Steroid Effect on Serum Leptin in Children with MCNS

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Sebha University
Few studies have been looked at the status of leptin in renal diseases especially about nephrotic syndrome. Aim Study: To investigate the effect of steroid therapy on serum leptin, anthropometric and appetite in patients with minimal change nephrotic syndrome (MCNS). Method: Twenty children were recruited for this prospective study. Group-I included ten children aged between 2-12 years with MCNS without any associated complications as impaired renal functions, hematuria, hypertension and others. Group-II included ten healthy children with matching age, sex and BMI as a control group.Body weight, height, nutritional history including appetite, quantity of food, clinical examination, blood pressure and blood for kidney function parameter and serum leptin were taken before and after 3 day and after 2 weeks following prednisolone dose of 2 mg/kg/day. The same parameters were also performed for group II. Results: Serum leptin was higher in group II than group I (1.575 ± 1.07 vs 0.575 ± 0.76 ng/ml P = 0.01). After 3 days and also after 2 weeks of 2mg/Kg of prednisolone, serum leptin increased significantly in group II (t = 4.65,P = 0.014) without significant difference as it compared with group I (t = 1.65, P = 0.08). A highly significant increase in serum leptin concentration was detected in 2 weeks after prednisone therapy compared to the base line levels before therapy, compared to 3 days after therapy and to the control group (t = 5.69, P = 0.001, t = 3.95,P = 0.001 and t = 8.96, P = 0.001 respectively). In group I, serum leptin was higher in females than males (4.8 ± 2.8, P = 0.001). BMI was also higher in females compared to males. Patients' appetite improved after prednisolone for food quantity as recorded by the recall methods. Blood urea and serum creatinine in Group I and Group II changed significant within group II after the steroid and even the changes were not significantly different from the control group. Serum albumin, total serum protein, serum cholesterol concentrations and proteinuria revealed a significant difference between the two groups (t = 5.9, 8.9, 8.98 and 16.33 respectively P = 0.01 for all). Weight, BMI in group I before and 2 weeks after intake of prednisone did not reveal any significant differences in weight, BMI before and after 2 weeks of prednisone (t=0.99, and 0.88.8, respectively) in spite of the increase in appetite. Blood pressure did not change significantly after the steroid therapy in MCNS patients’ group. Conclusion: Serum leptin concentration andappetite were significantly higher especially in females without significant change in anthropometric, blood pressure and renal function indices after steroid therapy in minimal change nephropathy.
leptin, nephrotic syndrome, steroid, weight.