Serum leptin and glucagon-like peptide-1 levels in diabetic patients with end-stage renal disease on hemodialysis ‒ a cross-sectional study in Iraqi patients
DOI:
https://doi.org/10.15584/ejcem.2025.4.25Keywords:
Chronic kidney disease, diabetic kidney disease, end-stage renal failure, lucagon-like peptide 1, hemodialysis, leptinAbstract
Introduction and aim. Diabetic kidney disease (DKD), a common complication of type 2 diabetes mellitus, is the leading cause of end-stage renal disease (ESRD). This study aimed to evaluate differences in serum leptin and glucagon-like peptide-1 (GLP-1) levels between diabetic ESRD patients undergoing hemodialysis and healthy controls.
Material and methods. A cross-sectional observational study was conducted involving 65 participants: 31 type 2 diabetic patients with ESRD on hemodialysis and 34 healthy controls. Serum leptin and GLP-1 concentrations were measured using enzyme-linked immunosorbent assays.
Results. Patients with ESRD exhibited significantly higher serum leptin levels (1.7±1.0 ng/mL) compared to controls (1.4±0.7 ng/mL; p=0.001), and significantly lower GLP-1 levels (19.6±11.2 pmol/L vs. 37.0±25.7 pmol/L; p=0.001).
Conclusion. Elevated leptin levels and reduced GLP-1 concentrations in diabetic ESRD patients suggest a potential role of these biomarkers in renal injury and metabolic regulation. The findings highlight the therapeutic promise of GLP-1 receptor agonists in this population.
Downloads
References
Hoogeveen EK. The Epidemiology of Diabetic Kidney Disease. Kidney Dial. 2022;2(3):433-442. doi: 10.3390/kidneydial2030038
Hussain S, Chand Jamali M, Habib A, Hussain MS, Akhtar M, Najmi AK. Diabetic kidney disease: An overview of prevalence, risk factors, and biomarkers. Clin Epidemiol Glob Health. 2021;9:2-6. doi: 10.1016/j.cegh.2020.05.016
Murton M, Goff-Leggett D, Bobrowska A, et al. Burden of Chronic Kidney Disease by KDIGO Categories of Glomerular Filtration Rate and Albuminuria: A Systematic Review. Adv Ther. 2020;38(1):180-200. doi: 10.1007/s12325-020-01568-8
Park YC, Lee S, Kim YS, et al. Serum leptin level and incidence of CKD: a longitudinal study of adult enrolled in the Korean genome and epidemiology study (KoGES). BMC Nephrol. 2022;23(1):1-9. doi: 10.1186/s12882-022-02795-7
Korczynska J, Czumaj A, Chmielewski M, Swierczynski J, Sledzinski T. The Causes and Potential Injurious Effects of Elevated Serum Leptin Levels in Chronic Kidney Disease Patients. Int J Mol Sci. 2021;22(9):4685. doi: 10.3390/ijms22094685
Perrini S. Leptin: a marker of renal injury. Intern Emerg Med. 2019;14(4):493-494. doi: 10.1007/s11739-019-02074-8
Liu B, Qiao J, Hu J, et al. Leptin promotes endothelial dysfunction in chronic kidney disease by modulating the MTA1-mediated WNT/β-catenin pathway. Mol Cell Biochem. 2020;473(1-2):155-66. doi: 10.1007/s11010-020-03816-5
Müller TD, Finan B, Bloom SR, et al. Glucagon-like peptide 1 (GLP-1). Mol Metab. 2019;30:72-130. doi: 10.1016/j.molmet.2019.09.010
Gribble FM, Reimann F. Metabolic Messengers: glucagon-like peptide 1. Nat Metab. 2021;3(2):142-148. doi: 10.1038/s42255-020-00327-x
Felix N, Gauza MM, Bittar V, et al. Cardiovascular and Kidney Outcomes of Glucagon-Like Peptide 1 Receptor Agonist Therapy in Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Cardiorenal Med. 2025;15(1):98-107. doi: 10.1159/000543149
KDIGO. Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4):117-314. doi: 10.1016/j.kint.2023.10.018
Mendivil CO, Gnecco-González S, Herrera-Parra LJ, et al. MDRD is the eGFR equation most strongly associated with 4-year mortality among patients with diabetes in Colombia. BMJ Open Diabetes Res Care. 2023;11(4):e003495. doi: 10.1136/bmjdrc-2023-003495
Hashim IA. Tutorials in Clinical Chemistry. Elsevier; 2024:81-102.
Rebholz CM, Inker LA, Chen Y, et al. Risk of ESRD and Mortality Associated With Change in Filtration Markers. Am J Kidney Dis. 2017;70(4):551-560. doi: 10.1053/j.ajkd.2017.04.025
Kim CS, Kim B, Choi HS, et al. Cumulative hypertension burden and risk of end-stage renal disease. Hypertens Res. 2021;44(12):1652-1661. doi: 10.1038/s41440-021-00723-0
Katsiki N, Mikhailidis DP, Banach M. Leptin, cardiovascular diseases and type 2 diabetes mellitus. Acta Pharmacol Sin. 2018;39(7):1176-1188. doi: 10.1038/aps.2018.40
Ghaedian MM, Nazari Jaz A, Momeni M, Ghaedian T, Samiei N. Plasma leptin level is positively associated with blood pressure measures independent of gender and BMI. Clin Exp Hypertens. 2018;42(1):31-35. doi: 10.1080/10641963.2018.1557684
McGrath K, Edi R. Diabetic Kidney Disease: Diagnosis, Treatment, and Prevention. Am Fam Physician. 2019;99(12):751-759.
Oluboyo AO. Evaluation of selected renal markers in hyperten‑sive subjects in Ekiti State, Nigeria. Int J Med Lab Res. 2020;5(2):13-19.
Azeez F, Sultan S, Othman L. Estimation of urea and creatinine in type 2 diabetes mellitus patients. In IMDC-SDSP 2020: Proceedings of the 1st International Multi-Disciplinary Conference Theme: Sustainable Development and Smart Planning. IMDC-SDSP. 2020:175-181.
Chawla D, Kar R, Puri D, Madhu SV. Role of glucagon-like peptide 1 (GLP-1) and its association with inflammatory markers in the pathogenesis of type 2 diabetes mellitus. GSC Biol Pharm Sci. 2023;22(3):99-106. doi: 10.30574/gscbps.2023.22.3.0094
Lebherz C, Schlieper G, Möllmann J, et al. GLP-1 Levels Predict Mortality in Patients with Critical Illness as Well as End-Stage Renal Disease. Amer J Med. 2017;130(7):833-841. doi: 10.1016/j.amjmed.2017.03.010
Cao Y, Zhao J, Ma Y, Cao S, Liu Y. Real-World Clinical Effectiveness of Glucagon-Like Peptide-1 Receptor Agonist on Mild-to-Moderate Diabetic Kidney Disease in Patients with Type 2 Diabetes: A Retrospective, Single-Arm Clinical Trial. Diabetes, Metab Syndr Obes. 2024;17:2913-2921. doi: 10.2147/dmso.s472968
Tomasik J, Rustogi N, Larsen JR, et al. Leptin serum levels are associated with GLP-1 receptor agonist-mediated effects on glucose metabolism in clozapine-or olanzapine-treated, prediabetic, schizophrenia patients. Schizophr Bull Open. 2020;1(1):1-11. doi: 10.1093/schizbullopen/sgaa044
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 European Journal of Clinical and Experimental Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.




