Association of Serum Leptin and Coronary Artery Calcification in end Stage Renal Disease Patients on Dialysis

ABSTRACT

Patients with End Stage Renal Disease (ESRD) on dialysis have 2 to 5-fold more coronary artery calcification (CAC) than age-matched individuals. Leptin receptors are expressed in atherosclerotic lesions, and leptin signaling has been implicated in the promotion of vascular calcification. In this study, we evaluated the role of Serum Leptin in coronary artery calcification in ESRD patients on dialysis. Methods: This study was done on 50 CKD-ESRD patients on maintenance dialysis and 20 normal subjects. Plasma leptin was measured in all CKD-ESRD patients and normal control by DRG Leptin ELISA Kit. Blood samples were obtained for analysis of leptin prior to dialysis. All patients with ESRD and normal subjects were subjected to Multi Row Spiral Computed Tomography (MSCT) for detection of coronary artery calcification scoring (CACS). Results: The mean serum leptin value in ESRD subjects was 8.91+ 1.42 ng/ml. The mean serum leptin value in normal subjects was 3.14 + 0.61 ng/ml. This difference in serum leptin value between ESRD on dialysis and normal subjects was statistically significant (Z=2.91, p< 0.05). The mean CACS in 50 patients with ESRD was 91.4 + 32.7 Agatston units. The mean CACS in normal subjects was 7.75 + 6.5 Agatston units. Difference in prevalence of CACS between ESRD patients on dialysis and normal subjects was statistical significant. In ESRD patients on dialysis with CACS in range 0-10, 11-100 and 101-400 Agatston units, the mean serum leptin values were 3.1 + 0 ng/ml, 6.2 + 3.4 ng/ml, 14.3 + 3.5 ng/ml respectively. So it was evident that with increase in CACS, the serum leptin values also increased. The difference in the serum leptin concentration between the group with CACS in the range of (0-10), (11-100), (101-400) Agatston units were statistically significant. [(z=5.16, p < 0.05), (z= 7.8, p< 0.05) respectively)]. Conclusion: CAC is amplified in renal patients and it progresses rapidly with advancement of the disease. Our study results suggest a positive co relation with Serum leptin and CAC in ESRD patients. In ESRD patient’s serum leptin is elevated as compared to normal subjects. Hence, we conclude that controlling serum leptin will reduce CAC burden.