Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 92060

AbstractMaterial and MethodsResultsDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
Knowledge is treasure of a wise man. The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help ones reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journalsNo manuscriptsNo authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2012 | Month : February | Volume : 6 | Issue : 1 | Page : 17 - 20 Full Version

Study of the Correlation of Serum Leptin with BMI (A Nutritional Marker) in Patients of End Stage Renal Disease, Who were on Maintenance Haemodialysis

Published: February 1, 2012 | DOI:
Simran Kaur, Narinder Pal Singh, Ajay Kumar Jain, Archana Thakur

1. Senior Resident, Dept of Physiology, 2. Director Professor, Dept of Medicine, 3. Director Professor, Dept of Physiology, 4. Professor, Dept of Microbiology, Maulana Azad Medical College, Delhi. & G. B. Pant Hospital, Delhi, India.

Correspondence Address :
Dr. Simran Kaur
Senior Resident, Dept of Physiology,
Maulana Azad Medical College, Delhi, India
H-57, G.S. Apartments, Sector 13, Rohini, Delhi - 110085
Phone Number: +91-9810811594
Email Address:


Introduction: Leptin is a small peptide hormone which is produced mainly, but not exclusively by adipocytes. In the general population, it is believed to be an “appetite inhibitor”. It is partly cleared by the kidney and is increased in the patients of endstage renal disease, who are undergoing haemodialysis. There are conflicting reports in the literature about the relationship of serum leptin with the nutritional marker, body mass index (BMI) and studies which are available in the Indian population, which have explored such a relationship, are sparse.
Objective: This study was planned to assess the level of serum leptin and to explore its relationship with body mass index (BMI) in patients of end-stage renal disease (ESRD), who were on maintenance haemodialysis.
Methods: Eighty subjects (forty controls and forty ESRD patients who were on maintenance haemodialysis) were taken for this case-control study. A thorough history was taken and relevant clinical examinations including anthropometric measurements were done. All the subjects were subjected to routine haematological investigations and the evaluation of serum leptin.
Statistical Analysis: The data which was thus collected was subjected to the Student’s t-test for studying the significance. A correlation was found between the serum leptin levels and the body mass index by using Pearson’s correlation coefficient.
Observations and Result: Patients of ESRD, who were on maintenance haemodialysis, had significantly higher fasting blood sugar, blood urea, serum creatinine and serum leptin levels; and significantly lower haemoglobin levels vis-à-vis the healthy subjects. Serum leptin and body mass index were found to have a positive correlation (r=0.350), with a p value 0.027.
Conclusion: We observed a positive correlation between serum leptin and BMI in patients of end-stage renal disease who were on maintenance haemodialysis, which supported the theory of a reverse epidemiological role of serum leptin in the maintenance of haemodialysis patients.


Body Mass Index, Serum Leptin, Renal Failure, Physiology

Chronic kidney disease is a patho-physiological process of more than three months duration with multiple aetiologies, which leads to a gradual and a usually permanent loss of kidney function over time (1). It is divided into five stages according to its increasing severity. The stage five of chronic kidney disease is also referred to as End Stage Renal Disease and the patients need replacement therapy in the form of haemodialysis, peritoneal dialysis or kidney transplantation (2). Although there are geographic variations, haemodialysis remains the most common therapeutic modality for chronic kidney disease due to more patient compliance and its availability at peripheral centres (1). Original Article Physiology Section Malnutrition, which is multifactorial in origin, is one of the major hurdles (18-75%) in the long term survival of dialysis patients. The main causes include a restricted diet, metabolic acidosis, gastroparesis, appetite suppression as a side effect of the drugs, a chronic volume overload, the presence of acute or chronic systemic diseases which cause inflammatory responses and dialysis itself (3). Therefore, it is recommended to initiate haemodialysis before malnutrition has set in. Leptin (Greek word ‘Leptos’ means thin) is a 16 kilodalton protein which was found by Zhang et al in 1994. It is a product of the obese (ob)gene which is secreted primarily from adipocytes (4). Its gene is located on chromosome 7 and it acts via the JAK STAT mechanism. There is a regulatory loop i.e. when the energy stores fall; the declining leptin levels are sensed by the brain and the decreased leptin receptor activation in the hypothalamus causes increased neuropeptide Y production (hyperphagia and obesity) (5). Some recent studies on maintenance haemodialysis patients have suggested a paradoxically inverse association between higher serum leptin levels and improved markers of nutritional status, a finding that is consistent with the theory of reverse epidemiology (6). Our study was inspired by the fact that we found controversial results on the correlation between serum leptin and BMI in the literature; and very few studies been done in India, which have explored such a relationship. Thus, our study was planned to determine the level of serum leptin and to find its correlation with body mass index in patients of ESRD who were on maintenance haemodialysis.

