Relationship between Plasma Leptin Level and Chronic Kidney Disease

Background. Leptin is an adipose tissue-derived hormone shown to be related to several metabolic, inflammatory, and hemostatic factors related to chronic kidney disease. Recent animal studies have reported that infusion of recombinant leptin into normal rats for 3 weeks fosters the development of glomerulosclerosis. However, few studies have examined the association between leptin and CKD in humans. Therefore, we examined the association between plasma leptin levels and CKD in a representative sample of US adults. Methods. We examined the third National Health and Nutrition Examination Survey participants >20 years of age (n = 5820, 53.6% women). Plasma leptin levels were categorized into quartiles (≤4.3 Fg/L, 4.4–8.7 Fg/L, 8.8–16.9 Fg/L, >16.9 Fg/L). CKD was defined as a glomerular filtration rate of <60 mL/min/1.73 m2 estimated from serum creatinine. Results. Higher plasma leptin levels were associated with CKD after adjusting for age, sex, race/ethnicity, education, smoking, alcohol intake, body mass index (BMI), diabetes, hypertension, and serum cholesterol. Compared to quartile 1 of leptin (referent), the odds ratio (95% confidence interval) of CKD associated with quartile 4 was 3.31 (1.41 to 7.78); P-trend = 0.0135. Subgroup analyses examining the relation between leptin and CKD by gender, BMI categories, diabetes, and hypertension status also showed a consistent positive association. Conclusion. Higher plasma leptin levels are associated with CKD in a representative sample of US adults

Insufficient Rest or Sleep and Its Relation to Cardiovascular Disease, Diabetes and Obesity in a National, Multiethnic Sample

BACKGROUND: A new question on insufficient rest/sleep was included in the 2008 Behavioral Risk Factor Surveillance System (BRFSS) for the 50 states, District of Columbia, and three US territories. No previous study, however, has examined perceived insufficient rest/sleep in relation to cardiovascular disease (CVD) or diabetes mellitus. We examined the association between self-reported insufficient rest/sleep and CVD, diabetes, and obesity in a contemporary sample of US adults. METHODS: Multiethnic, nationally representative, cross-sectional survey (2008 BRFSS) participants were >20 years of age (n=372, 144, 50% women). Self-reported insufficient rest/sleep in the previous month was categorized into four groups: zero, 1-13, 14-29, and 30 days. There were five outcomes: 1) any CVD, 2) coronary heart disease (CHD), 3) stroke, 4) diabetes mellitus, and 5) obesity (body mass index≥30 kg/m2). We employed multivariable logistic regression to calculate odds ratio (OR), (95% confidence interval (CI), of increasing categories of insufficient rest/sleep, taking zero days of insufficient rest/sleep as the referent category. PRINCIPAL FINDINGS: Insufficient rest/sleep was found to be associated with 1) any CVD, 2) CHD, 3) stroke, 4) diabetes mellitus, and 5) obesity, in separate analyses. Compared to those reporting zero days of insufficient sleep (referent), the OR (95% CI) associated with all 30 days of insufficient sleep was 1.67 (1.55-1.79) for any cardiovascular disease, 1.69(1.56-1.83) for CHD, 1.51(1.36-1.68) for stroke, 1.31(1.21-1.41) for diabetes, and 1.51 (1.43-1.59) for obesity. CONCLUSIONS: In a multiethnic sample of US adults, perceived insufficient rest/sleep was found to be independently associated with CHD, stroke, diabetes mellitus and obesity

Clinical Study Relationship between Plasma Leptin Level and Chronic Kidney Disease

Background. Leptin is an adipose tissue-derived hormone shown to be related to several metabolic, inflammatory, and hemostatic factors related to chronic kidney disease. Recent animal studies have reported that infusion of recombinant leptin into normal rats for 3 weeks fosters the development of glomerulosclerosis. However, few studies have examined the association between leptin and CKD in humans. Therefore, we examined the association between plasma leptin levels and CKD in a representative sample of US adults. Methods. We examined the third National Health and Nutrition Examination Survey participants &gt;20 years of age (n = 5820, 53.6% women). Plasma leptin levels were categorized into quartiles (≤4.3 Fg/L, 4.4-8.7 Fg/L, 8.8-16.9 Fg/L, &gt;16.9 Fg/L). CKD was defined as a glomerular filtration rate of &lt;60 mL/min/1.73 m 2 estimated from serum creatinine. Results. Higher plasma leptin levels were associated with CKD after adjusting for age, sex, race/ethnicity, education, smoking, alcohol intake, body mass index (BMI), diabetes, hypertension, and serum cholesterol. Compared to quartile 1 of leptin (referent), the odds ratio (95% confidence interval) of CKD associated with quartile 4 was 3.31 (1.41 to 7.78); P-trend = 0.0135. Subgroup analyses examining the relation between leptin and CKD by gender, BMI categories, diabetes, and hypertension status also showed a consistent positive association. Conclusion. Higher plasma leptin levels are associated with CKD in a representative sample of US adults

Association between insufficient rest/sleep and obesity.

<p>*Adjusted for age (years), sex (men, women), race-ethnicity (non-Hispanic whites, non-Hispanic blacks, Mexican Americans, others), education categories (high school), smoking (never, former, current), employment status (employed, unemployed, retired, unable to work), heavy drinker (no, yes), no regular exercise (yes, no).</p><p>+p-interaction by gender = 0.375.</p

Association between insufficient rest/sleep and stroke.

<p>*Adjusted for age (years), sex (men, women), race-ethnicity (non-Hispanic whites, non-Hispanic blacks, Mexican Americans, others), education categories (high school), smoking (never, former, current), employment status (employed, unemployed, retired, unable to work), heavy drinker (no, yes), body mass index categories (<25, 25–29, ≥30 kg/m²), no regular exercise (yes, no).</p><p>+p-interaction by gender = 0.573.</p

Association between insufficient rest/sleep and coronary heart disease (CHD).

<p>*Adjusted for age (years), sex (men, women), race-ethnicity (non-Hispanic whites, non-Hispanic blacks, Mexican Americans, others), education categories (high school), smoking (never, former, current), employment status (employed, unemployed, retired, unable to work), heavy drinker (no, yes), body mass index categories (<25, 25–29, ≥30 kg/m²), no regular exercise (yes, no).</p><p>+p-interaction by gender = 0.192.</p

Association between insufficient rest/sleep and any cardiovascular disease (CVD).

<p>*Adjusted for age (years), sex (men, women), race-ethnicity (non-Hispanic whites, non-Hispanic blacks, Mexican Americans, others), education categories (high school), smoking (never, former, current), employment status (employed, unemployed, retired, unable to work), heavy drinker (no, yes), body mass index categories (<25, 25–29, ≥30 kg/m²), no regular exercise (yes, no).</p><p>+p-interaction by gender = 0.312.</p

Baseline characteristics of the study population (N = 372,144).

<p>Baseline characteristics of the study population (N = 372,144).</p

Association between insufficient rest/sleep and diabetes mellitus.

<p>*Adjusted for age (years), sex (men, women), race-ethnicity (non-Hispanic whites, non-Hispanic blacks, Mexican Americans, others), education categories (high school), smoking (never, former, current), employment status (employed, unemployed, retired, unable to work), heavy drinker (no, yes), body mass index categories (<25, 25–29, ≥30 kg/m²), no regular exercise (yes, no).</p><p>+p-interaction by gender = 0.244.</p