Background
Methods
Data Source and Study Approval
Study population
Endpoint definition
Statistical analysis
Results
Cohort characteristics
Men | Women | P | ||
---|---|---|---|---|
N | 2646 | 1100 | 1546 | < 0.001 |
Age, years | 54.99 (8.18) | 56.20 (8.04) | 54.14 (8.18) | < 0.001 |
Hypertension, n (%) | 550 (20.79) | 213 (19.39) | 337 (21.79) | 0.135 |
Diabetes mellitus, n (%) | 230 (8.70) | 118 (10.75) | 112 (7.22) | 0.002 |
Dyslipidemia, n (%) | 147 (5.54) | 64 (5.79) | 83 (5.36) | 0.642 |
Myocardial infarction, n (%) | 46 (1.73) | 15 (1.38) | 31 (1.99) | 0.228 |
Cerebrovascular accident, n (%) | 40 (1.50) | 22 (2.020) | 17 (1.13) | 0.077 |
Current smoking, n (%) | 463 (17.50) | 441 (40.01) | 22 (1.43) | < 0.001 |
Regular exercise, n (%) | 720 (27.20) | 272 (24.70) | 448 (28.98) | 0.014 |
Body mass index, kg/m2 | 24.65 (3.14) | 24.33 (2.95) | 24.88 (3.25) | < 0.001 |
Waist circumference, cm | 83.67 (8.62) | 86.40 (7.72) | 81.72 (8.70) | < 0.001 |
Systolic BP, mmHg | 127.20 (17.55) | 129.01 (17.14) | 125.91 (17.74) | < 0.001 |
Diastolic BP, mmHg | 83.00 (11.79) | 84.73 (11.34) | 81.76 (11.95) | < 0.001 |
Fasting glucose, mg/dL | 95.29 (19.92) | 98.83 (24.05) | 92.76 (17.83) | < 0.001 |
HbA1c | 5.61 (0.80) | 5.65 (0.85) | 5.58 (0.76) | 0.022 |
HDL-cholesterol, mg/dL | 46.91 (11.09) | 45.54 (11.59) | 44.89 (10.62) | < 0.001 |
LDL-cholesterol, mg/dL | 118.67 (33.07) | 113.93 (32.35) | 122.05 (33.17) | < 0.001 |
Triglycerides, mg/dL | 147.94 (98.06) | 167.00 (115.88) | 134.39 (80.43) | < 0.001 |
HOMA-IR, units | 1.98 (1.60) | 1.97 (2.10) | 1.99 (1.13) | 0.782 |
hs-CRP, mg/L | 2.07 (4.95) | 2.40 (6.02) | 1.82 (3.98) | 0.006 |
eGFR, mL/min/1.73m2 | 76.14 (9.90) | 78.38 (10.81) | 74.55 (8.86) | < 0.001 |
Leptin, ng/L | 6.42 (5.47) | 2.74 (2.04) | 9.04 (5.64) | < 0.001 |
BP, blood pressure; HDL, high density lipoprotein; LDL, low density lipoprotein; TG, triglyceride; HOMA-IR, Homeostasis Model Assessment of Insulin Resistance; hs-CRP, high sensitivity-C reactive protein; eGFR, estimated glomerular filtration rate |
Serum leptin level | ||||
---|---|---|---|---|
Tertile 1 | Tertile 2 | Tertile 3 | P | |
All | ||||
N (%) | 872 | 873 | 901 | |
Age, years | 56.53 (8.09) | 54.36 (8.28) | 54.13 (7.98) | < 0.001 |
Hypertension, n (%) | 137 (15.7) | 168 (19.3) | 245 (27.18) | < 0.001 |
Diabetes mellitus, n (%) | 75 (8.6) | 89 (10.18) | 66 (7.36) | 0.350 |
Dyslipidemia, n (%) | 40 (4.53) | 50 (5.73) | 57 (6.34) | 0.100 |
Myocardial infarction, n (%) | 9 (1.05) | 17 (1.99) | 19 (2.15) | 0.078 |
Cerebrovascular accident, n (%) | 13 (1.51) | 18 (2.11) | 8 (0.91) | 0.293 |
Current smoking (%) | 334 (38.25) | 110 (12.65) | 19 (2.12) | < 0.005 |
Regular exercise (%) | 211 (24.25) | 254.48 (29.15) | 254 (28.17) | 0.067 |
Body mass index, kg/m2 | 23.07 (2.60) | 24.33 92.69) | 26.49 (3.08) | < 0.001 |
Waist circumference, cm | 82.48 (7.74) | 82.88 (9.21) | 85.57 (8.52) | < 0.001 |
Systolic BP, mmHg | 126.89 (17.05) | 126.91 (17.59) | 127.77 (18.00) | 0.295 |
Diastolic BP, mmHg | 83.23 (11.49) | 82.89 (11.78) | 82.87 (12.09) | 0.530 |
