Increases in Serum Leptin Levels during Peritoneal Dialysis Are Associated with Inflammation and a Decrease in Lean Body Mass

Abstract. Leptin, secreted from fat cells, functions as a lipostat mechanism through modulation of satiety signals. Markedly elevated leptin levels have been documented in uremic patients, especially in those who are treated by peritoneal dialysis (PD). However, the role of hyperleptinemia in uremic patients is not clear, and it is not known whether elevated leptin levels contribute to uremic anorexia and changes in body composition. In this prospective study, serum leptin, C-reactive protein (CRP), plasma insulin, and body composition (dual-energy x-ray absorptiometry) were measured in 36 patients (53 ± 1 yr) close to start and after about 1 yr of PD. In addition, markers of dialysis adequacy and urea kinetics were followed during treatment with PD. During PD, the total body fat mass (20.5 ± 1.0 to 22.9 ± 1.3 kg ;P< 0.01), truncal fat mass (11.5 ± 0.7 to 13.2 ± 0.9 kg ;P< 0.001), and serum leptin levels (20.1 ± 3.8 to 35.6 ± 6.8 ng/ml ;P< 0.01) increased markedly, especially in patients with diabetes mellitus. Twenty-five PD patients that lost lean body mass during PD had significantly (P< 0.05) elevated initial CRP levels (14 ± 2 mg/L) compared to 11 patients (<10 mg/L) who gained lean body mass during PD. A significant increase in serum leptin levels (20.9 ± 4.2 to 42.7 ± 4.0 ng/ml ;P< 0.001) was observed in those patients who lost lean body mass, whereas no such change (18.4 ± 8.4 to 19.2 ± 6.4 ng/ml) was observed in the patients that gained lean body mass during PD treatment. The present longitudinal results demonstrate that serum leptin level and body fat content increase markedly during PD, especially in diabetic patients. Patients that lost lean body mass during PD had higher initial CRP levels and increased their serum leptin levels significantly during PD compared to those patients that gained lean body mass. Additional studies are therefore needed to elucidate the role of hyperleptinemia and inflammation in causing anorexia, protein-malnutrition, and changes in body composition during treatment with PD.

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Comparison of the Effect of Soy protein and Whey protein on Body Composition: A Meta-Analysis of Randomized Clinical Trials

British Journal Of Nutrition ◽

10.1017/s0007114521001550 ◽

2021 ◽

pp. 1-27

Author(s):

Masoome Piri Damaghi ◽

Atieh Mirzababaei ◽

Sajjad Moradi ◽

Elnaz Daneshzad ◽

Atefeh Tavakoli ◽

...

Keyword(s):

Body Composition ◽

Whey Protein ◽

Lean Body Mass ◽

Body Mass ◽

Body Fat ◽

Fat Mass ◽

Soy Protein ◽

Protein Supplementation ◽

Body Fat Percentage ◽

Fat Percentage

Abstract Background: Essential amino acids (EAAs) promote the process of regulating muscle synthesis. Thus, whey protein that contains higher amounts of EAA can have a considerable effect on modifying muscle synthesis. However, there is insufficient evidence regarding the effect of soy and whey protein supplementation on body composition. Thus, we sought to perform a meta-analysis of published Randomized Clinical Trials that examined the effect of whey protein supplementation and soy protein supplementation on body composition (lean body mass, fat mass, body mass and body fat percentage) in adults. Methods: We searched PubMed, Scopus, and Google Scholar, up to August 2020, for all relevant published articles assessing soy protein supplementation and whey protein supplementation on body composition parameters. We included all Randomized Clinical Trials that investigated the effect of whey protein supplementation and soy protein supplementation on body composition in adults. Pooled means and standard deviations (SD) were calculated using random-effects models. Subgroup analysis was applied to discern possible sources of heterogeneity. Results: After excluding non-relevant articles, 10 studies, with 596 participants, remained in this study. We found a significant increase in lean body mass after whey protein supplementation weighted mean difference (WMD: 0.91; 95% CI: 0.15, 1.67. P= 0.019). Subgroup analysis, for whey protein, indicated that there was a significant increase in lean body mass in individuals concomitant to exercise (WMD: 1.24; 95% CI: 0.47, 2.00; P= 0.001). There was a significant increase in lean body mass in individuals who received 12 or less weeks of whey protein (WMD: 1.91; 95% CI: 1.18, 2.63; P<0.0001). We observed no significant change between whey protein supplementation and body mass, fat mass, and body fat percentage. We found no significant change between soy protein supplementation and lean body mass, body mass, fat mass, and body fat percentage. Subgroup analysis for soy protein indicated there was a significant increase in lean body mass in individuals who supplemented for 12 or less weeks with soy protein (WMD: 1.48; 95% CI: 1.07, 1.89; P< 0.0001). Conclusion: Whey protein supplementation significantly improved body composition via increases in lean body mass, without influencing fat mass, body mass, and body fat percentage.

