维持性血液透析患者脂联素与左室肥厚的相关性

Correlation between serum adiponectin and left ventricular hypertrophy in patients undergoing maintenance hemodialysis

目的:探讨血清脂联素(APN)、高分子量脂联素(HMW-APN)、高分子量脂联素/脂联素(HMW-APN/APN)在维持性血液透析(MHD)患者中的含量变化及其与左室肥厚的相关性。方法:收集健康对照组30例,慢性肾衰竭未透析患者41例(A组),非糖尿病肾病的MHD患者(B组)31例,糖尿病肾病的MHD患者(C组)33例,抽取静脉血检测;完成超声心动图检查,测量左室质量指数(LVMI)。结果:MHD患者及A组APN、HMW-APN、HMW-APN/APN水平及LVMI均高于健康对照组(P<0.05),MHD患者HMW-APN/APN低于A组(P<0.05),B组HMW-APN/APN高于C组,但差异无统计学意义。行相关性分析发现,MHD患者HMW-APN/APN与体质量指数、甘油三酯、C反应蛋白、LVMI成负相关,与空腹血糖无明显相关性。结论:MHD患者HMW-APN/APN与左室肥厚存在明显相关性,有助于预测心血管事件的发生发展。

Objective: To discuss the relationship among serum adiponectin(APN), high molecular weight of adiponectin(HMW-APN),HMW-APN/APN,and left ventricular mass index(LVMI) in maintenance hemodialysis(MHD) patients. Methods: The study included 135 subjects, 30 of them were healthy subjects and served as the control group, 41 were chronic renal failure(CRF) without MHD patients(group A), 31 were MHD without diabetes mellitus patients(group B), and 33 were MHD with diabetes mellitus patients(group C). Each subject was conducted venous blood test and echocardiography.Results: The levels of serum APN, HMW-APN and HMW-APN/APN were significantly higher in groups A, B, and C than that of healthy controls(P<0.05). Group A had higher HMW-APN/APN than MHD patients(P<0.05). Group B had higher HMW-APN/APN than group C,but there was no statistically significant difference. Correlation analysis found that there was a reverse correlation between Body mass index, triglyceride, C-reactive protein, LVMI and HMW-APN/APNin MHD patients. The levels of HMW-APN/APN were not correlated with fasting blood glucose.Conclusion: In MHD patients, the serum HMW-APN/APN is significantly correlated with the development of LVMI, and is helpful for predicting cardiovascular events.