中国血液净化

›› 2009, Vol. 8 ›› Issue (3): 141-143.

• 论著 • 上一篇    下一篇

维持性血液透析患者血清脂联素水平分析

岑 俊1 顾谊铮1 魏莉莉1 伏春明2 王雪英1 王传祥2 余 杰2   

  1. 上海市建工医院
  • 收稿日期:2008-10-16 修回日期:1900-01-01 出版日期:2009-03-12 发布日期:2009-03-12

Analysis of serum adiponectin in patients undergoing maintenance hemodialysis

CEN Jun1, GU Yi-zheng1, WEI Li-li1, FU Chun-ming2, WANG Xue-ying1, WANG Chuan-xiang2, YU Jie   

  1. 1Department of Nephrology, 2Department of Clinical Laboratory, Jiangong Hospital, Shanghai 200083, China
  • Received:2008-10-16 Revised:1900-01-01 Online:2009-03-12 Published:2009-03-12

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摘要： 【摘要】目的 探讨维持性血液透析(MHD)患者血清脂联素(Adiponectin,ADPN)水平和影响因素，及其ADPN与合并症的相关性。 方法 测定79例维持性血液透析患者和16例健康对照者的血清ADPN(ELISA法)、肝肾功能、血脂、C反应蛋白(CRP)、胰岛素(Fins)，计算体重指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)，及透析患者的尿素清除指数(Kt/V)、标准化蛋白分解代谢率(nPCR)，分组观察合并糖尿病、高血压及心脑血管疾病的MHD患者的血清ADPN，分析血清ADPN与这些参数、合并症的相关性。结果 MHD组的血清ADPN显著高于对照组[(13.73±8.64)mg/L vs (6.27±3.57)mg/L，P＜0.01]。MHD组血清ADPN与BMI、Fins、HOMA-IR、CRP、甘油三酯(TG)呈明显负相关，与胆固醇(TC)、高密度脂蛋白(HDL)呈明显正相关，Kt/V对血清ADPN水平有一定影响。在合并糖尿病和心脑血管疾病的MHD患者中血清ADPN水平较低。结论 血清ADPN在MHD患者中明显升高，与糖脂代谢、动脉硬化关系密切，是一个心脑血管保护因子。

关键词: 血液透析, 脂联素, 胰岛素拮抗, 脂代谢紊乱, 动脉硬化

Abstract: 【Abstract】 Objective To observe serum adiponectin (ADPN) change in patients undergoing maintenance hemodialysis (MHD) and to investigate the correlation between serum ADPN and complications. Methods we measured serum ADPN, albumin, creatinine, blood urea nitrogen, lipoproteins, C-reactive protein, fasting glucose and fasting insulin in 79 MHD patents and 16 healthy individuals. Body mass index (BMI), homeostatic model assessment of insulin resistance (HOMA-IR), Kt/V and normalized protein catabolic rate (nPCR) were calculated from established formulas. We then correlated serum ADPN levels with diabetes, hypertension and cardiocerebral vascular diseases in MHD patients. Results Serum ADPN was significantly higher in MHD patients (13.73±8.64mg/L) than in healthy individuals (6.27±3.57mg/L, P＜0.01). Serum ADPN correlated reversely with BMI, fasting insulin, HOMA-IR, C-reactive protein and triglycerides, and positively with total cholesterol and high density lipoproteins. Serum ADPN was partially affected by Kt/V, and was lower in MHD patients with diabetes and cardiocerebral vascular diseases. Conclusion Serum ADPN increases significantly in MHD patients. Serum ADPN is closely correlated with insulin resistance, dyslipidemia and atherosclerosis, and may be a protective factor for cardiocerebral vascular system in MHD patients.

Key words: Adiponectin, Insulin resistance, Dyslipidemia, Atherosclerosis