Leptin is an adipokine secreted from adipocytes that mediate lipid metabolism and inflammation. This cross-sectional study evaluated association between serum leptin level and sarcopenia in chronic hemodialysis (HD) patients. Blood samples and measurement of muscle mass, handgrip strength, and gait speed were obtained from 76 chronic HD patients. We grouped participants into sarcopenia and non-sarcopenia groups according to the Asian Working Group for Sarcopenia. Eight (10.5%) of the total participants were in the sarcopenia group. Compared to the non-sarcopenia group, patients in the sarcopenia group were lower in height (P = 0.014), weighed less (P < 0.001), had lower waist circumference (P < 0.001), body mass index (BMI, P < 0.001), body fat mass (P = 0.048), serum triglyceride (P = 0.032), creatinine (P = 0.017), phosphorus (P = 0.015), leptin level (P = 0.001), appendicular skeletal muscle mass (P < 0.001), and handgrip strength (P = 0.043). However, urea reduction rate (URR, P < 0.001) and Kt/V (P < 0.001) were higher. After multivariate stepwise linear regression, lower logarithmically transformed leptin (log-leptin, β: -0.392, adjusted R² change = 0.130, P < 0.001), lower URR (β: -2.491, adjusted R² change = 0.054, P < 0.001)), lower handgrip strength (β: -0.243, adjusted R² change = 0.030, P = 0.013), lower serum phosphorus level (β: -0.176, adjusted R² change = 0.023, P = 0.036), and higher Kt/V (β: 2.878, adjusted R² change = 0.319, P < 0.001) were the independent predictors of sarcopenia in chronic HD patients. We conclude that low serum leptin level is independently associated with sarcopenia in chronic HD patients. Further studies are needed to establish the casual relationship between circulating leptin levels and uremic sarcopenia.

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