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Serum leptin is not correlated with body fat in severe food restriction

Applied Physiology Nutrition and Metabolism ◽

10.1139/h2012-092 ◽

2012 ◽

Vol 37 (6) ◽

pp. 1063-1071 ◽

Cited By ~ 5

Author(s):

Sarah E. Gairdner ◽

Catherine E. Amara

Keyword(s):

Body Composition ◽

Body Mass ◽

Body Fat ◽

Fat Mass ◽

Food Restriction ◽

Wistar Rats ◽

Serum Leptin ◽

Wide Range ◽

Female Wistar Rats ◽

Ad Libitum

Leptin is an adipose-derived hormone with established roles in energy balance that can impact the response to refeeding after malnutrition. Although the amount of circulating leptin has traditionally been associated with the amount of adipose tissue, controversy exists as to whether this relationship is constant in both humans and animals and over a wide range of body composition. Our objective was to evaluate whether the leptin – body fat ratio is constant in the range of healthy to low body mass in female Wistar rats. Eight ad libitum fed (C) and eight food-restricted (FR) rats were compared over a period of four weeks. FR rats attained the target 75% of baseline body mass after the first two weeks, which was maintained for the remaining two weeks. Serum leptin and IGF-1 (ELISA) and body composition (DXA) were measured at baseline (t0) and once weekly for the remainder of the study (t1–t4). The leptin – body fat ratio was reduced during the two-week period of weight loss (t0 = 0.036 ± 0.016 (ng·mL–1)·g–1 vs. t1 = 0.010 ± 0.004 (ng·mL–1)·g–1 and t2 = 0.015 ± 0.007 (ng·mL–1)·g–1, p < 0.05). Leptin concentration plateaued at its nadir (~0.24 (ng·mL–1)·g–1) at fat mass < 22 g. IGF-1 was correlated with lean mass (r = 0.45, p < 0.05) and fat mass (r = 0.58, p < 0.05), regardless of body mass. We concluded that the leptin – body fat ratio was reduced early in food restriction and the correlation between these two variables was absent at low body fat.

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Associations of Adiponectin, Leptin Levels, and the Change of Body Composition in Patients on Peritoneal Dialysis: A Prospective Cohort Study

Peritoneal Dialysis International ◽

10.3747/pdi.2017.00177 ◽

2018 ◽

Vol 38 (4) ◽

pp. 278-285 ◽

Cited By ~ 2

Author(s):

Xiao Xu ◽

Xue Tian ◽

Yuan Chen ◽

Zhi-Kai Yang ◽

Zhen Qu ◽

...

Keyword(s):

Body Composition ◽

Lean Body Mass ◽

Body Mass ◽

Fat Mass ◽

Adiponectin Level ◽

Demographic Data ◽

Serum Adiponectin ◽

Serum Leptin ◽

Hs Crp

Background Although the association between adipokines such as adiponectin, leptin, and body composition has been noted, whether they could predict the change of fat mass and lean body mass is unknown. We aimed to examine these associations in patients on peritoneal dialysis (PD) through a prospective cohort study. Methods Body composition (by dual-energy x-ray absorptiometry) including fat mass and lean body mass were examined at baseline and then at year 3. Serum leptin and adiponectin levels were measured. Demographic data, comorbidity, biochemical data, inflammation (high-sensitive C-reactive protein [hs-CRP]) and insulin resistance (homeostatic model assessment [HOMA-IR]) were also examined. Results At baseline, serum adiponectin levels were significantly inversely correlated with weight, lean body mass index (LBMI), fat mass index (FMI), lean body mass (LBM), and fat mass (FM) in 213 prevalent patients. At year 3, FMI, LBMI, FM, and the percentage of FM (FM%) increased while the percentage of LBM (LBM%) significantly decreased despite unchanged weight and LBM among the remaining 112 patients. After adjustment for demographic data, comorbidities, hs-CRP, HOMA-IR, and daily energy intake (DEI), serum adiponectin at baseline was not associated with increases in LBMI, FMI, and FM, but independently associated with an increase in FM% and a decrease in LBM%. The predictive effect of high-serum adiponectin level on mortality disappeared after adjusting for diabetes and cardiovascular disease. Serum leptin was not associated with any changes in body composition during the follow-up, nor with the mortality in this cohort. Conclusions A high adiponectin level could predict an increase in FM% and a decrease in LBM% during a 3-year follow-up in PD patients. Serum adiponectin could not independently predict mortality in PD patients.

