高脂血症患者肾功能指标的变化及与瘦素和脂联素的关系

Correlationship of renal function parameters with serum levels of leptin and adiponectin in patients with hyperlipidemia

目的 探讨不同临床类型的高脂血症患者肾功能改变与血清瘦素和脂联素水平之间的关系。方法选择正常对照组204例和不同临床类型的高脂血症患者336例，后者又分为高胆固醇血症组（高TC组）、高甘油三酯血症组（高TG组）、混合型高脂血症组（混合组）和低高密度脂蛋白血症组（低HDL-C组）4组，分别检测每组患者血尿素氮（BUN）、肌酐（SCr）等肾功能指标和血清瘦素、脂联素水平，并分析它们在脂代谢中的作用。结果与正常对照组相比，4组高脂血症组BUN水平均有不同程度的升高，但只有混合组BUN水平的升高具有统计学意义（P〈0．05）；4组高脂血症组之间两两比较，混合组BUN水平高于高TC组和高TG组（P〈0．05）。高TG组及低HDL-C组SCr水平不仅高于正常对照组（P〈0．05），也高于高TC组和混合组（P〈0．05）。与正常对照组比较，除低HDL-C组脂联素水平明显升高外（P〈0．05），其余各高脂血症组无论是血清瘦素水平，还是脂联素水平均未见显著升高（P〉0．05）；高脂血症各组之间两两比较可见，高TG组瘦素水平低于低HDL-C组（P〈0．05），高TC组脂联素水平低于低HDL-C组（P〈0．05）。结论高脂血症人群中存在不同程度的BUN和SCr水平升高，血清瘦素和脂联素有可能成为反映高脂血症患者的肾功能损害严重程度及预后的指标。

Objective To evaluate the correlation of renal function parameters with serum levels of leptin and adiponectin in patients with hyperlipidemia. Methods Totally 540 cases were enrolled, including 336 patients with hyperlipidemia and 204 cases as normal controls. All patients with hyperlipidemia were divided into 4 subgroups according to their clinical types, including hypercholesterolemia group, hypertriglyceridemia group, mixed hyperlipidemia group, and low high-density lipoproteinemia cholesterol （HDL-C） group. Blood urea nitrogen （BUN）, serum creatinine （SCr） concentrations, serum levels of leptin and adiponectin were measured in each group. Results Compared with normal control group, BUN levels in all the groups of hyperlipidemia were higher to various extent, but only the mixed hyperlipidemia group had statistical significance （P 〈 0.05）. BUN levels in the mixed hyperlipidemia group were significantly higher than those in hypercholesterolemia group and hypertriglyceridemia group （P 〈 0.05）. SCr concentrations in hypertriglyceridemia group and low HDL-C group were significantly higher than those in normal controls, as well as than those in hypercholesterolemia group and the mixed hyperlipidemia group （P 〈 0.05）. Adiponectin level in low HDL-C group was higher than that in normal control group （P 〈 0.05）. Leptin concentration in hypertriglyceridemia group was lower than low HDL-C group （P 〈 0.05）. Adiponectin level in hypercholesterolemia group was also lower than that in low HDL-C group （P 〈 0.05）. Conclusion Elevated BUN and SCr levels are observed in patients with hyperlipidemia. Serum levels of leptin and adiponectin may serve as diagnostic and prognostic indicators of renal function injury in patients with hyperlipidemia.