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Steroide Duyarlı Nefrotik Sendromlu Çocuklarda Kemik Mineralizasyonu ile Leptinin İlişkisi

Relationship of Leptin to Bone Mineralization in Children With Steroid-sensitive Nephrotic Syndrome

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Aim: Serum leptin concentrations and bone 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=8), <1B) after one nephrotic attacks (n=10), (10 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 (DXA) 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 lower in the group 1C, ID, 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 (10 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 10. Leptin, however, prevents the changes in bone mineral density, suggesting that the intermittant prednisone treatment lead to increased leptin level as a physiologic defense mechanisms.
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Abstract (Original Language): 
Amaç: Serum leptin konsantrasyonu ve kemik kitlesi birçok açıdan birbiriyle ilişkilidir. Erişkin ve çocuklardaki beslenme bozuklukları serum leptin konsantrasyonu ve kemik mineralizasyonunu azaltır. Glukokortikoidler (GK) kemik oluşumunu baskılar, büyüme bozukluğu yapar ve obezite oluşturur. Biz bu çalışmada GK'ye duyarlı nefrotik sendromlu INS) çocuklarda kemik mineral içeriği ve leptin düzeyi üzerine kısa ve uzun dönem glukokortikoid tedavisinin etkilerini araştırdık. Hastalar ve Yöntem: Çalışma iki grupta yapıldı: (1) NS'Iİ 47 çocuk, I1A) öncesinde (n=8), [1B1 ilk nefrotik ataktan sonra (n=10), (1CI proteinürinin düzelmesinden sonra prednizon tedavisi süresince (n=16), (1D| uzun dönem steroid tedavisi alırken remisyonda olanlarda (n=13), (2) 23 sağlıklı çocuk. Tüm hastalarda plazma lep-îini IRMA, lomber ve femur boynu kemik mineral dansitesi ise dual enerji x-ray absorbsiyometri IDXAI yöntemiyle ölçüldü. Bulgular: Grup IC'de ortalama leptin düzeyi tüm hasta gruplarından daha yüksekti. NS'li çocuklarda grup lA'daki ortalama leptin konsantrasyonu grup 1C, İD ve grup 2'den önemli oranda daha düşüktü. Grup 1A ve IC'de serum leptin düzeyi ile serum albümin düzeyi arasında pozitif korelasyon mevcuttu [r=0,69, p<0,01). NS'li çocuklarda (grup 1) tedavi almakta olan grupta (10 leptin düzeyi ile serum IGF-I, albümin, kalsiyum, total steroid dozu, vücut kitle indeksi ve lomber kemik mineral dansitesi arasında pozitif korelasyon tespit edildi. Sonuç: Özet olarak, proteinlin düzelmesinden sonra (grup 10 prednizon tedavisi almakta olan çocuklarda leptin düzeyinde önemli bir artış görülmektedir. Bununla birlikte, leptinin kemik mineral dansitesindeki değişiklikleri önlemesi, aralıklı prednizon tedavisinin fizyolojik defans mekanizması olarak leptin düzeyinde artışa neden olduğunu düşündürmektedir.
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176-182
  • Turkish

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Official Journal of the Turkish Society of Nephrology / Türk Nefroloji Diyaliz ve Transplantasyon Dergisi
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