Adiponectin, resistin and leptin in paediatric chronic renal failure: correlation with auxological and endocrine profiles

作者：Maggio Maria Cristina^*; Montaperto Daniela; Maringhini Silvio; Corrado Ciro; Gucciardino Eleonora; Corsello Giovanni

来源：Journal of Nephrology, 2014, 27(3): 275-279.

DOI：10.1007/s40620-013-0015-2

• Chronic renal failure
• Adipokines
• Leptin
• Adiponectin
• Resistin
• HOMA-IR

Introduction Chronic renal failure (CRF) compromises nutrition, growth, puberty, glycometabolic homeostasis, and adipokine secretion (i.e. adiponectin, resistin, and leptin). Adipokines play a role in the clinical outcome, but data in paediatric patients is scant. %26lt;br%26gt;Aim To evaluate the link between kidney function, adiponectin, resistin, leptin, hormonal status, nutritional state and late outcome of CRF children. %26lt;br%26gt;Materials and methods We studied leptin, adiponectin and resistin levels in 31 CRF patients (19 males, 12 females, aged 12.1 +/- A 4.47 years) managed conservatively, and 30 healthy age- and gender-matched controls. Clinical, auxological, biochemical, hormonal data, glucose and insulin levels were correlated with adipokine levels. %26lt;br%26gt;Results Six percent of patients had glycaemia T0%26apos; %26gt; 126 mg/dl, 23 % glycaemia T60%26apos; %26gt; 126, and 23 % glycaemia T120%26apos; %26gt;= 140. Glycated haemoglobin (HbA1c) measured during follow-up was in the normal range in all patients (4-5.6 %). Insulinaemia was significantly higher in CRF patients than controls. Homeostatic model of assessment-insulin resistance (HOMA-IR) levels were more elevated in patients (32 % had HOMA-IR %26gt; 2.5) than controls. Leptin levels were significantly higher in CRF patients than controls and differed significantly between males and females. Leptin correlated significantly with creatinine, body mass index (BMI), BA, pubertal stage, insulin-like growth factor 1, and HOMA-IR in females. Adiponectin levels were significantly higher in patients than controls, higher in patients with BMI %26lt; 85th centile and significantly inversely correlated to BMI, BA, haemoglobin, ferritin, proteins, albumin, and creatininuria. Resistin levels showed a direct correlation with C-reactive protein and an inverse correlation with haemoglobin. %26lt;br%26gt;Conclusion Normal resistin levels are an expression of both adequate nutritional state and controlled inflammatory state. Adiponectin could protect against chronic inflammation, atherosclerosis, and cardiovascular diseases. Preventing obesity and ensuring a correct nutritional state are primary goals for physicians following children with CRF. Adipokines could be a useful marker in the follow-up.

• 出版日期2014-6