血液透析患者营养状况与瘦素水平

游宇平; 娄探奇; 唐骅; 陈珠江; 石成钢; 刘迅

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中国血液净化 ›› 2003, Vol. 2 ›› Issue (11) : 598-600.

论著

血液透析患者营养状况与瘦素水平

游宇平娄探奇唐骅陈珠江石成钢刘迅

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摘要

目的研究慢性终末期肾衰竭血液透析患者血清瘦素（Leptin）水平与营养相关指标的关系。方法 ①慢性终末期肾衰竭维持性血液透析患者31例，男16例，女15例，平均年龄(54.0±11.0)岁；②采用放射免疫分析法测定血清Leptin浓度；③采用生物电阻抗技术（BIA）测量患者的体重指数（BMI）、脂肪百分比（％Fat）和瘦体重（LBM），检测患者血清白蛋白、血红蛋白、胆固醇等浓度。结果 ①慢性肾衰竭血液透析患者血清Leptin水平与体重指数（BMI）、脂肪百分比（％Fat）呈正相关（分别为r＝0.605、P<0.001；r＝0.779、P < 0.001）；与瘦体重呈负相关（r＝－0.731，P<0.001）；②慢性肾衰竭血液透析患者血清Leptin水平与血清白蛋白、胆固醇、血红蛋白等无相关性(P>0.05)。结论 ①慢性肾衰竭血液透析患者血清 Leptin水平与患者的脂肪含量呈正相关，Leptin可作为评价机体脂肪含量的营养指标；②慢性肾衰竭血液透析患者血清Leptin水平与患者的瘦体重呈负相关，高Leptin血症可造成血液透析患者瘦体重丢失；③Leptin没有在慢性终末期肾衰竭血液透析患者蛋白质营养不良中发挥显著作用。

Abstract

Objective To study the relationship between serum leptin levels and nutrition status in maintenance hemodialysis patients. Methods Thirty-one chronic end-stage renal failure HD patients (16 males, 15 females, mean age: 54.0±11.0 years) were observed; Serum leptin concentration was detected by Radioimmunoassay (RIA); BMI, percentage body fat (%Fat) and lean body mass (LBM) were measured by Bioelectrical Impedance Analysis device (BIA); Plasma hemoglobin (HGB) and serum albumin (ALB), serum cholesterol (CHO), blood urea nitrogen (BUN), and serum creatinine (Scr) were examined. Results Serum leptin levels were positively correlated with BMI (r=0.605, P<0.001), % Fat (r=0.779, P<0.001), and were reversely correlated with LBM (r＝－0.731, P<0.001) in HD patients; Serum leptin levels were not correlated with HGB, ALB, and CHO in chronic end-stage renal failure HD patients (P>0.05). Conclusion Serum leptin levels were positively correlated with fat content of the body. The serum leptin levels can reflect the fat content of HD patients; Serum leptin levels were reversely correlated with lean body mass in HD patients. Hyperleptinemia may cause the loss of lean body mass of HD patients; Serum leptin did not play a significant role in protein malnutrition in chronic end-stage renal failure HD patients.