Acta clinica Croatica, Vol. 62. No. 4, 2023.
Original scientific paper
https://doi.org/10.20471/acc.2023.62.04.9
The Predictive Role of Leptin in Malnutrition-Inflammation Complex Syndrome in Hemodialysis Patients
Ivona Risović
orcid.org/0000-0002-3391-9801
; Department of Endocrinology, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina; Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
*
Vlastimir Vlatković
; Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina; Department of Nephrology, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
Snježana Popović Pejičić
; Department of Endocrinology, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina; Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
Jasna Trbojević Stanković
orcid.org/0000-0002-1940-6188
; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Dr Dragiša Mišović - Dedinje University Clinical Center, Belgrade, Serbia
Gabrijela Malešević
; Department of Endocrinology, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina; Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
* Corresponding author.
Abstract
Leptin is a protein hormone secreted by adipocytes. Its role in malnutrition-inflammation
complex syndrome (MICS) in hemodialysis (HD) patients has not been fully resolved yet. We aimed
to assess the predictive role of serum leptin in MICS in maintenance HD patients. This prospective study
included 93 HD patients who were distributed in three groups according to serum leptin levels (low-normal-
high). Nutritional and inflammatory parameters of MICS, as well as malnutrition-inflammation score
(MIS), were determined at baseline and after 12 months. In all subjects, the median serum leptin levels were
above the relevant reference range at both the baseline (10 ng/mL; interquartile range (IQR) 4.2-29.9 ng/
mL) and at the 12-month follow-up (13 ng/mL; IQR 3.5-39.5 ng/mL). Patients with decreased serum
leptin levels had elements of MICS present. Leptin exhibited good sensitivity (0.89), while its specificity
was similar to that of other nutritional and inflammatory parameters (0.45 for leptin vs. 0.65 for body mass
index, 0.46 for MIS, 0.63 for C-reactive protein, 0.44 for albumins, 0.47 for ferritin and 0.50 for transferrin).
The ROC curve analysis identified leptin levels of ≤3.4 ng/mL in men and ≤11.4 ng/mL in women
to have the best predictive value for MICS. In conclusion, leptin appears to be a reliable marker of MICS.
Keywords
Leptin; Malnutrition-inflammation complex syndrome; Hemodialysis
Hrčak ID:
320299
URI
Publication date:
31.12.2023.
Visits: 208 *