.237, p=0.026) and OH/ECW (r= -0.288, p=0.006). On the contrary, leptin had positive correlations with BMI (r=0.351, p=0.001), PhA (r=0.263, p=0.012) and GNRI (r=0.281, p=0.007). In multivariate logistic regression test, high level of leptin (OR 6.12, 95% CI 1.01-37.13) and albumin (OR 10.14, 95% CI 1.51-68.20) predicted proper nutrition well, while increased level of NT-proBNP (OR 0.07, 95% CI 0.01-0.84) and OH/ECW (OR 0.04, 95% CI 0.01-0.19) were related to poor nutrition.

Conclusion

Our study demonstrates that ESRD patients with poor nutrition generally have a problem of excessive body fluid as well. Leptin is well correlated positively with nutritional status. Low leptin level suggests poor nutrition in ESRD patients. We believe that these relationships may be due to a counter-regulatory mechanism of leptin to nutritional status as an appetite suppressing hormone.