Material and Methods

Ours was a case control study which was conducted on eighty subjects (40 cases and 40 controls) who were in the age group of 18-70 years. Patients of end-stage renal disease who were on maintenance haemodialysis for more than 3 months, who consented to the study, were selected as the cases. Patients who suffered from any acute infection, acute renal failure or any endocrine disorder except diabetes mellitus and who were taking glucocorticoids 8 weeks prior or during the study, were excluded from our study. Forty apparently healthy staff members, with matched ages and body mass index were taken as the controls. This study was approved by the ethical committee of the institution.
Sample Size Calculation
The Kelsey Method for unmatched case-control studies was used to compute the minimum sample size for each BMI category in the cases and the controls, by using the following inputs:
• Two-sided Confidence Level : 95%
• Power (% chance of detecting): 80%
• Ratio of sample size (Controls: Cases): 1
• % of Controls with ESRD on maintenance hemodialysis: 0%
• % of Cases with ESRD on maintenance hemodialysis: 100%
On the basis of the Kelsey Method, we needed a minimum of 4 subjects for each BMI category. To ensure sufficient sample size across the five BMI groups, we selected 40 subjects for both the cases and the control groups.
A relevant history was taken and clinical examinations (general and physical, including anthropometry and systemic findings) were carried out, which included:
a. Standing height with bare feet, which was measured accurate
to the nearest 0.5cm.
b. Body weight which was recorded with an “Avery” weighing
scale, which was accurate to within 50 grams.
c. Body surface area (BSA) in square meter (m2) which was
calculated from the height and weight by using the “Dubois”
BSA (m²) = Wt (kg) 0.425 x Ht (cm) 0.725 x 0.007184
d. Body Mass Index (BMI) in kg/ m2: BMI is a reliable indicator
for the estimation of body fat, wherein a high value indicates
high levels of body fat. It was calculated from total body mass
(M- i.e. weight in kilograms) and height (H-in meters) by using
the formula:
BMI (kg/ m2 )= M / (H x H)
Routine haematological investigations (haemogram, blood sugar, serum creatinine, urea and lipid profile) and special investigations (serum leptin) were carried out. The DRG Leptin ELISA enzyme immunoassay kit, which was a solid phase enzyme linked immunosorbent assay which was based on the sandwich principle, was used for the quantitative determination of the leptin levels in serum. The average absorbance value (OD) for each set of standards, controls and the patient samples was used for the estimation of the leptin levels in the serum. A standard curve was constructed by plotting the average absorbance value which was obtained from each standard on the vertical (Y) axis against the serum leptin concentration (ng/ml) on the horizontal (X) axis.
The Student’s t-test was used for the analysis and a p value of < 0.05 was considered as significant. The correlation between the different parameters was studied by using Pearson’s correlation coefficient.


The mean age group was 40.6±15.50 for the cases and it was 41.1±15.8 for the controls. On comparing to the anthropometric data, no significant difference (p >0.05) was observed between the cases and the controls with respect to their age, height, weight and body mass index (Table/Fig 1). The mean value of various biochemical parameters were calculated and tests of significance were applied. It was observed that the haemoglobin and the random blood sugar levels and the kidney function tests (urea and creatinine) were significant and that the rest (lipid profile and serum electrolytes) were not significant (Table/Fig 2).
The mean value of serum leptin was found to be significantly higher in males as well as in females, in patients of chronic kidney disease who were on maintenance haemodialysis as compared to that in the controls (Table/Fig 3). (Table/Fig 4) summarizes the mean values ± SD of serum leptin for the various BMI groups across the cases and the controls – it was observed that with an increase in the BMI levels for the cases, the corresponding serum leptin levels also increased. For the two BMI groups (18-20; 20-22 Kg/m2) for which we had data for both the cases and the controls, we found that the cases had significantly higher levels of serum leptin than the controls. Serum leptin and BMI showed a statistically significant positive correlation in the cases, with a correlation of 0.351 and a p-value of 0.027 (Table/Fig 5).


