尿毒症血液透析患者血浆瘦素水平与营养状态的研究

目的　研究尿毒症维持性血液透析（血透）患者血浆瘦素水平及其与营养状态的关系。方法　选择维持性血透患者及健康人各30例，于空腹取血，应用放射免疫分析法测定血浆中瘦素水平；同时检测肾功能、血浆白蛋白、转铁蛋白、前白蛋白和胰岛素水平等。结果　血透患者的血浆瘦素浓度明显高于正常对照组（P＜0.01）；血浆白蛋白、转铁蛋白及前白蛋白含量两组间差异均有显著性（P＜0.01）。血透组患者血浆瘦素浓度与体重指数（BMI，体重/身高2）、肱三头肌皮褶厚度（TSF）和胰岛素水平呈明显正相关（r值分别为0.53、0.66、0.57,P＜0.01），而与血尿素氮（BUN）、肌酐（Scr）、甘油三脂（TG）、总胆固醇、高密度脂蛋白、低密度脂蛋白、白蛋白、转铁蛋白、前白蛋白、标准化蛋白分解率等则无明显相关关系。结论　尿毒症维持性血透患者血浆瘦素浓度明显升高，其浓度与BMI、TSF及胰岛素水平呈正相关，未发现瘦素浓度与常用的评价营养指标、尿素氮、血肌酐和血脂有相关关系。

Serum leptin level in hemodialysis patients and its relation to their nutritional status

Objective To investigate the leptin levels of hemodialysis (HD) patients and the relation to their nutritional status. Methods Thirty maintenance hemodialysis patients and thirty healthy control subjects were recruited for the study. Blood was drawn after an overnight fast. Serum leptin was measured using a human leptin RIA kit. There were also blood tests to measure BUN, creatinine, serum albumin, transferrin, prealbumin, insulin, cholesterol etc. Results Mean serum leptin concentration was significantly higher in the HD group than that in the control ( P <0 01). HD group had significantly higher concentrations of BUN, creatinine, serum albumin, transferrin and prealbumin ( P <0 01). Leptin levels in HD patients correlated positively with body mass index (BMI), total systemic flow (TSF), and concentration of insulin ( r =0 53, 0 66, 0 57, respectively, P <0 01). No significant correlations were observed in HD patients between leptin and BUN or creatinine, or between leptin and nutritional indices. Conclusion Our data suggests that leptin is markedly increased in HD patients. Serum leptin correlates strongly with BMI, TSF and insulin level. No significant correlations were observed in HD patients between leptin and other indices.