PMID- 37840358 OWN - NLM STAT- MEDLINE DCOM- 20231129 LR - 20231129 IS - 1098-2825 (Electronic) IS - 0887-8013 (Print) IS - 0887-8013 (Linking) VI - 37 IP - 19-20 DP - 2023 Oct TI - Elevated plasma leptin levels are associated with vascular access dysfunction in patients on maintenance hemodialysis. PG - e24974 LID - 10.1002/jcla.24974 [doi] LID - e24974 AB - BACKGROUND: Inflammation has been associated with vascular access (VA) dysfunction. The adipocytokine leptin can directly induce pro-inflammatory T helper 1 immune responses and the pathogenesis of chronic inflammation. We explored the association between plasma leptin and VA dysfunction in patients on maintenance hemodialysis (HEMO). METHODS: A total of 344 consecutive patients who received anastomosis for VA at a single HEMO center between June 1, 2010 and December 31, 2021 were screened. Of these patients, 267 met the inclusion criteria and were included. ELISA was used to measure circulating levels of leptin. RESULTS: The VA dysfunction group had a higher leptin level than the patent VA group. A higher concentration of leptin was independently and significantly associated with an elevated risk of VA dysfunction. Multiple logistic regression analysis showed that leptin, female sex, and hypertension were independently associated with VA dysfunction, even after adjusting for known biomarkers. We then evaluated the ability of leptin, female sex, and hypertension to predict the risk of VA dysfunction, and the area under the curve (AUC) for leptin was 0.626 (p = 0.0001). When leptin, female sex, and hypertension were added to this multivariate model, the AUC increased to 0.679 (p = 0.001) for leptin and hypertension, and 0.690 for leptin, hypertension, and female sex (p = 0.004). In addition, plasma leptin levels were associated with sex, body mass index, and hemoglobin. CONCLUSIONS: In addition to the association between leptin and VA dysfunction, hypertension and female sex independently predicted VA dysfunction in patients with HEMO. CI - (c) 2023 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC. FAU - Yu, Teng-Hung AU - Yu TH AUID- ORCID: 0000-0002-6764-0374 AD - Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. AD - School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. FAU - Tang, Wei-Hua AU - Tang WH AD - Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualien, Taiwan. AD - Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Hung, Wei-Chin AU - Hung WC AD - Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. AD - School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. FAU - Lee, Thung-Lip AU - Lee TL AD - Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. AD - School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan. FAU - Tsai, I-Ting AU - Tsai IT AD - School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. AD - Department of Emergency, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. FAU - Hsuan, Chin-Feng AU - Hsuan CF AD - Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. AD - School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. AD - Division of Cardiology, Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan. FAU - Chen, Chia-Chi AU - Chen CC AD - School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. AD - Department of Pathology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. AD - Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan. AD - The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan. FAU - Chung, Fu-Mei AU - Chung FM AD - Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. FAU - Lee, Yau-Jiunn AU - Lee YJ AD - Lee's Endocrinologic Clinic, Pingtung, Taiwan. FAU - Wu, Cheng-Ching AU - Wu CC AUID- ORCID: 0000-0003-4530-9901 AD - Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. AD - School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. AD - Division of Cardiology, Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan. LA - eng GR - EDAHI111001/E#x2010;Da Hospital/ GR - EDAHP111047/E#x2010;Da Hospital/ PT - Journal Article DEP - 20231015 PL - United States TA - J Clin Lab Anal JT - Journal of clinical laboratory analysis JID - 8801384 RN - 0 (Leptin) RN - 0 (Biomarkers) SB - IM MH - Humans MH - Female MH - *Leptin MH - Renal Dialysis/adverse effects MH - Biomarkers MH - *Hypertension/complications MH - Inflammation/complications MH - Body Mass Index PMC - PMC10681410 OTO - NOTNLM OT - hemodialysis OT - hypertension OT - leptin OT - sex OT - vascular access dysfunction COIS- The authors have declared that no competing interest exists. EDAT- 2023/10/16 06:48 MHDA- 2023/11/29 06:42 PMCR- 2023/10/15 CRDT- 2023/10/16 03:48 PHST- 2023/09/16 00:00 [revised] PHST- 2023/05/09 00:00 [received] PHST- 2023/10/03 00:00 [accepted] PHST- 2023/11/29 06:42 [medline] PHST- 2023/10/16 06:48 [pubmed] PHST- 2023/10/16 03:48 [entrez] PHST- 2023/10/15 00:00 [pmc-release] AID - JCLA24974 [pii] AID - 10.1002/jcla.24974 [doi] PST - ppublish SO - J Clin Lab Anal. 2023 Oct;37(19-20):e24974. doi: 10.1002/jcla.24974. Epub 2023 Oct 15.