An attempt is made to determine the levels of serum leptin and to explore their relationship with BMI in patients of ESRD who were on maintenance haemodialysis. In the complex variety of the chronic kidney disease syndrome, malnutrition deserves particular attention. The markers of malnutrition are strongly associated with a poor quality of life (7). Many causes of malnutrition have been mentioned in the literature; one of them is an increase in the serum leptin levels (3). Zhangy et al (1994) reported that the hormone, leptin increases in chronic kidney disease and that it may be responsible for the “Anorexia Malnutrition Syndrome” (4).The mean values ± SD of the serum leptin levels in the present study have been significantly higher in patients of chronic kidney disease who were on maintenance haemodialysis than in the controls. This may be because the kidney is responsible for about 80% of the leptin clearance in healthy individuals. Leptin is cleared from the circulation by the process of glomerular filtration, followed by metabolic degradation in the renal tubules (8). In patients with normal renal function, there is a net renal intake of 12% of circulating leptin, whereas in patients of chronic kidney disease, there is no renal uptake of leptin [6, 9]. Consequently, the plasma leptin concentrations are found to increase in patients with advanced renal failure, who are undergoing dialysis. Body Mass Index (BMI) is a simple, accurate and reproducible calculation, based on height and weight. It is considered as one of the markers for the estimation of malnutrition (10). Studies which are available in the literature, which have looked into the correlation between the serum leptin levels and body mass index in haemodialysed patients of ESRD have controversial results. The present study further reinforces the direct correlation of serum leptin with BMI in chronic kidney disease patients who were on haemodialysis. This paradoxical inverse association between higher serum leptin levels and an improved nutritional status (increase in BMI) is consistent with the theory of reverse epidemiology (6).


We observed a positive correlation between serum leptin and BMI in patients of end-stage renal disease who were on maintenance haemodialysis, which supports the theory of a reverse epidemiological role of serum leptin in the maintenance of haemodialysis patients.

The leptin receptor insensitivity may contribute to an increase in the serum leptin levels and peripheral leptin resistance. Further studies can attempt to assess this impact of leptin receptor insensitivity. Other pro-inflammatory cytokines such as interleukin 1 (IL 1) and tumour necrosis factor α (TNF α) may also cause inflammation. Further studies can investigate this hypothesis further.


Kasper D, Braunwald E, Fauci A. Harrison’s Principles of Internal Medicine, 16th edition. New York: McGraw-Hill Medical Publishing Division. 2005;259:1653-63
National Kidney foundation: Kidney Disease Outcome Quality Initiative. American Journal of Kidney Disease 2002; 39(2 Suppl 2): S65.
Ahamadi F, Bosorgmehr R, Razeghi E. Relationship between the serum leptin level and the laboratory and anthropometric indices of malnutrition in patients who were on hemodialysis. Indian J Nephrol. 2008; 18:105-11.
Zhangy, Proenca R, Maffei M, Barone M, Leopald L, Friedman JM. Positional cloning of the mouse obese gene and its human analogue. Nature 1994; 372:425-32.
Erikson J, Hollopeter G, Palmiter R. Attenuation of the obesity syndrome of ob/ob mice by the loss of neuropeptide Y. Science 1996; 274:1704-07.
Pecoits-Filho R, Lindholm B, Stenveikel P. End-stage renal disease: A state of chronic inflammation and hyperleptinemia. European Journal of Clinical Investigation 2003; 33:527-28.
Chumlea WC, Dwyer J, Bergen C et al. The nutritional status assessed from anthropometric measures in the HEMO study. Journal of Renal Nutrition 2003; 13:31-38.
Tsujimoto Y, Tabata T, Morita A, Emoto M, Nishizawa Y, Morii H. Leptin in the peritoneal dialysate from CAPD patients. American Journal of Kidney Diseases.1999; 34: 832-38
Kumar S. Evaluation of the role of serum leptin in hemodialysis patients. Indian Journal of Nephrology 2002; 12:69-72.
Boxall M, Timothy H, Goodship J. Nutritional requirements in hemodialysis. Handbook of Nutrition and the Kidney 2005; 11: 218-27.

DOI and Others

DOI: JCDR/2012/3077.3404:1865


Date of Submission: Sep 09, 2011
Date of Peer Review: Oct 06, 2011
Date of Acceptance: Nov 09, 2011
Date of Publishing: Feb 15, 2012

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)