Kidney Week

Abstract: SA-PO442

Association between Serum Leptin Levels and Vascular Reactivity Index in Patients on Long-Term Peritoneal Dialysis

Session Information

• Home Dialysis - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Chang, Yu Chi, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

Yu Chi Chang, MD

• Lai, Yu-Hsien, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

Yu-Hsien Lai, MD, PhD

• Hsu, Bang-Gee, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

Bang-Gee Hsu, MD, PhD

Background

Leptin directly affects vascular function, including atherosclerotic effects, endothelial dysfunction resulting from the long-term effect of leptin on nitritic oxidase synthesis, and disturbed bioavailability. This study investigated the correlation between serum leptin levels and endothelial dysfunction in patients undergoing peritoneal dialysis (PD).

Methods

This cross-sectional, single-center study included 74 patients with long-term PD for end-stage kidney failure. A digital thermal monitoring device calculated the vascular reactivity index (VRI) to measure endothelial function, and an enzyme immunoassay was used to determine serum leptin levels. In this study, VRI < 1.0 denoted poor vascular reactivity, 1.0 ≤ VRI < 2.0 intermediate vascular reactivity, and VRI ≥ 2.0 good vascular reactivity.

Results

Out of the long-term PD patients, thirty-four (45.9%) displayed poor vascular reactivity (VRI < 1.0), while 29 (39.2%) exhibited intermediate vascular reactivity (1.0 ≤ VRI < 2.0), leaving the remaining 11 patients demonstrating good vascular reactivity. Higher waist circumference (P < 0.001), elevated serum C-reactive protein (CRP, P = 0.003), and leptin levels (P < 0.001) were found to be associated with poor vascular reactivity. Waist circumference (r = −0.336, P = 0.003), log-transformed serum levels of CRP (log-CRP, r = −0.552, P < 0.001), and serum leptin levels (r = −0.497, P < 0.001) exhibited a negative correlation with VRI values in long-term PD patients. Following the multivariate linear regression test, serum log-CRP level (β = −0.431, adjusted R² change = 0.295, P < 0.001) and leptin level (β = −0.346, adjusted R² change = 0.098, P = 0.001) emerged as significantly and independently associated with VRI values among PD patients. Using the Spearman correlation analysis, the log-PD vintage (r = −0.234, P = 0.048) was negatively correlated, while waist circumference (r = 0.412, P < 0.001) and log-CRP level (r = 0.351, P = 0.002) was positively correlated with serum leptin level.

Conclusion

In patients with long-term PD, a negative association was observed between serum log-CRP and leptin levels and endothelial dysfunction determined by VRI values.