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A placebo-controlled randomized study with testosterone in Klinefelter syndrome: beneficial effects on body composition

Endocrine Connections ◽

10.1530/ec-19-0323 ◽

2019 ◽

Vol 8 (9) ◽

pp. 1250-1261 ◽

Cited By ~ 10

Author(s):

Christian Høst ◽

Anders Bojesen ◽

Mogens Erlandsen ◽

Kristian A Groth ◽

Kurt Kristensen ◽

...

Keyword(s):

Body Composition ◽

Oxygen Uptake ◽

Lean Body Mass ◽

Body Mass ◽

Body Fat ◽

Fat Mass ◽

Maximal Oxygen Uptake ◽

Klinefelter Syndrome ◽

Abdominal Fat ◽

Testosterone Treatment

Context and objective Males with Klinefelter syndrome (KS) are typically hypogonadal with a high incidence of metabolic disease, increased body fat and mortality. Testosterone treatment of hypogonadal patients decrease fat mass, increase lean body mass and improve insulin sensitivity, but whether this extends to patients with KS is presently unknown. Research design and methods In a randomized, double-blind, placebo-controlled, BMI-matched cross-over study, 13 males with KS (age: 34.8 years; BMI: 26.7 kg/m2) received testosterone (Andriol®) 160 mg per day (testosterone) or placebo treatment for 6 months. Thirteen age- and BMI-matched healthy controls were recruited. DEXA scan, abdominal computed tomography (CT) scan and a hyperinsulinemic–euglycemic clamp, muscle strength and maximal oxygen uptake measurement were performed. Results Total lean body mass and body fat mass were comparable between testosterone-naïve KS and controls using DEXA, whereas visceral fat mass, total abdominal and intra-abdominal fat by CT was increased (P < 0.05). Testosterone decreased total body fat (P = 0.01) and abdominal fat by CT (P = 0.04). Glucose disposal was similar between testosterone-naïve KS and controls (P = 0.3) and unchanged during testosterone (P = 0.8). Free fatty acid suppression during the clamp was impaired in KS and maximal oxygen uptake was markedly lower in KS, but both were unaffected by treatment. Testosterone increased hemoglobin and IGF-I. Conclusion Testosterone treatment in adult males with KS for 6 months leads to favorable changes in body composition with reductions in fat mass, including abdominal fat mass, but does not change measures of glucose homeostasis.

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The Effects of Intermittent Fasting Combined with Resistance Training on Lean Body Mass: A Systematic Review of Human Studies

Nutrients ◽

10.3390/nu12082349 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2349

Author(s):

Stephen Keenan ◽

Matthew B. Cooke ◽

Regina Belski

Keyword(s):

Body Composition ◽

Resistance Training ◽

Lean Body Mass ◽

Body Mass ◽

Fat Mass ◽

Energy Restriction ◽

Human Studies ◽

Future Research ◽

Intermittent Fasting ◽

Eligibility Criteria

Diets utilising intermittent fasting (IF) as a strategic method to manipulate body composition have recently grown in popularity, however, dietary practices involving fasting have also been followed for centuries for religious reasons (i.e., Ramadan). Regardless of the reasons for engaging in IF, the impacts on lean body mass (LBM) may be detrimental. Previous research has demonstrated that resistance training promotes LBM accrual, however, whether this still occurs during IF is unclear. Therefore, the objective of this review is to systematically analyse human studies investigating the effects of variations of IF combined with resistance training on changes in LBM in previously sedentary or trained (non-elite) individuals. Changes in body weight and fat mass, and protocol adherence were assessed as a secondary objective. This review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. MEDLINE, CINAHL, PubMed and SportDiscus databases were searched for articles investigating IF, combined with resistance training that reported measures of body composition. Eight studies met the eligibility criteria. LBM was generally maintained, while one study reported a significant increase in LBM. Body fat mass or percentage was significantly reduced in five of eight studies. Results suggest that IF paired with resistance training generally maintains LBM, and can also promote fat loss. Future research should examine longer-term effects of various forms of IF combined with resistance training compared to traditional forms of energy restriction. Prospero registration CRD42018103867.

