van Tellingen Anne, Grooteman Muriel P C, Schoorl Margreet, ter Wee Piet M, Bartels Piet C M, Schoorl Marianne, van der Ploeg Tjeerd, Nubé Menso J
Department of Nephrology, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands.
Nephrol Dial Transplant. 2004 May;19(5):1198-203. doi: 10.1093/ndt/gfh122. Epub 2004 Feb 19.
BACKGROUND: Hyperleptinaemia in chronic haemodialysis (CHD) patients has been associated with malnutrition, which is an independent predictor of morbidity and mortality in this patient group. METHODS: To assess the influence of HD on plasma leptin, 10 CHD patients were crossover randomized to low-flux polysulfone (PS: F 6HPS), high-flux PS (F 60S), super-flux PS (F 500S) or super-flux cellulose-tri-acetate (CTA: Tricea 150G) for 12 weeks each. Blood samples were collected at the start of the study and each 12-week period. In addition, the relationship between patient characteristics, inflammation and leptin was analysed. RESULTS: At baseline, all groups showed similar leptin concentrations (mean 33.6+/-21.7 ng/ml). After a single HD session, a significant (P<0.01) decrease was observed with all three high permeable devices (Tricea 150G -52.7+/-6.4%; F 60S -63.1+/-5.7%; F 500S -68.7+/-8.2%), whereas leptin remained stable with low-flux PS. After 12 weeks, a marked increase was observed with low-flux PS (week 1, 30.4+/-23.0; week 12, 40.5+/-5.4 ng/ml, P = 0.05), no change with super-flux CTA and high-flux PS (Tricea 150G week 1, 29.4+/-23.7; week 12, 32.0+/-27.9 ng/ml, P = ns; F 60S week 1, 36.0+/-31.8; week 12, 33.0+/-31.2 ng/ml, P = ns), and a significant decrease with super-flux PS (week 1, 38.3+/-33.0; week 12, 29.5+/-31.9 ng/ml, P = 0.02). The change in leptin after 12 weeks was significantly different between super-flux PS, and both low-flux PS (P = 0.009) and super-flux CTA (P = 0.01). Besides interleukin-6 (IL-6) at the start of the study (P = 0.006), no correlations were observed between patient characteristics, parameters of inflammation and plasma leptin levels. CONCLUSIONS: Apart from low-flux PS, plasma leptin decreased considerably with all three high permeable dialysers after a single HD session. In the long run, leptin levels were lower with high-flux PS than with low-flux PS. Moreover, after switching from high-flux PS to super-flux PS (but not super-flux CTA), an additional decrease in leptin was observed. Apart from IL-6 at the start of the study, neither patient characteristics nor inflammatory parameters correlated with plasma leptin levels in this patient group.
背景：慢性血液透析（CHD）患者的高瘦素血症与营养不良有关，而营养不良是该患者群体发病和死亡的独立预测因素。 方法：为评估血液透析（HD）对血浆瘦素的影响，10例CHD患者交叉随机分组，分别使用低通量聚砜（PS：F 6HPS）、高通量PS（F 60S）、超高通量PS（F 500S）或超高通量三醋酸纤维素（CTA：Tricea 150G）进行治疗，每组治疗12周。在研究开始时及每个12周治疗期结束时采集血样。此外，分析了患者特征、炎症与瘦素之间的关系。 结果：基线时，所有组的瘦素浓度相似（平均33.6±21.7 ng/ml）。单次HD治疗后，使用三种高通透性透析器（Tricea 150G -52.7±6.4%；F 60S -63.1±5.7%；F 500S -68.7±8.2%）后瘦素均显著（P<0.01）下降，而使用低通量PS时瘦素保持稳定。12周后，低通量PS组瘦素显著升高（第1周，30.4±23.0；第12周，40.5±5.4 ng/ml，P = 0.05），超高通量CTA组和高通量PS组无变化（Tricea 150G第1周，29.4±23.7；第12周，32.0±27.9 ng/ml，P = 无统计学意义；F 60S第1周，36.0±31.8；第12周，33.0±31.2 ng/ml，P = 无统计学意义），超高通量PS组显著下降（第1周，38.3±33.0；第12周，29.5±31.9 ng/ml，P = 0.02）。12周后，超高通量PS组与低通量PS组（P = 0.009）和超高通量CTA组（P = 0.01）的瘦素变化有显著差异。除研究开始时的白细胞介素-6（IL-6）（P = 0.006）外，未观察到患者特征、炎症参数与血浆瘦素水平之间的相关性。 结论：除低通量PS外，单次HD治疗后，使用三种高通透性透析器均可使血浆瘦素显著下降。从长期来看，高通量PS组的瘦素水平低于低通量PS组。此外，从高通量PS转换为超高通量PS（而非超高通量CTA）后，瘦素进一步下降。除研究开始时的IL-6外，该患者群体的患者特征和炎症参数均与血浆瘦素水平无关。
Nephrol Dial Transplant. 2004-5
Nephrol Dial Transplant. 1996-6
Nephrol Dial Transplant. 2004-10
Biomedicines. 2022-10-20
Clin Kidney J. 2021-12-27
Pediatr Nephrol. 2012-12-11
Int J Pept. 2012
Cochrane Database Syst Rev. 2005-7-20
Curr Control Trials Cardiovasc Med. 2005-5-20
Zotero 插件