老年慢性肾衰患者瘦素水平与营养状况的关系

目的　探讨瘦素与老年慢性肾功能衰竭患者营养状况的关系。方法　检测 2 6例老年慢性肾功能衰竭患者和 2 8例正常老年人的生化指标、血浆瘦素及胰岛素水平 ,同时应用生物电阻抗方法测量身体脂肪容量和体重指数 (BMI)。结果　两组年龄与BMI相匹配。老年慢性肾衰组平均血浆瘦素水平显著高于对照组 (P <0 .0 1 ) ,两组女性的平均血浆瘦素水平均显著高于男性的平均血浆瘦素水平 (P <0 .0 5)。肾衰组男性的平均血浆瘦素水平稍高于对照组男性的平均血浆瘦素水平 ,而二者的平均身体脂肪容量和leptin/fat比值有统计学意义。两组的血浆瘦素水平均与身体脂肪容量、BMI、胰岛素浓度呈显著的正相关 ;而未发现与白蛋白、前白蛋白、血肌酐、尿素氮和肌酐清除率有相关关系。结论　瘦素可以作为评价老年CRF患者营养状况的灵敏指标之一

The relationship between serum leptin level and the nutrition status in elderly patients with chronic renal failure

Objective To investigate the relationship between serum leptin level and the nutrition status in elderly patients with chronic renal failure (CRF). Methods 26 elderly patients with CRF and 28 healthy elderly people were recruited for the study. Serum leptin, insulin, BUN, serum (S ) albumin, S cholesterol, S triglycerides, Scr and other biochemical indexes were measured. At the same time, the content of lipid and the weight indexes were determined with bioimpedance Results The mean serum leptin concentration were significantly higher in elderly CRF patients than that in elderly control subjects ( P <0.01). Old women had significantly higher serum leptin concentration compared with old men. The serum leptin concentrations was no significantly different between healthy old men and old men with CRF, whereas, in healthy old men the percentage body fat was significantly ( P <0.05) higher compared with old men with CRF There was a strong positive correlation ( P <0.05) between the serum leptin concentration and the percentage of body fat, BMI insulin among patients with CRF. No significant correlations were obtained between serum leptin concentration and these parameters including age, ALB, BUN, Scr, Ccr, TG and TCH Conclusions Our data suggests that leptin is markedly increased in elderly patients with CRF. Serum leptin correlates strongly with BMI, the body fat and insulin level