慢性肾衰竭维持性血液透析患者血清瘦素水平及其意义

Serum leptin level and its significance in the maintenance hemodialysis patients with chronic renal failure

目的:探讨慢性肾衰竭维持性血液透析患者的血清瘦素水平及其与残余肾功能、人体构成和营养状况的关系。方法:分别采用放射免疫分析技术、生物电阻抗技术和常规生化方法测定68例慢性肾衰竭维持性血透患者的血清瘦素水平、残余肾功能、人体构成和营养相关指标。结果:慢性肾衰竭维持性血透患者血清瘦素水平显著高于对照组(P<0.01);瘦素水平与体重指数和脂肪百分比呈正相关,与去脂体重呈负相关(P均<0.01),与内生肌酐清除率、血清肌酐、尿素氮、白蛋白、胆固醇、血红蛋白相关性无统计学意义(P均>0.05)。结论:慢性肾衰竭维持性血透患者存在高瘦素血症,血清瘦素水平可以作为评价机体脂肪含量的营养指标,其在终末期慢性肾衰竭血透患者蛋白质营养不良中未发挥显著作用。

Objective To study the serum leptin level of the hemodialysis patients with chronic renal failure and the relationship between serum leptin level and residue renal function, body composition, and indices of malnutrition. Methods Sixty-eight maintenance hemodialysis patients with chronic renal failure and sixty-six healthy people were enrolled. Serum leptin levels were detected by radioimmunoassay; BMI, Fat and LBM were measured by bioelectrical impedance analysis device . Alb, TC, Hgb, BUN, SCr and Ccr of the patients were also examined. Results Serum leptin level in the hemodialysis patients of chronic renal failure was markedly higher than that in healthy controls （P 0. 01）. The leptin level of the patients was positively correlated with BMI and Fat, and was reversely correlated with LBM （P〈0.01）. There was no relation between the leptin level and Alb, TC, Hgb, BUN, SCr and Ccr（P〉0. 05）. Conclusion Hyperleptinemia exists in the hemodialysis patients with chronic renal failure. The serum leptin level can reflect the fat content. However, the serum leptin does not play any significant role in protein malnutrition in the hemodialysis patients.