Fasting glucose, mg/dL | 95.96 (21.02) | 96.47 (22.37) | 93.49 (15.76) | 0.008 |
HbA1c | 5.56 (0.80) | 5.64 (0.93) | 5.62 (0.67) | 0.218 |
HDL-cholesterol, mg/dL | 47.14 (11.79) | 45.98 (11.03) | 47.60 (10.39) | 0.365 |
LDL-cholesterol, mg/dL | 111.15 (31.86) | 117.22 (31.63) | 127.37 (33.61) | < 0.001 |
Triglycerides, mg/dL | 149.12 (114.04) | 145.38 (95.17) | 149.29 (83.00) | 0.964 |
HOMA-IR, units | 1.59 (1.16) | 2.05 (2.14) | 2.29 (1.25) | < 0.001 |
hs-CRP, mg/L | 2.12 (6.09) | 2.02 (4.29) | 2.06 (4.26) | 0.825 |
Baseline eGFR, mL/min/1.73m2 | 78.57 (10.21) | 75.87 (9.91) | 74.05 (9.04) | < 0.001 |
Follow-up eGFR, mL/min/1.73m2 | 82.71 (11.72) | 80.18 (11.45) | 77.73 (10.45) | < 0.001 |
Leptin, ng/L | 1.82 (0.69) | 4.96 (1.18) | 12.29 (5.40) | < 0.001 |
Male | ||||
N (%) | 362 | 363 | 375 | |
Age, years | 57.20 (8.18) | 55.79 (7.97) | 55.62 (7.91) | 0.008 |
Hypertension, n (%) | 40 (11.08) | 73 (20.11) | 101 (26.83) | < 0.001 |
Diabetes mellitus, n (%) | 15 (4.16) | 48 (13.13) | 56 (14.91) | < 0.001 |
Dyslipidemia, n (%) | 13 (3.6) | 17 (4.75) | 34 (8.94) | 0.002 |
Myocardial infarction, n (%) | 3 (0.83) | 4 (1.12) | 8 (2.17) | 0.121 |
Cerebrovascular accident, n (%) | 3 (0.83) | 9 (2.51) | 10 (2.71) | 0.072 |
Current smoking (%) | 176 (48.75) | 142 (39.05) | 122 (32.53) | < 0.001 |
Regular exercise (%) | 76 (21.11) | 99 (27.22) | 97 (25.74) | 0.151 |
Body mass index, kg/m2 | 22.11 (2.19) | 24.33 (2.21) | 26.47 (2.63) | < 0.001 |
Waist circumference, cm | 80.65 (6.40) | 86.37 (5.92) | 91.98 (6.19) | < 0.001 |
Systolic BP, mmHg | 125.96 (16.15) | 129.07 (17.15) | 131.89 (17.58) | < 0.001 |
Diastolic BP, mmHg | 82.86 (10.86) | 84.55 (11.67) | 86.70 (11.19) | < 0.001 |
Fasting glucose, mg/dL | 94.17 (20.63) | 99.82 (22.85) | 102.37 (21.86) | < 0.001 |
HbA1c | 5.51 (0.84) | 5.65 (0.83) | 5.79 (0.87) | < 0.001 |
HDL-cholesterol, mg/dL | 48.58 (12.38) | 45.02 (10.35) | 43.12 (11.33) | < 0.001 |
LDL-cholesterol, mg/dL | 107.58 (30.48) | 114.75 (33.29) | 119.25 (32.23) | < 0.001 |
Triglycerides, mg/dL | 130.49 (93.56) | 177.23 (134.73) | 192.33 (106.79) | < 0.001 |
HOMA-IR, units | 1.41 (1.11) | 1.80 (1.32) | 2.67 (3.04) | < 0.001 |
hs-CRP, mg/L | 2.27 (7.78) | 2.17 (4.81) | 2.75 (4.99) | 0.280 |
Baseline eGFR, mL/min/1.73m2 | 80.58 (10.66) | 78.04 (9.93) | 76.57 (11.42) | < 0.001 |
Follow-up eGFR, mL/min/1.73m2 | 85.25 (11.50) | 82.03 (11.04) | 81.18 (12.72) | < 0.001 |
Leptin, ng/L | 1.15 (0.32) | 2.20 (0.34) | 4.79 (2.26) | < 0.001 |
Female | ||||
N (%) | 510 | 510 | 526 | |
Age, years | 54.43 (8.49) | 53.97 (8.06) | 54.01 (7.98) | 0.416 |
Hypertension, n (%) | 71 (14) | 120 (23.45) | 145 (27.61) | < 0.001 |
Diabetes mellitus, n (%) | 30 (5.88) | 47 (9.22) | 35 (6.56) | 0.698 |
Dyslipidemia, n (%) | 18 (3.6) | 24 (4.75) | 47 (8.94) | 0.004 |
Myocardial infarction, n (%) | 6 (1.22) | 12 (2.4) | 12 (2.32) | 0.215 |
Cerebrovascular accident, n (%) | 6 (1.22) | 6 (1.2) | 5 (0.97) | 0.703 |
Current smoking (%) | 9 (1.78) | 5 (0.99) | 8 (1.52) | 0.736 |
Regular exercise (%) | 145 (28.46) | 156 (30.65) | 147 (27.86) | 0.825 |
Body mass index, kg/m2 | 22.50 (2.24) | 24.80 (2.47) | 27.25 (3.01) | < 0.001 |