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Seasonal and Longitudinal Changes in Body Composition by Sport-Position in NCAA Division I Basketball Athletes

Sports ◽

10.3390/sports6030085 ◽

2018 ◽

Vol 6 (3) ◽

pp. 85 ◽

Cited By ~ 5

Author(s):

Jennifer Fields ◽

Justin Merrigan ◽

Jason White ◽

Margaret Jones

Keyword(s):

Body Composition ◽

Body Mass ◽

Body Fat ◽

Fat Mass ◽

Ncaa Division I ◽

The Body ◽

Fat Free Mass ◽

Strength And Conditioning ◽

Air Displacement Plethysmography ◽

Within Subjects

The purpose of this study was to assess the body composition of male and female basketball athletes (n = 323) across season, year, and sport-position using air displacement plethysmography. An independent sample t-test assessed sport-position differences. An analysis of variance was used to assess within-subjects across season (pre-season, in-season, and off-season), and academic year (freshman, sophomore, and junior). For both men and women basketball (MBB, WBB) athletes, guards had the lowest body fat, fat mass, fat free mass, and body mass. No seasonal differences were observed in MBB, but following in-season play for WBB, a reduction of (p = 0.03) in fat free mass (FFM) was observed. Across years, MBB showed an increase in FFM from freshman to sophomore year, yet remained unchanged through junior year. For WBB across years, no differences occurred for body mass (BM), body fat (BF%), and fat mass (FM), yet FFM increased from sophomore to junior year (p = 0.009). Sport-position differences exist in MBB and WBB: Guards were found to be smaller and leaner than forwards. Due to the importance of body composition (BC) on athletic performance, along with seasonal and longitudinal shifts in BC, strength and conditioning practitioners should periodically assess athletes BC to ensure preservation of FFM. Training and nutrition programming can then be adjusted in response to changes in BC.

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Seasonal Body Composition Variation Amongst Elite European Professional Soccer Players: An Approach of Talent Identification

Journal of Human Kinetics ◽

10.1515/hukin-2017-0132 ◽

2018 ◽

Vol 62 (1) ◽

pp. 177-184 ◽

Cited By ~ 6

Author(s):

Adam Lee Owen ◽

Carlos Lago-Peñas ◽

Gordon Dunlop ◽

Rouissi Mehdi ◽

Moktar Chtara ◽

...

Keyword(s):

Body Composition ◽

Lean Body Mass ◽

Body Mass ◽

Fat Mass ◽

Body Height ◽

Fat Free Mass ◽

Soccer Players ◽

Professional Soccer ◽

Elite Level ◽

Composition Profiles

AbstractThe primary aim of the investigation was to study the seasonal changes in body composition in elite European soccer players and identify key playing positional differences. Twenty-two players (age = 24 ± 3.7 years, body height = 180.45 ± 5.12 cm, body mass = 76.66 ± 5.34 kg) were tested. Players’ mass (kg), lean body mass (LBM), fat free mass (FFM), fat mass (FM), muscle girths (MG) and sum of 8 skinfolds (mm) were measured across 5 time points (T0 = Start of pre-season training; T1 = End of pre-season training; T2 = Mid-season; T3 = End of mid-season break; T4 = End of season). Players were divided into their tactical positional roles for analysis. The specific positions they were divided into included defenders (n = 8), midfielders (n = 8) and forwards (n = 6). Assessment of training and matchplay exposure were also recorded. Sites-4, Sites-7, Sites-8 and Fat Mass decreased dramatically from T0 to T1 and T2 in all playing positions (p < 0.01), while no remarkable differences were found between T2, T3 and T4. Except for defenders, calf girth and lean mass were higher in T2, T3 and T4 compared to T0 and T1 (p < 0.01). Midfielders were found to be leaner than forwards and defenders in all data collection time point sessions. Defenders showed higher values in calf girth and lean body mass than midfielders and forwards. It can be concluded from this investigation that there are large variances n positional body composition profiles amongst professional European soccer players. Furthermore, significant changes are prevalent and occur across the season from LBM, FFM, MG and skinfold assessment amongst European elite level soccer players.

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Body Morphometrics in NAFLD Population

Proceedings of IMPRS ◽

10.18060/23455 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Harkeerat Dhami ◽

Niharika Samala

Keyword(s):

