Low serum leptin levels are associated with malnutrition status according to malnutrition-inflammation score in patients undergoing chronic hemodialysis

Introduction: Leptin is an adipokine secreted from adipocytes that mediate lipid metabolism and inflammation. This cross-sectional study investigated the relationship between serum leptin level and nutrition status evaluated by malnutrition-inflammation score (MIS) among patients undergoing hemodialysis (HD). Methods: This study included 100 patients on HD. Nutritional status was based on MIS (malnutrition >= 7 points). Body composition, biochemistry data, and serum leptin level were evaluated. Findings: Of 100 subjects, 33 (33.0%) were categorized as having malnutrition. Compared with subjects in the well-nourished group, those in the malnutrition group had on average an older age, longer HD duration, and lower height, weight, body mass index, waist circumference, body fat mass, serum triglyceride level, and creatinine level. Serum leptin levels were also significantly lower in the malnutrition group (P < 0.001), whereas C-reactive protein (CRP) levels were higher (P = 0.002). Multivariable linear regression analysis revealed that HD duration (beta = 2.06, P = 0.009), serum leptin level (beta = -5.16, P < 0.001), CRP level (beta = 3.33, P < 0.001), and albumin level (beta = -1.95, P = 0.008) were factors independently associated with MIS. The discriminative power of serum leptin level to predict malnutrition was 0.834 (95% confidence interval: 0.747-0.901, P < 0.001). Discussion: Low serum leptin level was associated with malnutrition, and serum leptin level may be a valuable marker for nutrition assessment in patients undergoing HD.