Akademik Veri Yönetim Sistemi
TURKISH NEPHROLOGY DIALYSIS AND TRANSPLANTATION JOURNAL, sa.4, ss.176-182, 2007 (ESCI)
Aim: Serum leptin concentrations and hone mass are concordant with several respects Undernutrition reduces serum leptin concentrations and bone mineralization in adults and children. Glucocorticoids (GC) suppress bone formation, impair growth, and induce obesity. We investigated the effects of short and long-term treatment with GC on bone mineral content and leptin levels in children with glucocorticoid-sensitive nephrotic syndrome (NS), a disorder with minimal known independent effects on bone. Patients and Methods: The study was performed in two groups: (1) 47 children with nephrotic syndrome, 1A) before (n=81, 1B) after one nephrotic attacks (n=101,(1C) during prednisone therapy after proteinuria regression (n=16), (1D) in remission while receving long-term steroids (n=13); (2) 23 healthy children. Plasma leptin was measured by human leptin IRMA methods and bone mineral density was measured by Dual-energy x-ray absorptiometry IDXAI of the lumbar vertebra and femoral neck in all subjects. Results: The mean leptin level in group 1C was significantly higher than in all patients groups. In NS children (group 1) the mean concentration of leptin in group 1A was significantly Cower;in the group 1C, 1D, and group 2. Serum leptin level was positively correlated with serum albumin level r=0.,69, p < 0,01) in group 1A and 1C. In NS children (group 1) during treatment (1C) a positive correlation was observed between leptin level and serum IGF-I, albumin, calcium, total steroid dose, body mass index (BMI), and lumbar bone mineral density (BMD). Conclusion: In summary, our data demonstrate a significant increased leptin level in children under the prednisone therapy after proteinuria regression (group 1C). Leptin, however, prevents the changes in bone mineral density, suggesting that the intermittent prednisone treatment lead to increased leptin level as a physiologic defense mechanisms.