Litwin M, Abuauba M, Wawer Z T, Grenda R, Kurył T, Pietraszek E
Kliniki Dializoterapii i Transplantacji Nerek, Instytut-Pomnik Centrum Zdrowia Dziecka.
Pol Merkur Lekarski. 2000 Apr;8(46):268-9.
Aim of the study was to: 1) estimate plasma profile of sulphur AA in children with chronic renal failure (CRF) and in children on hemodialysis (HD), and 2) to evaluate any correlation with serum folic acid (FA) and vitamin B12.
32 pts with CRF: 9 with GFR > 20 ml/min/1.73 m2 (group 1), 9 with GFR < 20 ml/min/1.73 m2 (group 2), and 14 pts on HD (group 3).
plasma homocysteine (Hcys), methionine (Met), cysteine (Cys), serine (Ser) were measured with gas chromatography. Serum FA and vit. B12 were measured using MEIA method.
median Hcys concentrations were the lowest in group 1: 5 mumol/l vs 9 mumol/l (group 2) and 20 mumol/l (group 3) (p = 0.03). Similarly, the lowest Met levels were observed in group 1--26 mumol/l, vs 66 mumol/l (group 2) and 281 mumol/l (group 3) (p = 0.001). Median Cys level in group 1 was 98 mumol/l vs 54 mumol/l (group 2), and 122 mumol/l (group 3) (p = 0.02). No differences were found in median Ser levels: 153 mumol/l (group 1) vs 239 mumol/l (group 2) and 240 mumol/l (group 3). The median concentrations of FA were 6.3 ng/ml (group 1) vs 8 ng/ml (group 2) and 15 ng/ml (group 3) (NS). Median concentrations of vit. B12 were 256 pg/ml (group 1) vs 379 pg/ml (group 2) and 322 pg/ml (group 3) (NS). There were no correlation between sulphur AA and FA and vit. B12 levels. The only difference between pts with Hcys levels remaining in lower and upper quartile concerned Met concentration (38 vs 263 mumol/l, p < 0.02) and GFR (p < 0.01).
Hyperhomocysteinemia develops already in moderate CRF. In pts on HD levels of Met and Cys are also raised. FA and vit. B12 concentrations are normal and do not correlate with plasma concentrations of sulphur AA.
本研究的目的是：1）评估慢性肾衰竭（CRF）患儿和接受血液透析（HD）患儿的血浆含硫氨基酸水平，以及2）评估其与血清叶酸（FA）和维生素B12的相关性。
32例CRF患者：9例肾小球滤过率（GFR）>20 ml/min/1.73 m²（第1组），9例GFR<20 ml/min/1.73 m²（第2组），14例接受HD治疗的患者（第3组）。
采用气相色谱法测定血浆同型半胱氨酸（Hcys）、蛋氨酸（Met）、半胱氨酸（Cys）、丝氨酸（Ser）水平。采用微粒子酶免疫分析法（MEIA）测定血清FA和维生素B12水平。
第1组Hcys浓度中位数最低：5 μmol/L，而第2组为9 μmol/L，第3组为20 μmol/L（p = 0.03）。同样，第1组Met水平最低——26 μmol/L，第2组为66 μmol/L，第3组为281 μmol/L（p = 0.001）。第1组Cys水平中位数为98 μmol/L，第2组为54 μmol/L，第3组为122 μmol/L（p = 0.02）。Ser水平中位数无差异：第1组为153 μmol/L，第2组为239 μmol/L，第3组为240 μmol/L。FA的中位数浓度第1组为6.3 ng/ml，第2组为8 ng/ml，第3组为15 ng/ml（无显著性差异）。维生素B12的中位数浓度第1组为256 pg/ml，第2组为379 pg/ml，第3组为322 pg/ml（无显著性差异）。含硫氨基酸与FA和维生素B12水平之间无相关性。Hcys水平处于下四分位数和上四分位数的患者之间的唯一差异在于Met浓度（38 vs 263 μmol/L，p < 0.02）和GFR（p < 0.01）。
中度CRF时已出现高同型半胱氨酸血症。接受HD治疗的患者Met和Cys水平也升高。FA和维生素B12浓度正常，且与血浆含硫氨基酸浓度无相关性。
