Leptin Receptor and Prolactin Are Prognostic Factors for Pubertal Disorders in Male Adolescents With Advanced Chronic Kidney Disease

Abstract

\n Background: Few research studies have assessed chronic kidney disease (CKD) with pubertal disorders (PD) in adolescent boys and limited data are available. Thus, this study was planned to identify the usefulness of assessing hormonal parameters in male adolescents with CKD and their relationship with PD with a 1-y follow-up period.Methods: A prospective cohort study was performed on adolescents with CKD, stages IV and V. We collected information about the age at puberty onset, menarche, and the date of last menstrual period from the subjects’ clinical records and interrogation. A 1-y follow-up was conducted over pubertal development. At the beginning of the follow-up, the routine hormonal profile tests were performed to check the thyroid profile, prolactin level, luteinizing hormone level, follicle-stimulating hormone level, testosterone level, leptin level, and receptor leptin level. We compared the hormonal profiles of patients with and without PD (wPD vs. woPD). Comparisons between the groups were made using Wilcoxon and Fisher s tests. Logistic regression analysis was also performed.Results: Sixty-four patients, including 26 patients who were classified into the wPD group were analyzed. The median age of the study population was 15 y, and the median time for CKD evolution was 11 mon. There were no differences in the general and biochemical characteristics of wPD and woPD subjects. In terms of the hormonal measurements, the levels of prolactin were higher, while those of free leptin and free thyroxine were lower in wPD patients. Leptin receptor levels > 0.90 ng/mL (RR 8.6 p = 0.004) and hyperprolactinemia (RR 21.3 p = 0.049) were risk factors for the development of PD.Conclusions: Leptin receptor levels < 0.90 ng/mL and hyperprolactinemia are associated with the development of PD in male adolescents with CKD.