血液透析患者血清脂联素、瘦素与炎症及脂代谢异常的关系

目的 探讨维持性血液透析(maintenance hemodialysis,MHD)患者中血清脂联素(adiponectin,ADPN)、瘦素(leptin)的水平及其与炎症及脂代谢异常的相关性.方法测定79例MHD患者(MHD组)和26例健康对照者(对照组)的血清ADPN、瘦素、肝肾功能、血脂、C反应蛋白(C-reactive protein,CRP),计算体质晕指数(body mass index,BMI)、腰臀围比(waist to hip ratio,WHR),分析血清ADPN、瘦素与MHD患者慢性炎症及脂代谢异常发生之间的关系.结果 MHD组的血清ADPN、瘦素均显著高于对照组(均P＜0.01),二者间呈显著负相关(P＜0.05).MHD组血清ADPN与BMI、WHR及CRP显著负相关,与总胆固醇、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)显著正相关(均P＜0.05).血清瘦素与年龄、BMI、WHR及三酰甘油显著正相关,与HDL-C显著负相关(均P＜0.05).合并慢性炎症的MHD患者血清ADPN水平降低,而瘦素水平升高(P＜0.05).结论血清ADPN、瘦素水平在MHD患者中明显升高,与慢性炎症及脂代谢紊乱关系密切,在心脑血管疾病发生中起重要作用.

The correlation of serum adiponectin and leptin to inflammation and dyslipidemia in hemodialysis patients

Objective To observe the levels of serum adiponectin（ADPN） and leptin,and their correlations to chronic inflammation and dyslipidemia in patients on maintenance hemodialysis（MHD）.Methods We measured serum ADPN,leptin,albumin,serum creatinine,blood urea nitrogen,lipoproteins,C-reactive protein（CRP） in 79 MHD patents and 26 healthy individuals.Their body mass index（BMI） and waist to hip ratio（WHR） were calculated and correlated with serum ADPN and leptin.Results Serum ADPN and leptin were significantly higher in MHD patients than tin healthy individuals（P0.01）.ADPN was negatively correlated with BMI,WHR,CRP and leptin,and was positively correlated with total cholesterol and high density lipoprotein cholesterol（HDL-C）（P0.05）.Leptin was positively correlated with age,BMI,WHR and triglycerides,and was negatively correlated with HDL-C（P0.05）.In patients with chronic inflammation,serum ADPN was lower,but serum leptin was higher.Conclusion Serum ADPN and leptin increased significantly in MHD patients,which closely correlate to chronic inflammation and dyslipidemia.Therefore,the higher serum ADPN and leptin may have important roles in the pathogenesis of cardiocerebral vascular diseases.