Dialysis – Transplantation
Kidney International (1998) 54, 932–937; doi:10.1046/j.1523-1755.1998.00041.x
Acute leptin regulation in end-stage renal failure: The role of growth hormone and IGF-11
Denis Fouque, Laurent Juillard, Yves Lasne, Alba Tabakian, Martine Laville, Marie-Odile Joly and Maurice Laville
Departments of Nephrology, Biochemistry, and Centre de Recherche en Nutrition Humaine de Lyon, Hôpital Edouard Herriot, Lyon, France
Correspondence: Dr Denis Fouque, Department of Nephrology, Hôpital Edouard Herriot, 69437 Lyon Cedex 03, France. E-mail: fouque@univ-lyon1.fr
1See Editorial by Dagogo-Jack, p. 997.
Received 20 August 1997; Revised 12 February 1998; Accepted 27 March 1998.
Abstract
Acute leptin regulation in end-stage renal failure: The role of growth hormone and IGF-1.
Background
Leptin, a recently discovered peptide involved in nutrient intake and energy expenditure, has been shown to be abnormally regulated in certain conditions such as obesity. In chronic renal failure, leptin appears to be increased. However, little is known about leptin regulation during chronic renal failure (CRF).
Methods
We measured serum leptin in eight well nourished, chronic hemodialysis patients (seven males, one female) receiving anabolic factors for three days as either recombinant insulin-like growth factor-1 (rhIGF-1) or a combination of recombinant growth hormone (rhGH) plus recombinant IGF-1, in a random cross-over trial.
Results
Serum leptin values were in the range of normal volunteers matched for body mass index. As reported in other conditions, serum leptin was strongly correlated with patients dry body wt (P = 0.01) and body fat (P = 0.0001). Both treatments affected serum leptin in a rapid and opposite manner. RhIGF-1 decreased serum leptin from 11.2 
20.8 (SD) to 4.3 3.8 
g/liter (P = 0.011), whereas the combination of rhGH + rhIGF-1 increased serum leptin from 7.4 9.4 to 21.0 32.9 g/liter (P = 0.011). Regression analyses indicated a linear regression between serum leptin and insulin variations after treatment.
Conclusions
This study shows for the first time that both rhIGF-1 and rhGH acutely regulate serum leptin in dialysis patients. Whether leptin changes are explained by the concomitant insulin variation should be further studied under renal failure conditions.
Keywords:
nutrition, leptin, dialysis, chronic renal failure, peptides, obesity, insulin