Lean Body Mass ◽

Body Mass ◽

Body Fat ◽

Fat Mass ◽

Percent Body Fat ◽

Composition Analysis ◽

Processed Meat ◽

Body Fat Mass ◽

High Sodium ◽

Obstructive Sleep

Introduction: NAFLD is one of the common causes of liver disease in the US and is commonly associated with metabolic syndrome. Among obese, prevalence of NAFLD is 7090%. We wanted to determine body morphometrics in NAFLD. Methods: All individuals presenting to Indiana University Hospital with NAFLD were approached to participate in cross-sectional study. All participants were offered beverage, diet (REAP) questionnaires and body composition analysis using InBody 570, which utilizes bioelectrical impedance. Results: Of the 321 NAFLD individuals enrolled, 256 completed body morphometric analysis. Mean age of the cohort was 51.58 ± 13.54, 58% were female, 297 White and had a mean BMI of 35.92. 76% were obese, 48% had type 2 diabetes, 49.2% had hypertension, 38.6% had dyslipidemia, and 20.5% had obstructive sleep apnea. Despite having similar BMI, females had lower lean body mass (51.01 vs 70.51) and skeletal muscle mass (28.05 vs 39.70), higher body fat mass (46.71 vs 41.04) and percent body fat (46.59 vs. 35.7). Regular coffee consumers had lower BMI (35.3 vs 38, p=0.038), but lower body fat mass (39.9 vs 46.2, p=0.01), percent body fat (41.1 vs 44.4, p=0.05) and higher lean body mass % (58.8 vs 55.5, p=0.049). Processed meat consumption was associated with higher BMI (39 vs 35.3, P=0.01), percent body fat (45.5 vs 42, p=0.04), and lower lean body mass percentage (54.5 vs 58.2, P=0.04). Similar trends were seen with consumption of high sodium processed foods and watching television for ≥ 2 hours/day. Conclusion: Among individuals with NAFLD, we saw a higher female preponderance, who were found to have unfavorable body morphometrics despite similar BMI as males. Consumption of high sodium processed food and meat and excess screen time have unfavorable, while regular coffee drinkers have favorable body morphometrics, which offer modifiable measures for risk factors associated with NAFLD.

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Exercise and body composition

Journal of Applied Physiology ◽

10.1152/jappl.1991.70.3.994 ◽

1991 ◽

Vol 70 (3) ◽

pp. 994-997 ◽

Cited By ~ 28

Author(s):

G. B. Forbes

Keyword(s):

Young Adults ◽

Body Composition ◽

Lean Body Mass ◽

Body Mass ◽

Body Fat ◽

Training Programs ◽

Published Data ◽

Additional Information ◽

Body Fat Content ◽

Ad Libitum

We assessed changes in body composition in 41 young adults who engaged in various exercise and/or training programs on ad libitum diets. Most of those who gained weight sustained an increase in lean body mass (LBM), and most of those who lost weight lost LBM as well as fat. The change in LBM was directly related to the change in weight, with a regression slope of 0.500. An analysis of published data confirms these findings and, in concert with our data, provides the additional information that the magnitude of the change in body composition in exercising individuals is influenced by body fat content, just as it is for nonexercising individuals.

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High Levels of Physical Activity May Promote a Reduction in Bone Mineral Density in Peritoneal Dialysis

Medicina ◽

10.3390/medicina56090464 ◽

2020 ◽

Vol 56 (9) ◽

pp. 464

Author(s):

Armando Raimundo ◽

Zelinda Charrua ◽

Nuno Batalha ◽

Catarina Pereira ◽

Jose Parraca ◽

...

Keyword(s):

Physical Activity ◽

Bone Mineral Density ◽

Body Composition ◽

Peritoneal Dialysis ◽

Lean Body Mass ◽

Body Mass ◽

Bone Mineral ◽

Biochemical Parameters ◽

Vigorous Activity ◽

Mineral Density

Background and objectives: Peritoneal dialysis (PD) patients are expected to present lower levels of physical activity, unhealthy changes at the body composition level, and low levels of strength. Firstly, this study aimed to report the sex differences in physical activity, body composition and muscle strength and the relations among these variables. Secondly, we analyze the relationship between physical activity and biochemical parameters. Materials and Methods: Thirty-four patients (13 women and 21 men) participated in this study. Body composition was assessed by bioimpedance and dual-energy X-ray absorptiometry (DXA), and maximum isokinetic unilateral strength, analytical parameters and physical activity levels were evaluated. Results: The men showed higher values for weight, height, lean body mass, bone mineral content, bone mineral density (BMD) and total body water, while women showed higher values for the percentage of fat mass and hydration of lean body mass (p < 0.05). No differences between the sexes were found in different levels of physical activity; however, males registered significantly higher values for isokinetic strength variables except for knee extensor strength. BMD was positively related to sedentary activity and negatively related to moderate and vigorous activity (r = 0.383 and r = −0.404, respectively). Light physical activity was negatively correlated with albumin (r = −0.393) and total protein (r = −0.410) levels, while moderate/vigorous activity was positively correlated with urea distribution volume (r = 0.446) and creatinine clearance (r = 0.359) and negatively correlated with the triglyceride level (r = −0.455). Conclusions: PD patients with higher levels of physical activity present better results in terms of body composition and biochemical parameters. Additional studies should be conducted to clarify the relation between physical activity level and BMD.

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