血清瘦素对慢性肾衰竭患者营养状态的影响

Preliminary investigation of serum leptin effect on nutrition state of chronic renal failure patients

目的探讨血清瘦素对慢性肾衰竭患者 (CRF)营养状态的影响。方法测定 5 3例CRF患者 (未透析组 2 8例 ,血透组 2 5例 )及 2 5例正常人的瘦素 (Leptin)浓度、体重指数 (BMI)、血清白蛋白(ALB)、前白蛋白 (PA)、视黄醇结合蛋白 (RBP)、肌酐 (Scr)、肌酐清除率 (Ccr)、主观评价法 (SGA)法等参数。瘦素测定用EIA法。结果 (1)血透组瘦素浓度 (10 4± 8 1μg/L ,P <0 0 5 )和未透析组瘦素浓度(8 3± 6 7μg/L ,P <0 0 5 )均明显高于对照组 (3 9± 1 7) μg/L。 (2 )血透组瘦素浓度与BMI、RBP呈明显正相关 (r值为 0 710和 0 714 ,P <0 0 0 1) ,未透析组瘦素浓度与BMI、RBP呈明显正相关 (r值为0 6 85 ,P <0 0 0 1和 0 4 36 ,P <0 0 5 ) ,而与其他营养指标无明显相关关系。 (3)两组CRF患者按SGA分级比较 ,血清ALB、瘦素在原基础上随营养不良的程度加重而降低 ,PA则在升高的基础上降低 ,甚至低于对照组。结论血透组、未透析组血清瘦素浓度明显升高 ,且均与BMI、RBP呈显著正相关关系 。

Objective To investigate the effect of serum leptin on nutritional status of chronic renal failure (CRF) patients. Methods Serum leptin was measured by enzyme immunoassay and BMI (body Mass Index), album (ALB), prealbumin (PA), retinal-binding protein (RBP), serum creatine (Scr), creatine clearance (Ccr), subjective global assessment (SGA) were determined in 53 patients with CRF (28 nondialytic and 25 hemodialysis) and in 25 heathy controls. Results (1) Serum leptin concentrations were significantly higher in hemodialysis ( P <0.05) and nondialystic group than control group. (2) Serum leptin concentrations were significantly correlated with both BMI and RBP in hemodialysis patients ( P <0.001) and nondialytic patients ( P <0.001). (3) There were high leptin, ALB concentrations in good nutrition CRF patients which were divided by SGA, PA decreased from the increased concentrations. Conclusion CRF patients of low leptin may have malnutrition.