Waist circumference, cm | 76.52 (7.18) | 81.44 (7.28) | 87.04 (8.17) | < 0.001 |
Systolic BP, mmHg | 122.96 (17.29) | 125.25 (17.57) | 129.40 (17.77) | < 0.001 |
Diastolic BP, mmHg | 80.11 (11.92) | 81.49 (11.87) | 83.63 (11.81) | < 0.001 |
Fasting glucose, mg/dL | 91.21 (18.06) | 93.94 (20.41) | 93.12 (14.55) | 0.088 |
HbA1c | 5.48 (0.83) | 5.59 (0.77) | 5.66 (0.68) | < 0.001 |
HDL-cholesterol, mg/dL | 48.71 (10.94) | 47.52 (10.70) | 47.44 (10.17) | 0.055 |
LDL-cholesterol, mg/dL | 113.12 (28.76) | 124.34 (33.71) | 128.49 (34.78) | < 0.001 |
Triglycerides, mg/dL | 110.03 (65.86) | 142.41 (84.75) | 150.23 (83.54) | < 0.001 |
HOMA-IR, units | 1.58 (0.81) | 1.96 (1.10) | 2.41 (1.27) | < 0.001 |
hs-CRP, mg/L | 1.51 (3.38) | 1.83 (4.25) | 2.12 (4.22) | 0.017 |
Baseline eGFR, mL/min/1.73m2 | 75.41 (8.85) | 74.40 (8.00) | 73.85 (9.59) | 0.005 |
Follow-up eGFR, mL/min/1.73m2 | 79.42 (11.28) | 78.13 (9.63) | 77.43 (10.80) | 0.002 |
Leptin, ng/L | 4.20 (1.22) | 7.88 (1.08) | 14.86 (5.74) | < 0.001 |
Values are expressed as mean (SD) or number (%) BP, blood pressure; HDL, high density lipoprotein; LDL, low density lipoprotein; TG, triglyceride; HOMA-IR, Homeostasis Model Assessment of Insulin Resistance; hs-CRP, high sensitivity-C reactive protein; eGFR, estimated glomerular filtration rate |
Serum leptin and CKD
Serum leptin level | Odds ratio (95% CI) | ||||
---|---|---|---|---|---|
Tertile 1 | Tertile 2 | Tertile 3 | Odds ratio for trend | P for trend | |
All (n = 2646) | |||||
Serum leptin (ng/L) | < 3.09 | 3.09 – 7.23 | ≥ 7.23 | ||
No. of new-onset CKD | 14 | 26 | 28 | ||
Crude | Reference | 1.88 (0.98 – 3.63) | 1.97 (1.03 – 3.76) | 1.36 (1.00 – 1.83) | 0.048 |
Model 1 | Reference | 2.25 (1.16 – 4.37) | 2.44 (1.27 – 4.71) | 1.50 (1.11 – 2.03) | 0.009 |
Model 2 | Reference | 1.44 (0.74 – 2.82) | 1.17 (0.60 – 2.28) | 1.05 (0.77 – 1.43) | 0.770 |
Model 3 | Reference | 1.62 (0.83 – 3.19) | 1.41 (0.72 – 2.78) | 1.15 (0.34 – 1.57) | 0.394 |
Men (n = 1100) | |||||
Serum leptin (ng/L) | < 1.68 | 1.68 – 2.87 | ≥ 2.87 | ||
No. of new-onset CKD | 2 | 3 | 13 | ||
Crude | Reference | 1.50 (0.25 – 9.03) | 6.46 (1.45 – 28.83) | 2.95 (1.41 – 6.18) | 0.004 |
Model 1 | Reference | 1.76 (0.29 – 10.68) | 7.91 (1.75 – 35.64) | 3.19 (1.53 – 6.68) | 0.037 |
Model 2 | Reference | 1.17 (0.19 – 7.21) | 3.53 (0.76 – 16.30) | 2.13 (1.00 – 4.53) | 0.049 |
Model 3 | Reference | 1.14 (0.18 – 7.12) | 3.81 (0.82 – 17.77) | 2.25 (1.05 – 4.85) | 0.037 |
Women (n = 1546) | |||||
Serum leptin (ng/L) | < 6.07 | 6.07 – 9.77 | ≥ 9.77 | ||
No. of new-onset CKD | 17 | 13 | 20 | ||
Crude | Reference | 0.76 (0.37 – 1.58) | 1.14 (0.59 – 2.21) | 1.08 (0.76 – 1.52) | 0.667 |
Model 1 | Reference | 0.80 (0.38- 1.68) | 1.22 (0.63 – 2.37) | 1.11 (0.79 – 1.57) | 0.550 |
Model 2 | Reference | 0.70 (0.33 – 1.46) | 0.91 (0.47 – 1.80) | 0.96 (0.68 – 1.37) | 0.829 |
Model 3 | Reference | 0.73 (0.34 – 1.53) | 0.97 (0.49 – 1.91) | 0.99 ()0.70 – 1.41) | 0.967 |
Model 1: adjusted for age Model 2: adjusted for baseline eGFR Model 3: adjusted for age and baseline eGFR |