Associations between serum leptin level and bone turnover in kidney transplant recipients

Csaba P. Kovesdy, Miklos Z. Molnar, Maria E. Czira, Anna Rudas, Akos Ujszaszi, Laszlo Rosivall, Miklos Szathmari, Adrian Covic, Andras Keszei, Gabriella Beko, Peter Lakatos, Janos Kosa, Istvan Mucsi

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2297-2304
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume5
Issue number12
DOIs
StatePublished - Dec 1 2010

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Bone Remodeling
Leptin
Parathyroid Hormone
Kidney
Serum
Vitamin D
glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine
Transplant Recipients
Osteocalcin
Bone Resorption
Chronic Renal Insufficiency
Osteogenesis
Adipose Tissue
Obesity
Biomarkers

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Associations between serum leptin level and bone turnover in kidney transplant recipients. / Kovesdy, Csaba P.; Molnar, Miklos Z.; Czira, Maria E.; Rudas, Anna; Ujszaszi, Akos; Rosivall, Laszlo; Szathmari, Miklos; Covic, Adrian; Keszei, Andras; Beko, Gabriella; Lakatos, Peter; Kosa, Janos; Mucsi, Istvan.

In: Clinical Journal of the American Society of Nephrology, Vol. 5, No. 12, 01.12.2010, p. 2297-2304.

Research output: Contribution to journalArticle

Kovesdy, CP, Molnar, MZ, Czira, ME, Rudas, A, Ujszaszi, A, Rosivall, L, Szathmari, M, Covic, A, Keszei, A, Beko, G, Lakatos, P, Kosa, J & Mucsi, I 2010, 'Associations between serum leptin level and bone turnover in kidney transplant recipients', Clinical Journal of the American Society of Nephrology, vol. 5, no. 12, pp. 2297-2304. https://doi.org/10.2215/CJN.03520410
Kovesdy, Csaba P. ; Molnar, Miklos Z. ; Czira, Maria E. ; Rudas, Anna ; Ujszaszi, Akos ; Rosivall, Laszlo ; Szathmari, Miklos ; Covic, Adrian ; Keszei, Andras ; Beko, Gabriella ; Lakatos, Peter ; Kosa, Janos ; Mucsi, Istvan. / Associations between serum leptin level and bone turnover in kidney transplant recipients. In: Clinical Journal of the American Society of Nephrology. 2010 ; Vol. 5, No. 12. pp. 2297-2304.
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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

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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.

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