TY - JOUR
T1 - Associations between Serum Leptin Level and Bone Turnover in Kidney Transplant Recipients
AU - Kovesdy, Csaba P.
AU - Molnar, Miklos Z.
AU - Czira, Maria E.
AU - Rudas, Anna
AU - Ujszaszi, Akos
AU - Rosivall, Laszlo
AU - Szathmari, Miklos
AU - Covic, Adrian
AU - Keszei, Andras
AU - Beko, Gabriella
AU - Lakatos, Peter
AU - Kosa, Janos
AU - Mucsi, Istvan
PY - 2010/12
Y1 - 2010/12
N2 - Background and objectives: Obesity is associated with increased parathyroid hormone (PTH) in the general population and in patients with chronic kidney disease (CKD). A direct effect of adipose tissue on bone turnover through leptin production has been suggested, but such an association has not been explored in kidney transplant recipients. Design, setting, participants, & measurements: This study examined associations of serum leptin with PTH and with biomarkers of bone turnover (serum beta crosslaps [CTX, a marker of bone resorption] and osteocalcin [OC, a marker of bone formation]) in 978 kidney transplant recipients. Associations were examined in multivariable regression models. Path analyses were used to determine if the association of leptin with bone turnover is independent of PTH. Results: Higher leptin levels were associated with higher PTH and lower vitamin D levels, and adjustment for vitamin D attenuated the association between leptin and PTH. However, higher leptin was also significantly associated with lower levels of the bone turnover markers: 1 SD higher leptin was associated with 0.13 lower log-OC (-0.17, -0.08, P <0.001) and 0.030 lower log-CTX (-0.045, -0.016, P <0.001) after multivariable adjustments. Path analysis indicated that the association of leptin with PTH was mostly mediated through vitamin D, and that the association between leptin and bone turnover was independent of PTH and vitamin D. Conclusions: Elevated leptin level is associated with lower bone turnover independent of its effects on serum PTH in kidney transplant recipients. Clin J Am Soc Nephrol 5: 2297-2304, 2010. doi: 10.2215/CJN.03520410
AB - Background and objectives: Obesity is associated with increased parathyroid hormone (PTH) in the general population and in patients with chronic kidney disease (CKD). A direct effect of adipose tissue on bone turnover through leptin production has been suggested, but such an association has not been explored in kidney transplant recipients. Design, setting, participants, & measurements: This study examined associations of serum leptin with PTH and with biomarkers of bone turnover (serum beta crosslaps [CTX, a marker of bone resorption] and osteocalcin [OC, a marker of bone formation]) in 978 kidney transplant recipients. Associations were examined in multivariable regression models. Path analyses were used to determine if the association of leptin with bone turnover is independent of PTH. Results: Higher leptin levels were associated with higher PTH and lower vitamin D levels, and adjustment for vitamin D attenuated the association between leptin and PTH. However, higher leptin was also significantly associated with lower levels of the bone turnover markers: 1 SD higher leptin was associated with 0.13 lower log-OC (-0.17, -0.08, P <0.001) and 0.030 lower log-CTX (-0.045, -0.016, P <0.001) after multivariable adjustments. Path analysis indicated that the association of leptin with PTH was mostly mediated through vitamin D, and that the association between leptin and bone turnover was independent of PTH and vitamin D. Conclusions: Elevated leptin level is associated with lower bone turnover independent of its effects on serum PTH in kidney transplant recipients. Clin J Am Soc Nephrol 5: 2297-2304, 2010. doi: 10.2215/CJN.03520410
U2 - 10.2215/CJN.03520410
DO - 10.2215/CJN.03520410
M3 - Article
C2 - 20688883
SN - 1555-9041
VL - 5
SP - 2297
EP - 2304
JO - Clinical journal of the American Society of Nephrology
JF - Clinical journal of the American Society of Nephrology
IS - 12
ER -