维持性血透患者血浆leptin水平与营养不良的关系

目的 研究维持性血液透析（MHD）患者血浆leptin水平与营养不良的关系。方法 选择MHD患者25例和健康对照组15例，采用放射免疫法测定血浆leptin水平；用常规营养指标、视黄醇结合蛋白（RBP）、人体测量、生物电阻抗法、改良主观全面营养评价法评价营养状况。结果 MHD患者血浆leptin水平显著高于对照组（P〈0．01）。MHD患者血清前白蛋白（PA）和RBP水平、肱三头肌皮褶厚度（TSF）、瘦体重量指数（LMI）、脂肪重量指数（FMI）均显著低于对照组，血浆leptin、leptin／BMI、leptin／Body Fat Mass、leptin／FMI水平与MS、MAC、TSF、FAT％、FMI呈明显的正相关，其中与FAT％、FMI的相关呈递减趋势；与RBP、LMI呈明显的负相关，其中与LMI相关呈递增趋势。结论 血浆leptin水平可作为评价MHD患者营养状况的指标。

Malnutrition is Associated with Hyperleptinemia in Patients Maintaining Hemodialysis

Objective To determine whether plasma leptin level is associated with malnutrition in patients maintaining hemodialysis.Methods Twenty-five MHD patients and fifteen healthy volunteers were included in this study.Plasma leptin levels were measured by RIA.The nutrition status was assessed by common biochemical indicators of nutrition, RBP, anthropometric measurements,Bioelectrical Impedance Analysis(BIA) and modified quantitative subjective global assessment.Results Plasma leptin levels in the MHD patients were higher than those in the healthy volunteers.The indicators including serum prealbumin(PA) and retinol-binding protein(RBP) levels,triceps skin-fold thickness(TSF),lean body mass index(LMI),body fat mass index(FMI) in the MHD patients were significantly lower than those in the healthy volunteers.All of plasma leptin levels, the ratio of leptin/body mass index,leptin/body fat mass and leptin/FMI showed significant positive correlation with malnutrition score(MS),mid-arm circumference(MAC),TSF,FAT% and FMI respectively.The coefficient of correlation with FAT% had a decreased tendency.They showed a significant negative correlation with RBP and LMI respectively.The coefficient of correlation with LMI had an increasing tendency.Conclusion Plasma leptin level is a good marker of nutrition status in MHD patients.