腹膜透析和血液透析患者血浆Ghrelin水平的研究

目的检测腹膜透析和血液透析患者空腹血浆ghrelin水平,探讨影响ghrelin水平的因素及它与炎症、营养等的关系。方法用酶联免疫吸附法(ELISA)测定30名腹膜透析病人、30名血液透析病人和20名健康对照的空腹血浆ghrelin水平并进行比较,同时对透析患者的血浆ghrelin水平与营养指标、炎症指标等进行相关分析。结果透析患者的空腹血浆ghrelin水平明显高于健康对照(P<0.0001),而腹膜透析患者和血液透析患者的血浆ghrelin水平间无统计学差异(P=0.601)。透析患者血浆ghrelin水平与体重指数(BMI)负相关(P=0.004),与血白介素6水平呈正相关(P=0.006),与血前白蛋白水平呈负相关(P=0.037)。另外,营养良好组、轻中度营养不良和重度营养不良组间血浆ghrelin水平差异无显著性(P=0.165),炎症反应明显组和低或无炎症反应组间血浆ghrelin水平差异无显著性(P=0.423)。结论透析患者血浆ghrelin水平明显高于正常人,而腹膜透析和血液透析患者间血浆ghrelin水平差异无显著性。此人群的血浆ghrelin水平与体重指数负相关,而与年龄、其他营养及炎症指标等无明确关系。

Plasma gherlin levels in patients undergoing hemodialysis and peritoneal dialysis

[Objective] To study the correlations between the fasting plasma ghrelin levels, nutrition, inflammation markers, and other factors in peritoneal dialysis and hemodialysis patients. [Methods] The levels of fasting plasma ghrelin were measured and compared by ELISA in 30 peritoneal dialysis, 30 hemodialysis patients and 20 normal controls. The correlations between the plasma ghrelin levels, nutrition markers, and inflammation markers were also explored. [Results] The fasting plasma ghrelin levels in dialysis groups were much higher than that in controls(P <0.0001).However, there was no difference in plasma ghrelin levels between peritoneal dialysis and hemodialysis groups(P =0.601). In dialysis groups the plasma ghrelin levels were negatively correlated with body mass index (BMI) (P =0.004) and with the plasma prealbumin(P =0.037), but positively correlated with the plasma interleukin-6(P =0.006). There was no difference in the levels of plasma ghrelin between well-nourished, slightly malnourished and severe malnourished subgroup(P =0.165), and so was between the subgroups with slight inflammation and with marked inflammation(P =0.423). [Conclusions] The fasting plasma ghrelin levels in dialysis groups were much higher than that in controls. There was no difference in the plasma ghrelin levels between peritoneal dialysis and hemodialysis groups. In dialysis groups the plasma ghrelin levels were negatively correlated with BMI. There were no significant relations between the plasma ghrelin levels, age, residual renal function, and other nutrition and inflammation markers. These suggested that in dialysis patients ghrelin has correlation with BMI. The dialysis methods did not have effects on the patients' plasma ghrelin levels.