维持性血液透析患者脂代谢因子水平初探

目的:了解血液透析患者锌α2糖蛋白(ZAG)的改变情况。方法:选择50例慢性肾衰竭维持性血液透析患者为血液透析组(HD组),30例健康体检者为正常对照组(肾小球滤过率>60ml/min)。所有血清标本应用ELISA法检测ZAG、瘦素和脂联素水平,同时测定尿素氮(BUN)、肌酐(Cr)、空腹血糖(FG)、空腹胰岛素(FIns)、总胆固醇(TC)、游离脂肪酸(FFA)、甘油三酯(TG)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL),并计算体重指数(BMI)和胰岛素抵抗指数(HOMA-IR)。结果:HD组血清ZAG水平显著高于正常对照组,正常对照组血清ZAG水平与FIns、HOMA-IR、瘦素均负相关,与TG正相关,HD组ZAG水平与BMI和瘦素负相关,与脂联素正相关。结论:血液透析患者ZAG水平明显高于正常对照组,其升高的意义有待进一步研究。

Pre-test of serum lipid metabolism factor level in patients undergoing maintenance hemodialysis

Objective:To investigate renal elimination of the adipokine by comparing circulating zinc-α2-glycoprotein(ZAG)levels in patients on hemodialysis with controls.Methods:Fifty patients on chronic hemodialysis as well as 30 healthy control subjects with a glomerular filtration rate greater than 60ml/min were enrolled in this study.Serum ZAG,leptin,adiponectin was analyzed by enzyme linked immunosorbent assay.The levels of biochemical indicators were measured meanwhile.It included blood urea nitrogen,creatinine,fasting blood-glucose,fasting insulin,total cholesterol,free fatty acid,triacylglyceride,high-density lipoprotein and low density lipoprotein.Insulin resistance was evaluated using homeostasis model assessment insulin resistance index(HOMA-IR).Results:Serum ZAG level were significantly higher in hemodialysis patients than that of controls.The ZAG serum levels negatively correlated with fasting insulin,HOMA-IR and leptin,positive correlated with triacylglyceride in controls.In hemodialysis patients,negative correlation was detected between circulating ZAG and measures of BMI and leptin,positive correlation with adiponectin.Multiple linear regression analysis revealed that hemodialysis,leptin and adiponectin was independently associated with serum ZAG levels after adjustment for age,sex and fasting insulin.Conclusion:The ZAG level are significantly higher in hemodialysis patients than those of normal control group,the increasing significance needs further study.