胃癌患者血清瘦素与营养状况的关系

Relationship between Serum Leptin Concentration and Nutritional Status of Patients with Gastric Cancer

目的:探讨肥胖基因表达产物瘦素与胃癌病人营养状况的关系。方法:采用放射免疫分析法测定147例胃癌病人血清瘦素含量,同时测定身高、体重、疾病分期、ECOG法一般状况分级。体质指数(BMI)=体重(kg)/犤身高(m)犦2。营养正常的BMI范围为18.5～25;BMI<18.5为营养不良;BMI>25为肥胖。结果:胃癌病人合并营养不良组的血清瘦素平均含量明显低于营养正常组或肥胖组。男性胃癌病人合并营养不良、营养正常及肥胖组血清瘦素水平分别为(2.41±1.59)μg/L、(4.80±3.21)μg/L、(9.16±2.81)μg/L;女性则分别为(5.53±3.06)μg/L、(8.94±4.78)μg/L、(20.58±9.48)μg/L。全组男性、女性胃癌病人的血清瘦素水平分别为(4.39±3.42)μg/L、(8.97±6.56)μg/L;女性均值高于男性1倍。胃癌病人的血清瘦素水平与BMI显著相关(男性r=0.538,P<0.05;女性r=0.785,P<0.05)。BMI正常的胃癌病人的血清瘦素与健康人无差异。结论:血清瘦素含量可以反映胃癌病人的BMI变化和营养状况,且可作为判断胃癌病人营养状况的指标。

Objective: To investigate the relationship between serum leptin concentration and nutritional status of the patients with gastric cancer. Methods: Serum leptin concentration was measured by RIA in 147 gastric cancer patients. The patient's height, body weight,disease stage, and ECOG were measured. Body mass index (BMI)=body weight(kg)/2 . Patients with BMI range of 18.5-25,< 18.5 or >25 were diagnosed respectively as normal nutrition, malnutrition, and overweight. Results: Serum leptin concentrations in the patients with malnutrition were significantly lower than those with normal nutrition or obesity. In the male patients with malnutrition, normal nutrition, and obesity, they were 2.41±1.59, 4.80 ± 3.21, and 9.16±2.81 μg/L, respectively, those in female patients were 5.53 ±3.06,8.94±4.78, and 20.58±9.48 μg/L,respectively. They were 4.39±3.42 μg/L in male patients and 8.97±6.56 μg/L in female patients, which showed 1 times higher in women than in men. In both men and women, Serum leptin levels were significantly correlated with BMI (r=0.538, P< 0.05 in male and r=0.785, P< 0.05 in female). There was no significant difference in leptin levels between gastric cancer patients with BMI=18.5-25 and heathy persons with BMI=18.5-25. Conclusion: Serum leptin concentration are correlated with BMI, suggesting that serum leptin concentration can reflect nutritional status of the patients with gastric cancer. The leptin may become be a good index for diagnosing malnutrition in the gastric cancer patients.