腹膜透析患者瘦素水平及其影响因素的研究

Serum Leptin concentration in patients with Peritoneal Dialysis and its influencing factors.

目的探讨腹膜透析患者血清瘦素水平及其影响因素。方法选取2002—2004年沈阳军区总医院肾内科30例腹膜透析患者和30名志愿健康者为研究对象。采用 ELISA 法测定血清瘦素水平,用免疫散射比浊法测定 C 反应蛋白(CRP),同时观察体重指数(BMI),测定空腹胰岛素(FINS)及肾功能等指标。并用SGA 法评估营养状况,分析瘦素与各项参数间的关系。结果 (1)腹透患者血清瘦素水平比健康者明显增高(P<0.01)。(2)女性腹透患者瘦素质量浓度为(42.76±3.87)g/L,明显高于男性腹透患者[(34.885±3.36)g/L。P<0.01]。(3)营养不良患者瘦素水平(42.04±3.76)mg/mL 明显高于营养正常者[(33.34±2.51)g/L,P<0.01]。(4)相关分析腹透患者瘦素水平与 BMI,FINS 及 SGA 评分呈显著正相关(P<0.01),而瘦素质量浓度与 CRP,Scr 及 BUN 之间均未见明显相关(P>0.05)。结论腹透患者存在高瘦素血症,血清瘦素水平受体脂含量(BMI)、性别、胰岛素及营养状况等多因素的影响。

Objective To investigate the leptin in continuous ambulatory peritoneal dialysis(CAPD)and its influen- cing factors.Methods 30 CAPD patients and 30 henhhy controls were enrolled in the study.Leptin was measured by ELISA.C reactive protein(CRP)by transmisson turbidmetry.Body mass index(BMI),fasting insulin(FINS), blood urea nitrogen(BUN),serum creatinine(Scr)etc were also determined.These patients were classified to two nutritional categories based on SGA normal nutrition and malnutrition.The relationship between serum leptin concentra- tion and these indices was analysed.Results Serum leptin levels in CAPD group was significantly higher than those of healthy control(P<0.01).Leptin level in female patients was higher ,than that in male ones(P<0.01).Levels of leptin were positively correlated with BMI,FINS and SGA(P<0.01).Serum leptin was no correlation with CRP,Scr and BUN.Conclusion There is presense of hyperleptinmia in CAPD.Serum leptin concentration in CAPD is also in- fluenced by multiple factors,such as BMI,SEX,FINS,etc.